Source: The Lancet, Volume 373, Issue 9665, Page 693, 28 February 2009 Author: staff Tensions between provision of and payment for health care are familiar. Though doctors assume principal responsibility for patients' health, those who work for pharmaceutical companies view the patented medicines they design as key components of health care. Creative ways are continually found to make such drugs available to as many patients in high-income countries as possible, the profits contributing to future investment in development and leaving national drug budgets affordable, just. Yet, a few hours' flying away, patients in developing countries usually have no access to these very same patented drugs. GlaxoSmithKline (GSK) has grown in size and influence by successful drug development, timely takeovers, and shrewd management. Andrew Witty, who ascended to the vertiginous position of chief executive at GSK in the past year, has attracted attention by a surprising presentation at Harvard Medical School on Feb 13. He promises that GSK will now not only make its medicines available much more cheaply to patients in low-income countries, but also make a bolder commitment to research into neglected diseases. As one blogger puts it, “arise Sir Andrew Witty (or is it Saint Andrew?)”. Does this announcement mark a sea change in pharma's attitude to the provision of drugs in poor countries, or could it be more reminiscent of the zany hybrid vehicles that distract attention from car manufacturers' shamelessly polluting stock in trade? Witty's words were carefully weighed to cast a rosy glow around GSK's [...]