In the past decade, the global architecture around access to medicines for neglected diseases has changed, in particular with the rise of Global Health Initiatives (GHIs) as major sources of health technology funding. However, our knowledge of the impact of GHIs on access to medicines, as an essential part of functioning health systems, is limited. The Lancet paper written by the Positive Synergies Collaborative Group1 had little to say about medicines and especially about GHI impact on upstream supply markets, even though such impact is important to understand from a pricing and supply security point of view.
In the current economic environment donors are under increasing pressure to demonstrate value for money (VFM). As a large portion of the money spent by the major GHIs goes to health technologies, an obvious question is: are GHIs influencing market dynamics in ways that encourage VFM, and if so, how?