This chapter examines some of the factors that prevent existing medicines from being distributed in the most effective manner, as well as those elements of governance which actively undermine the supply of new medicines. It explores the major barriers to access, which includes weak healthcare systems, taxes on imported medicines, and poorly functioning insurance markets. The chapter examines several related issues, including the impact of poor government policy on the supply of medicine and the impact of pre-market regulations and price controls. Healthcare systems and associated infrastructure are vital for the effective distribution of medicines. Companies are required to comply with an increasing number of regulations before they can launch a pharmaceutical product onto the market. Producers respond to the perceived demands of consumers, whether those consumers are individuals, health agencies, insurance companies or governments. Health insurance enables individuals to pool their financial resources and thereby protect themselves against the risk of unexpected and expensive illness.