Expanding global research and development for neglected diseases.

In May 2003, the 56th World Health Assembly mandated the creation of the Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH), in large part because the trad ditional mechanisms of research and development (R&D) for new medicines are not performing well for diseases that affect the majority of the world’s poor.1 Consequently, inequities of access to medical innovations continue to grow. The CIPIH report takes us much further ahead in understanding the complex relationship of intellectual property to advances in medicine, but solutions will require difficult compromises. Genuine commitments will have to be made by senior health leaders and global institud tions for systemdwide changes and more equitable R&D investments, if the widd ening gap between technical discoveries and access to their lifedsaving benefits is to be halted.