ABSTRACT: Diseases that disproportionately affect the developing world cause immense suffering and ill health. Medical innovation has the potential to deliver new medicines, vaccines, and diagnostics to overcome these diseases, yet few treatments have emerged. Current efforts to resolve the crisis are inadequate: financing for research and development (R&D) is insufficient, uncoordinated, and mostly tied to the system of intellectual property rights. Delivering appropriate medicines and vaccines requires reforms to the existing R&D system and a willingness to invest in promising new approaches.