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A new global fund could help tackle disease in developing countries by rewarding pharmaceutical companies for developing drugs that improve global health, say Amitava Banerjee and colleagues.

Creating a successful new drug can cost hundreds of millions of dollars. Patents — which grant innovators exclusive rights to produce drugs — enable high mark-ups and allow companies to recoup their research and development costs.

But they do not encourage development of drugs for diseases that mainly affect the poor. Billions of people are excluded from the health benefits of advanced medicines because they cannot afford to buy them, say the authors.

Several proposals have been put forward to tackle this problem, including public-private partnerships, donations, prizes and advance purchase commitments. But although these help improve drug access, a system-wide reform of rewards for drug innovation would be more sustainable, argue the authors.

They propose creating a Health Impact Fund, as a global agency underwritten by governments, to provide rewards based on registered drugs' contributions to global health.

Registration would be optional and would entitle the innovator to receive a share of at least US$6 billion annually, depending on their contribution to the global health effect of all registered products.

The fund would be neither disease- nor country-specific and would pull research towards the medicines that can do the most good, to benefit rich and poor people alike. It offers industry the opportunity to develop new drugs targeted at developing country diseases that would be unprofitable without it, say the authors.

But they add that for the fund to become a reality, the proposal needs to be refined and planned in detail. They call on governments to make conditional commitments to support the fund at 0.03 per cent of gross national income.

Link to full article in The Lancet*

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