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Healthcare's grand challenge: basic science on diseases that primarily afflict the poor


Academy of Management Journal


Strategy and Entrepreneurship

Authors / Editors

McGahan A;Vakili V


Publication Year



Perhaps the most compelling Grand Challenge in healthcare is addressing diseases that primarily afflict the poor. In this paper, we examine the effect of the World Trade Organization's (WTO's) 1994 policy of Trade-Related Intellectual Property Rights (TRIPS), which was justified in part by a claim that patents and other intellectual property protections (IPPs) would improve the availability of drugs for 'neglected diseases' such as malaria and tuberculosis. To date, scholars have found little evidence associating TRIPS with clinical trials, patents, or trade in drugs for neglected diseases. We revisit the original economic logic behind TRIPS and introduce a complementary theory that TRIPS encouraged the time-consuming and complex development of the managerial institutions required for the prerequisite basic science for neglected diseases. We test this logic on a large cross-section of scientific publications. The results indicate an increase in basic science on neglected diseases and in applied science on non-neglected diseases in line with our predictions. Further analysis indicates increases in scientific activity authored in low-income countries on locally relevant neglected diseases. We interpret these results to call for application of theories of management to Grand Challenges, and especially to the evaluation of policies such as TRIPS. Addressing the Grand Challenge of healthcare for the poor depends on interventions that deepen the development of managerial institutions of science.

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