Global Health Reform Must Bolster Innovation
As funding falls for global public health, calls for a country-led system have grown louder. Such reforms are necessary, but they must not come at the expense of new vaccines, medicines, and diagnostics, which can be delivered by strengthening mechanisms—such as product development partnerships—that already work.
One model to is a product development partnership (PDP), a nonprofit organization that brings together public, private, academic, philanthropic, and civil-society actors to develop drugs, vaccines, and diagnostics for today’s most pressing global health challenges. Many of these challenges, from malaria and neglected diseases to neonatal infections and drug-resistant bacterial infections, cause immense human suffering but fall out of the scope of traditional market-driven pharmaceutical development, owing to high costs and uncertain returns. Governments, for their part, lack the capacity or will to move these technologies all the way through the development pipeline.
PDPs close this gap between scientific possibility and real-world solutions. By operating on a not-for-profit basis, they can take risks that commercial actors cannot and prioritize public health over market returns. This realignment of incentives treats innovation as a global public good. Over the course of nearly 30 years, PDPs have delivered more than 79 novel health tools to 2.4 billion people, aiding the at-risk populations—including children, newborns, pregnant women, and people living in low-resource settings—least ly to benefit from medical advances.
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We have witnessed firsthand the positive impact of PDPs. Acoziborole, a single-dose oral drug for sleeping sickness developed by the Drugs for Neglected Diseases initiative, has paved the way for the elimination of this deadly disease by improving treatment for patients in remote areas. Coartem Baby, developed through a partnership between the Medicines for Malaria Venture and Novartis, is the first and only antimalarial specifically for babies weighing 2–5 kilograms. And zoliflodacin, an antibiotic co-developed by the Global Antibiotic Research & Development Partnership, is the first new treatment in decades to be developed solely for drug-resistant gonorrhea—one of the world’s most urgent and neglected antimicrobial threats.
These breakthroughs show how PDPs can provide practical, life-saving tools to people who have been left behind by the traditional profit-driven pharmaceutical system. PDPs do this by working across the full continuum, from discovery to delivery, which allows them to integrate functions that are too often treated separately elsewhere in the global health system.
Equally important, PDPs collaborate not only with governments, but also the private sector, research organizations, and communities, allowing them to engage with national priorities, conduct trials in high-burden settings, and ensure that new products are relevant, affordable, and usable in real-world contexts. This is fundamental to how the model works. As the focus shifts to country leadership, PDPs illustrate how this can be achieved in practice, through partnership rather than prescription. A more challenging funding environment makes such an approach even more essential to maintaining progress.
Of course, no single model is a magic bullet. PDPs, too, must continue to evolve. While our three organizations have long collaborated closely, we are now committed to deepening our ties to pool more of our expertise and resources, adapt to new scientific and technological opportunities, reduce duplication, and ensure our accountability to the communities we serve.
Our collective experiences offer practical lessons for reform efforts. A country-led global health system must still deliver essential outputs innovation, which can be achieved by strengthening the mechanisms that already work. This is not an optional add-on: without new medicines, vaccines, and diagnostics, today’s gains will not be sustained, and tomorrow’s needs will go unmet. Partnership-based approaches must remain at the heart of a system designed to serve countries and communities first.
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