Perspectives on stimulating industrial research and development for neglected infectious diseases

This paper summarizes recent thinking on stimulating industrial research an d development (R&D) for neglected infectious diseases and argues that it is critical to enlarge the value of the market for medicines and vaccines thr ough, for example, global purchase funds. The most important economic barri ers to R&D are that the commercial markets are small and that individual pu rchasing power is severely limited, even though the number of patients may be very large. Since R&D costs for all diseases are high, this means that r eturns will not cover investments. Various mechanisms have been proposed to address this economic imbalance (accepting that other barriers will also n eed to be considered). Economic devices which reduce the costs of R&D - pus h factors - are useful, but our review suggests that high costs do not expl ain the shortfall in R&D. Economic devices which address the lack of viable markets have been termed pull factors and are designed to create or secure a market, thereby improving the likelihood of a return on investments. One pull mechanism is the commitment in advance to purchase a product that mee ts specified criteria, if invented. The purchase-precommitment approach has a number of attractive features. For example, it only rewards successful o utputs rather than supporting research that may not succeed. Pull programme s effectively mimic the market and lead companies to favour lines of attack that they believe will lead to marketable products. Overall, a combination of push and pull mechanisms is likely to represent an attractive approach. This could combine, for example, increased funding for public laboratories , public-private partnerships in R&D, purchases of underutilized existing p roducts, and a precommitment to purchase new drugs and vaccines when develo ped.