Project Medishare’s experience has taught several important lessons. To succeed in an environment such as Haiti, partnerships with community-based organizations and other committed local partners is essential. ‘Top down’ externally imposed programs will not succeed. The best programs are grassroots in nature and involve engaging all levels of the community. Improving health cannot happen successfully without also addressing its social, cultural and economic issues around it. Programs must be culturally acceptable and sensitive, utilizing realistic technologies and medications, and be cost effective.