Pharmaceutical expenditure accounts for up to 50% of total health spending in some countries. The high market value of pharmaceutical products means they are an obvious target for misuse. In fact, Transparency International estimates that 10 to 25% of global public health procurement spending (including pharmaceuticals) is lost due to the unethical practices and lack of systems transparency. The pharmaceutical sector, with its US$ 750 billion-plus global market value is particularly vulnerable. Medicines change hands several times before reaching patients. The large number of steps in the medicines chain allows numerous opportunities for unethical practices to take place. Lunched in 2004, the Good Governance for Medicines (GGM) programme's is the first global initiative to promote transparency, accountability, institutional integrity and moral leadership in pharmaceutical sector.