Ideas to Action:

Independent research for global prosperity


Global Health Policy Blog


Scientific and technological innovation has the potential to save lives, reduce global poverty, and help address the most pressing global challenges—but investments in R&D are mostly directed at lucrative, high-income markets versus the health problems that affect the global poor. Broadly, there are two ways to increase R&D for these neglected conditions: “push funding”, which directly subsidizes and defrays the up-front R&D costs through mechanisms such as governmental or philanthropic grants and direct funding of government or foundation research institutions; and “pull funding”, which uses the promise of future sales and/or other revenue to indirectly justify upfront expenditures in R&D, thereby “pulling” innovations to market.

There are substantial potential benefits to using pull mechanisms, which we’ve explored in recent work (see here and here, for example). Yet global use of pull mechanisms has been limited, in part stymied by regulatory and legal barriers. The same is true at the national level within the United States. At the same time, and across the US government, pull-like mechanisms do exist, which can be and have been used in creative, novel ways to support innovation. CGD’s recent paper explored some of these approaches, as well as barriers to their use and potential strategies to increase their application.

As a next step, we want to explore the practical opportunities for the US to use pull mechanisms in pursuit of high-value global health innovation.

Here’s where we need your help:

Which areas in health/pharmaceutical R&D hold the most promise, both in general terms and for use of pull mechanisms? Where are the most significant R&D and funding gaps, and where are market failures limiting private investment? For COVID-19 (e.g., therapeutics, diagnostics, or next generation vaccines)? For other high-value/low-cost innovations targeted to low-and middle-income countries? For underfunded global public goods, such as antimicrobials? We welcome all your ideas!

Over the next few months, we hope to engage with as many of you as possible in helping to identify the most promising opportunities for greater US participation in pull mechanisms for high-value innovations. We welcome your thoughts by October 30 (to Rachel Silverman,; we’re also available to chat by phone or zoom. We plan to produce a report outlining three potential innovations and their associated business cases later this year.


CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.