15.5 DNDi was established to address chronic challenges in advancing R&D that meets needs of neglected populations. Many shortcomings of the R&D system identified by the Council are acute examples of decades of persistent failure to develop and ensure equitable access to health tools that we, countries, and communities have faced and worked to overcome. But political and commercial choices made during COVID-19 further entrenched the status quo. As the Council stated, the resulting inequities were ‘not just a moral failure’, but also a ‘health and economic catastrophe’. 

We agree with recommendations calling for re-orientation of health innovation governance for the common good. We support the Council’s recommendation that governments should use their leverage to negotiate clear terms and conditions to ensure development of and equitable access to health technologies. Public funders should secure a public return on their investments, including via the negotiation of the Pandemic Agreement.