by Pizarro L. BMJ Global Health 2026;11:e022292. doi: 10.1136/bmjgh-2025-022292
Summary: The alternative, non-profit model for developing health tools faces a double challenge of foreign aid cuts and structural changes in the pharmaceutical industry. These radical shifts raise concerns about the future of non-profit medical innovation. The author of this Commentary suggests some possible ways to move forward. First, challenge the false dichotomy that pits international solidarity against national interests. Second, redistribute power within the global health landscape and increase investment in the innovation capabilities of low- and middle-income countries (LMICs). Third, strengthen partnerships between the public, private, and non-profit sectors. Finally, in countries without resources to develop autonomous R&D infrastructure, develop regional partnerships between high-burden countries, needs-driven R&D organisations, donors, and industry, including small and medium enterprises from LMICs.
