Neither does it mean that there will be no income from commerce in countries without patent protection. In those countries there may be greater price competition. Profiting from IPR does not favor or disfavor by region. It favors and disfavors by wealth. Profiting from IPR first requires a patent applicant to have the funds to apply for a patent.
Enforcement is actually a rather lesser problem.
In the case of successful patents, the technology itself can reasonably be expected to provide the funds for enforcement. Clearly though, the more distant one is from the major markets, the more difficult and expensive it is to find a licensee or realize profits. Licensees Licensees of patent rights will ordinarily stand in the same position as patent holders. A licensee will conclude a patent license on the assumption that the royalty payments due the patent holder will still allow the licensee to profit from the patent. By these standards, in-licensing is less attractive in developing regions.