Since its inception, DNDi has advocated for public leadership and a sustainable, publicly-driven framework for essential health R&D. DNDi continues to build on its collaborative model, retaining the core focus on some of the most neglected diseases while providing flexibility to extend its disease scope to better address urgent unmet patient needs within the rapidly changing global health R&D landscape.
The R&D Landscape for neglected patients has changed but large gaps still remain. Between 1975-1999 only 1.1% of new therapeutic products had been developed for neglected diseases. Of the 850 new therapeutic products registered in 2000-2011, 4% were indicated for neglected diseases. A recent study predicts 4.7 new products will be developed by 2018.
An unsustainable biomedical innovation system
There is growing recognition and consensus that the current system for biomedical innovation has failed to deliver adequate and affordable health technologies, particularly for the world’s poor. Epidemiological trends are now shifting, with low- and middle-income countries (LMICs) increasingly experiencing a double-burden of non-communicable and communicable diseases. Compounding this situation, estimates show that by 2020 the majority of the world population living on less than USD 2 per day will be in emerging economies, and will be unable to access medical innovations if the current challenges in innovation and access are not addressed.This shifting epidemiological trend brings risks of emerging infectious diseases, such as anti-microbial resistance, which threatens the health of the entire world. Following the peak of the Ebola crisis, initiatives have been and will be proposed to address the need for a global fund and mechanism, which should align rather than further fragment prioritization, coordination, and funding of R&D efforts to accelerate innovation and ensure equitable treatment access for a wide range of diseases.
However, the current system of biomedical innovation is becoming unsustainable for all countries, irrespective of disease area or income classification, because of three main drivers of unmet need:
• R&D priorities do not sufficiently originate from low- and middle-income countries and do not prioritize patients’ needs;
• Medical innovation is not linked to equitable access;
• Market-based incentives aligned with the current intellectual property system do not adequately address global public health needs of poor people.
Within this context, the need is greater than ever for organizations such as DNDi to stimulate innovation in a way that guarantees equitable access and to continuously explore new pathways for drug development, while advocating for systemic change.