The Global Governance of HIV/AIDS
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The Global Governance of HIV/AIDS

Intellectual Property and Access to Essential Medicines

Edited by Obijiofor Aginam, John Harrington and Peter K. Yu

The Global Governance of HIV/AIDS explores the implications of high international intellectual property standards for access to essential medicines in developing countries. With a focus on HIV/AIDS governance, the volume provides a timely analysis of the international legal and political landscape, the relationship between human rights and intellectual property, and emerging issues in global health policy. It concludes with concrete strategies on how to improve access to HIV/AIDS medicines.
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Chapter 9: Increasing access through incentives for innovation: The Health Impact Fund

Laura Biron


The global pharmaceutical industry should be driven by two overarching goals: to create innovative medicines that improve global health and to enable people all over the world to access these products once developed. At present, there is widespread recognition that these twin goals – valuable innovation and widespread access – are not being met (Morgan, 2006). The most profitable research efforts for pharmaceutical companies are not those with the most therapeutic value. Moreover, when valuable drugs do exist, firms often price them out of the reach of many who need them in order to guarantee returns for expenditure on R & D. In the wake of global pandemics such as HIV/AIDS, the prevalence of neglected diseases in developing countries and the disproportionate spread of pharmaceutical R & D expenditure relative to the Global Burden of Disease (GBD), there is widespread agreement that something needs to be done to realign the industry’s goals. This chapter outlines a proposal called the Health Impact Fund (HIF) (Hollis and Pogge, 2008) which is designed to stimulate therapeutically valuable innovation and simultaneously achieve widespread access. The HIF offers to reward pharmaceutical innovators directly on the basis of health impact, whilst also requiring them to sell their products at low prices to enable access. Health impact would be rewarded globally at an equal rate, making it profitable for innovators to develop medicines to treat the poor, amongst whom the greatest health impacts are waiting to be realized. The most striking feature of the HIF is that it is an optional pay-for-performance scheme for new pharmaceuticals;

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