The role of IPRs during the pandemic has reinvigorated debates over the significance and feasibility of compulsory licensing as a governance tool to safeguard affordable access to technologies. This chapter examines how far WTO members are, in practice, able to effectively ensure access to technologies through compulsory licences. We argue that greater policy coherence is required for compulsory licensing to address major challenges such as access to medicines in emergencies or crucial technologies needed to deal with climate change. We emphasise that compulsory licences are part of the wider policy toolkit; they are not a standalone solution for governments acting in the public interest. In order to present the international and legal context for this analysis, we endorse the work of Professor Rochelle Dreyfuss showing that the institutional design matters. We argue that greater coherence can help ensure that compulsory licences can operate as an effective policy tool.