Weill Cornell Medical College in Qatar (WCMC-Q) was established in 2001. This case study describes the establishment and maintenance of access to licensed electronic resources from the libraries of Weill Cornell Medical College in New York City (WCMC-NY) and its parent institution, Cornell University in Ithaca, New York to the new and primarily digital WCMC-Q Distributed eLibrary (DeLib) in Doha, Qatar. Challenges in extending access included defining relationships in a way that vendors could understand, creating networks and support mechanisms on both sides, and communicating across logistical and cultural differences. Through collaboration and coordination, these separately funded libraries acquire and maintain access to electronic resources at a shared cost. doi:10.1300/J383v04n01_04