Abstract

Despite progress in global health, the general disease burden still disproportionately falls on low- and middle-income countries. The health needs of these countries’ populations are unmet because there is a shortage in drug research and development, as well as a lack of access to essential drugs. This health disparity is especially problematic for diseases associated with poverty, namely neglected tropical diseases and microbial infections. Currently, the pharmaceutical landscape focuses on innovations determined by profit margins and intellectual property protection. To expand drug accessibility and catalyze research and development for neglected diseases, a team of researchers proposed the Health Impact Fund as a potential solution. However, the fund is predominantly considering partnerships with pharmaceutical giants in high-income countries. This commentary explores the limitations and benefits in partnering with pharmaceutical companies based in Brazil, Russia, India, and China (BRIC), with the goal of expanding the Health Impact Fund’s vision to incorporate long-term, local partnerships. Identified limitations to a BRIC country partnership include lower levels of drug development expertise compared to their high-income pharmaceutical counterparts, and whether the Health Impact Fund and the participating stakeholders have the financial capability to assist in bringing a new drug to market. However, potential benefits include the creation of new incentives to fuel competitive local innovation, more equitable routes to drug discovery and development, and a product pipeline that could involve stakeholders in lower- and middle-income countries. Our commentary explores how partnership with pharmaceutical firms in BRIC countries might be advantageous for all: The Health Impact Fund, pharmaceutical companies in BRIC economies, and stakeholders in low- and middle- income countries.

Highlights

  • The Health Impact Fund as an incentive to catalyze research and development (R&D) and expand drug accessibility The Health Impact Fund (HIF) is a prospective pay-forperformance mechanism that encourages biopharmaceuticalLee et al Globalization and Health (2021) 17:101 incentives’’ for developing new medicines that provide considerable health impacts

  • We explore the lack of R&D expertise in pharmaceutical companies based in BRIC countries

  • In hopes of broadening the HIF’s scope in its search for suitable registrants, we explored the limitations and benefits in partnering with pharmaceutical companies based in BRIC countries

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Summary

Introduction

The Health Impact Fund as an incentive to catalyze R&D and expand drug accessibility The Health Impact Fund (HIF) is a prospective pay-forperformance mechanism that encourages biopharmaceuticalLee et al Globalization and Health (2021) 17:101 incentives’’ for developing new medicines that provide considerable health impacts. Because BRIC countries have a population still facing diseases associated with low-income populations, they may be incentivized to partner with the HIF and develop drugs that address health concerns suitable for LMIC markets. Partnering with pharmaceutical companies in BRIC countries could create an opportunity for the HIF to make a global health impact for those living in LMICs. The lower gross profit and net profit potential of BRIC-based pharmaceutical manufacturers incentivize these firms to register their products with the HIF.

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