In our final blog to mark the 20th anniversary of the signing of the Doha Declaration, we asked Dr. Bernard Pecoul, then head of MSF’s Access Campaign in 2001, to reflect on MSF’s role in the process, and the impact of the Doha Declaration on MSF’s medical humanitarian work. As well, with his current hat on as Executive Director of the Drugs for Neglected Diseases initiative (DNDi), we asked him to reflect on how the twin challenges of access and innovation can be best met today.