Providing access to medicines and health care is one of the most challenging issues facing society today. In this paper the author highlights some of the complexities of the health value chain as well as the problems that the world’s poor have in terms of access to medical care and medicines. He then attempts to delineate the roles and responsibilities of all stakeholders in order to define the specific corporate responsibilities of pharmaceutical companies in the context of the entire responsibility system - the strength of which is determined by its weakest link. Finally, he looks forward to a transformational change being wrought for pro-poor health development by forging new coalitions that cut across both the health and traditional development stakeholders.