Conducting multi-national clinical trials for rare diseases poses ethical and logistical challenges, particularly in ensuring equitable patient access and sustainable commercialization plans. This panel will examine strategies for balancing ethical considerations, such as treatment availability post-trial, with practical aspects like regulatory alignment and cultural sensitivity. Experts will discuss the importance of inclusive trial designs, transparency in patient engagement, and equitable access to therapies in low-resource settings. Additionally, the session will highlight the role of multi-stakeholder collaborations in addressing disparities and fostering global solutions. Attendees will leave with a deeper understanding of how to ethically and effectively navigate the complexities of multi-national clinical trials, ensuring that breakthroughs in rare disease therapies benefit patients worldwide.