The Medicines for All Institute, operating under the auspices of the Virginia Commonwealth University School of Engineering, has developed an innovative model that reduces the cost of manufacturing treatments, such as HIV/AIDS therapies, by accelerating the creation of more efficient ways of synthesizing the active pharmaceutical ingredients in the medications. With funding from the Bill and Melinda Gates Foundation, the Institute’s impact expands well beyond HIV/AIDS, as the process that reduces the cost per kilogram of specific drug targets can be applied to other medicines as well. While meeting an urgent health care need today, the Medicines for All Institute also signals dramatic change in future pharmaceutical manufacturing technologies.