I asked leading executives in companies of all sizes to share their views on whether the now dominant life sciences industry business model, with its focus on rare diseases affecting small patient populations, allows companies to meet their historical public health obligation. Public health is defined as national and/or global health challenges that require coordinated responses from public and private institutions, including industry. Past illustrations include the polio and HIV epidemics, which moved companies to enter into wider scientific collaborations, take on unprecedented risk, shift corporate resources, and readjust strategic priorities for the sake of public health. Here, forming a virtual roundtable, the responding leaders contribute their reflections on where the industry’s role in public health is headed in 2019. The following were the chief findings taken from all the responses together.