Select global initiatives in the area of good governance and medicines have been particularly useful in generating a political and policy dialogue around the issue of pharmaceutical system good governance. The initiatives examined in this paper have been taken by the World Bank, the WHO and the Global Fund, as well as the Medicines Transparency Alliance. The main findings include that these initiatives identify weaknesses in the pharmaceutical system and can provide important baseline data. Recommendations include the need for political analysis, monitoring and evaluation, and the streamlining and uniformity of assessment tools across institutions.