This paper deploys Laclau and Mouffe's discourse theory to examine the dispute over intellectual property protection and global HIV/aids medicines access. Over the 1980s and 1990s, major pharmaceutical companies and minority world governments successfully crafted a strong patent protection regime, institutionalized in the World Trade Organization's intellectual property rules. In the early 2000s, a transnational civil society campaign challenged this regime, positioning patents at the centre of a highly publicized dispute. This dispute has been retrospectively identified as a turning point (...) in medicines access discourse, with the 2001–2003 period dubbed the ‘golden window’ for expanded global HIV/aids medicines access. However, this ‘window’ has also been critiqued as an unsustainable aberration to a continuing hegemonic regime that prioritizes patent protection, to the detriment of equitable global medicines access. This paper draws on both political economy analyses and discourse theoretical concepts to examine the processes of rupture and suture in HIV/aids medicines access discourse. (shrink)