Ensuring that patients in the developing world get access to the medicines they need remains an unfulfilled desire. This is true in spite of the significant progress over the last decade in providing treatment to poor people suffering in particular from the "big three" pandemics, HIV/AIDS, malaria and tuberculosis. The reasons for this access gap are manifold, which points at a need for multiple responses by a diverse set of actors: policymakers, businesses, civil society at large, as well as development partners at national and international levels alike.