This week, international academic and industry leaders, investors, and policy-makers participated in the Biotechnology Industry Organization's International Convention in San Diego, a reminder that prospects for new drugs seem bleak. Only 17 new molecular entities were approved by the U.S. Food and Drug Administration (FDA) in 2007, a fall from 53 in 1996. Coincident trends worsen the situation: a decline in prescription drug sales, the flight of investors, corporate layoffs, and pricing inequities in advanced economies that fuse with demands from poorer countries to gain cheap and immediate access to new drugs.