In this paper we set out the context for the problem of insufficient affordable medicines to address health issues in developing countries. We also highlight some of the drivers of recent positive trends. We then detail policies and proposals intended to increase access to global medicines (those with a developed country market) by lowering prices, including: differential pricing; compulsory licensing; and donations. Finally, we consider policies aimed at encouraging the development of new medicines for neglected diseases (prevalent only in lower income countries) by reducing company born costs and risks and/or expanding the expected revenue for the manufacturer by increasing product demand. In particular, we describe “push” mechanisms that subsidize research inputs, and “pull” mechanisms that reward research output.