Pharmaceutical Knowledge Commons for the Most Neglected Populations in Global Health: The Drugs for Neglected Diseases initiative

This book presents the first in-depth study of how the Drugs for Neglected Diseases initiative (DNDi) has reshaped the global politics of neglected tropical diseases over the past twenty years. By weaving together concepts from different academic disciplines (commons, common goods, orchestration, and healthcare innovation ecosystems) into a novel theoretical framework for the analysis of transformational change in global health, the book argues that DNDi has orchestrated pharmaceutical knowledge commons to produce novel treatments and other knowledge for neglected tropical diseases as common goods. Focusing on Chagas disease, the leishmaniases, and sleeping sickness, the book examines the strengths and weaknesses of DNDi’s collaborative governance model and illustrates how pharmaceutical knowledge commons help conceptualize processes of innovative transformation in global health to serve the common good. The phenomenon of neglect in global health, most poignantly embodied by neglected tropical diseases (NTDs), exposes some of the deeper structural and ideological flaws of global health governance, ranging from a stark North–South divide to top-down policy responses to a pharmaceutical production model dominated by profit maximization. DNDi was created in 2003 to confront these flaws by developing a not-for-profit approach that would put neglected patients, rather than profits, first. In the past two decades, DNDi has consolidated its alternative pharmaceutical model, showing how to develop novel treatments for a range of neglected tropical diseases and empower R&D (research and development) communities from NTD-endemic countries. Despite these achievements, DNDi’s political role in global health has remained underexplored.