Coalitions and Compliance focuses on two periods of patent politics: initial conflicts over how to introduce drug patents, and then subsequent conflicts over how these new patent systems function. In contrast to explanations of national policy choice based on external pressures, domestic institutions, or Presidents' ideological orientations, this book attributes cross-national and longitudinal variation to the ways that changing social structures constrain or enable political leaders' strategies to construct and sustain supportive coalitions. The analysis begins with assessment of the relative resources and capabilities of the transnational and national pharmaceutical sectors, and these rival actors' efforts to attract allies. Emphasis is placed on two ways that social structures are transformed so as to affect coalition-building possibilities: how exporters fearing the loss of preferential market access may be converted into allies of transnational drug firms, and differential patterns of adjustment among state and societal actors that are inspired by the introduction of new policies. It is within the changing structural conditions produced by these two processes that political leaders build coalitions in support of different forms of compliance.