Судалгааны тайлбар: The history of modern pharmaceutical care in Mongolia began in 1923 when the first pharmacy in the country opened its doors. By the end of the 1980s, the pharmaceutical sector in Mongolia had evolved into a system, fully owned and strictly regulated by the state, with a focus on increasing the supply of medicines throughout the country, including every soum (sub-province administrative unit). In the early 1990s, a deep economic crisis and recession in Mongolia left the government unable to finance and maintain the operations of the vast pharmaceutical supply chain, leading to severe shortages of even the most essential medicines. The government introduced initial reforms that led to the privatization and liberalization of the pharmaceutical sector, which served the goal of eliminating the acute shortages in the supply of medicines in the 1990s. As a result of these initial reforms, the production and wholesale and retail distribution of medicines and medical devices are now entirely in the hands of the private sector. The initial reforms laid the foundation for the pharmaceutical sector in Mongolia as it currently stands and is the origin of the longer-term issues that persist in the sector and which undermine the safety and quality of medicines. With support from Asian Development Bank (ADB), the government is making significant progress in addressing these issues, including through (i) establishing a national medicines regulatory authority that consolidates previously fragmented regulatory functions, (ii) upgrading the national medicines safety laboratory to international standards, (iii) instituting good national pharmaceutical practices based on international standards, (iv) developing national strategies on pricing medicines and pharmacovigilance, and (v) introducing a system for the centralized procurement of medicines for public hospitals. These efforts have faced challenges, such as inadequate political support, lack of sustainable financing and investment options, and opposition from some stakeholders. Mongolia needs to transform the newly established national medicines regulatory authority into a more powerful, independent, evidence-based, and better funded institution that brings together disparate functions of different sectors. Improved regulation of medicines would ensure better quality and increased assurance of safety, covering areas such as pharmaceutical manufacturing, marketing, distribution, and inspection. All efforts to improve regulation of medicines in Mongolia must follow the implementation of a consistent policy, supported by improved coordination and collaboration with all stakeholders, including beneficiaries and, in particular, the private sector. This paper describes the pharmaceutical sector in Mongolia and ADB’s support for pharmaceutical sector reform, including the results of initial and ongoing reforms, challenges that remain, and future actions needed to ensure better regulation of medicines. The experience from ADB’s support for the reform of the pharmaceutical sector in Mongolia and the lessons learned will be useful for future programs in Mongolia and other countries.