An editorial in the November issue of the Bulletin of the World Health Organization claims that despite considerable investments in research and development (R & D), and the availability of powerful scientific and technological tools, innovation in the pharmaceutical industry has declined drastically in the last decade. In addition, most of the new molecules introduced into the market do not entail genuine therapeutic innovations or target the diseases that prevail in developing countries. Most importantly, the prices charged for new pharmaceutical products are unaffordable to the poor and, increasingly, to patients and social security systems, even in developed countries. The editorial describes a new effort to start multilateral negotiations for the possible adoption of a binding convention on health R & D.