Global Health Diplomacy (GHD) is a new area of scholarly research. While much has been written on this topic, to date few have analyzed the social and political origins of GHD processes and their outcomes. Using the case of Brazil as illustration, in this article I carefully analyze the historical social and institutional conditions motivating nations to engage in intensive international negotiations for access to essential medicines. Moreover, this article maintains that scholars have failed to address how praises from the international community can create incentives for nations to sustain their commitment to not only international negotiations but also bilateral assistance to other nations.