Colombia has a decision to make. A full year has passed from the November 24, 2014 request by iFarma, Misión Salud and CIMUN for a declaration of the public interest regarding the cancer drug imatinib (marketed by Novartis as Gleevec/Glivec), the first step on the path toward a compulsory license in Colombia. Thus far, Colombia’s Ministry of Health and Social Protection has failed to act one way or another, leaving patients in limbo and the government at the mercy of a Swiss pharmaceutical giant that reported revenue of over $57.9 Billion USD in 2013, write James Love and Andrew S. Goldman.