Abstract
Enabling innovation and access to health technologies remains a key strategy in combating infectious diseases in low- and middle-income countries (LMICs). However, a gulf between paying markets and the endemicity of such diseases has contributed to the dearth of R&D in meeting these public health needs. While the pharmaceutical industry views emerging economies as potential new markets, most of the world’s poorest bottom billion now reside in middle-income countries--a fact that has complicated tiered access arrangements. However, product development partnerships--particularly those involving academic institutions and small firms--find commercial opportunities in pursuing even neglected diseases; and a growing pharmaceutical sector in BRICS countries offers hope for an indigenous base of innovation. Such innovation will be shaped by 1) access to building blocks of knowledge; 2) strategic use of intellectual property and innovative financing to meet public health goals; 3) collaborative norms of open innovation; and 4) alternative business models, some with a double bottom line. Facing such resource constraints, LMICs are poised to develop a new, more resource-effective model of innovation that holds exciting promise in meeting the needs of global health.
Highlights
Infectious diseases remain a significant contributor to the burden of disease in low- and middle-income countries (LMICs)
95 percent of deaths from respiratory infections and 98 percent of deaths from diarrheal diseases occur in LMICs [2]; and diarrhea, pneumonia, measles, and malaria take many lives of children under five
As for diseases that make up substantial portions of global disease burden–Human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS), tuberculosis and malaria—over 95 percent of the deaths caused by each of these diseases are in LMICs
Summary
Infectious diseases remain a significant contributor to the burden of disease in low- and middle-income countries (LMICs). Though the price of antiretroviral (ARV) therapy has fallen dramatically by 99 percent over the past decade [7], less than a quarter of those in need of ARVs received treatment in 2010 [8] This leaves at least 29.5 million people living with HlV residing in low- and middle-income countries still without treatment, based on 2009 prevalence data [9,10]. Such technologies can come at considerable cost to these health systems. Therapeutic access refers to how well the R&D pipeline works, financial access to the market, and structural access to the delivery system
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