Abstract :
Neglected diseases (NDs), such as malaria, tuberculosis, cholera, schistosomiasis,
and Chagas disease, result in an estimated 35,000 deaths per day worldwide
(DNDi, 2006). They are also associated with a considerable disease and
social burden caused by chronic disabilities, disfigurement, reduced productivity,
and stigma (WHO, 2007). Indeed, NDs pose a major challenge to the fulfilment
of the Millennium Development Goals (MDGs), notably in Sub-Saharan
Africa, Asia, and the Americas.
Despite their social and economic impact, minimal investment has been made
to research and develop (R&D) treatments (e.g., vaccines) for NDs, principally
because they are not considered a lucrative commercial ‘market’ (Trouiller
et al., 2002; Mrazek and Mossialos, 2003). The absence of R&D means that
there are no or few treatments available for NDs, accounting for less than
2% of new drugs marketed during the last 25 years, and many of the limited
available treatments are outdated, ineffective, and unsafe (Trouiller et al.,
2002; Yamey, 2002). While various ‘push’ and ‘pull’ mechanisms (e.g., tax
credits, advanced purchase commitments) have been put forth to spur the development
of new technologies and better align the social and financial incentives
required to meet this aim, they have been somewhat ineffective, underused, or
not sufficiently pursued (Brogan and Mossialos, 2006; Fehr et al., 2006).
