This paper discusses Brazil’s efforts to provide essential medicines for its population while meeting international trade obligations. In the 1950s and 1960s, Brazil’s pharmaceutical industry was largely overtaken by foreign companies. To counteract this, Brazil enacted a law in 1971 that allowed the production of patented drugs in order to provide affordable medicines, encourage research and development, and reduce dependency on imports. Eventually, pressure from the United States government (through tariffs and sanctions) drove Brazil to introduce pharmaceutical patent laws. Local interests prevailed, however, through Brazil’s liberal interpretation of the TRIPS Agreement, which included a provision that pharmaceutical products must be “worked” or manufactured locally or the government could turn to the use of compulsory licensing. Brazil’s willingness to use the threat of compulsory licensing compelled drug companies to lower HIV/AIDS drug prices substantially. Finally, the paper discusses how Canada can facilitate improving drug access in Latin America through helping Brazil expand its role as a manufacturer and providing medicines to countries without manufacturing capabilities.