The pediatric ARV market, despite growth over the last 10 years, remains relatively small and at risk. To address procurement and access challenges in this particularly fragile market, the Pediatric ARV Procurement Working Group (PAPWG) was created to lead global collaboration and coordination amongst key partners, including through procurement promoting optimal products and regimens. Learnings from this working group can be applied to other commodities with similar market conditions. The group in fact expanded its mandate in 2016 to include adult ARVs with similar challenges, and to support the scale-up of new optimal regimens and formulations.