The debate over pharmaceutical pricing policies and access to AIDS-related drug treatment has greatly intensified over the past year. In this context, along with a succession of price reductions, several research-based pharmaceutical manufacturers have instituted donation programs as a response to the need for improved access to these drugs by HIV-infected persons in the developing world. The purpose of this paper is to examine Merck's Mectizan (ivermectin) donation as a successful paradigm for pharmaceutical industry donation programs: what characterizes it, what it responds to, how it was instituted, who implements it, who benefits, and how to measure its impact.