A Changing Model for Developing Health Products for Poverty-Related Infectious Diseases

To achieve disease control objectives, country programmes need effective tools for prevention, diagnosis, and treatment, but the current pharmaceutical profitdriven motive neglects ‘‘tropical diseases.’’ Over the 40 years of its existence, TDR has used a range of approaches to promote the development and effective use of new products. Many were successful and contributed to identifying, testing, registering, and implementing tools for tropical disease, but lessons can also be learnt from those which failed or proved not sustainable. This paper reviews examples of TDR approaches and contributions to drug discovery research and development (R&D) and the optimisation of existing treatments against the backdrop of vast changes in the R&D landscape for infectious diseases of poverty. New funders and organizations are now available to conduct product R&D, allowing TDR to reduce its own R&D role to one of facilitation and promotion of an environment more conducive to innovation in R&D and access to the resulting products. Our focus is now more on intervention and implementation research to generate the evidence needed for decisions on where, when, and how products can best be incorporated into national health services for maximum benefit to the people in need.