After a 10-year process, the World Health Organization (WHO) and its Member States have finally agreed on concrete steps to move towards needs-driven innovation. At the 66th World Health Assembly (WHA) in Geneva in May 2013, Member States adopted a much debated resolution on the follow-up of the report of the Consultative Expert Working Group on Research and Development (CEWG). This resolution was approved with an extra decision point unexpectedly introduced by the United States (US), which proposes a process for rapidly identifying research and development (R&D) demonstration projects. It recognises de-linking the price of the product from the cost of research, as well as open knowledge innovation, as guiding principles. This is promising because it will ensure that needs-driven innovation and affordable access to health products and knowledge sharing will be part of the design of these R&D initiatives. However, talks on a global framework for R&D should not be postponed any further.