Product development partnerships (PDPs) for neglected diseases: considerations on governance

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for less than 2% of new drugs marketed during the last 25 years, and many of the limited available treatments are outdated, ineffective, and unsafe (Trouiller et al., 2002; Yamey, 2002).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).