The Access to Medicine Foundation aims to help poor people in developing countries gain access to medicine by encouraging the pharmaceutical industry to improve its commitments and practices related to this issue. The Foundation’s major initiative is the Access to Medicine Index, which analyzes and ranks the access to medicine efforts of the world’s largest pharmaceutical companies. Over the last few years, much progress has been made in improving access to drugs, vaccines and diagnostic tests in developing countries. Several new organizations and funding mechanisms have been established and the pharmaceutical industry has shown increasing attention to both the need and the business opportunities. However, neglected tropical diseases continue to cause significant health burden while research to develop treatments for them remains limited. Meanwhile, diarrhea and pneumonia continue to be leading child killers in low-income countries. HIV/AIDS, tuberculosis, malaria remain endemic in a large part of the world and developing countries are experiencing an increasing burden of non-communicable diseases. For millions of people worldwide, medications are expensive, non-existent, inaccessible or of low quality. Addressing the global access to medicine problem demands the collaboration of multiple international and national stakeholders. However, there has been no consensus on the role of the pharmaceutical industry in this effort. Several organizations have attempted to define what should be expected from the industry, but because many stakeholders, including the pharmaceutical industry itself, were not consulted, such initiatives did not have a significant impact on industry practices.