Health Care’s Grand Challenge: Stimulating Basic Science on Diseases that Primarily Afflict the Poor
研究了世界贸易组织的TRIPS协议对主要困扰穷人的疾病（如疟疾和结核病）的基础科学的影响，发现TRIPS促进了相关基础科学研究，但对药物开发证据不足。
Perhaps the most compelling Grand Challenge in health care is addressing diseases that primarily afflict the poor. Policies and practices conceived in high-income countries for improving the lives of patients in low-income countries have been criticized as ineffective or harmful. We examine the impact of one such policy, the World Trade Organization’s 1994 Trade-Related Intellectual Property Rights (TRIPS), which was partly justified by a claim that patents and other intellectual property protections would improve the availability of drugs for “neglected diseases” such as malaria and tuberculosis. There is little evidence associating TRIPS with clinical trials, patents, or trade-in drugs for these diseases. One explanation for this is that basic science is required as a prerequisite to drug development. We theorize, test for, and find evidence that TRIPS encouraged the time-consuming and complex development of managerial institutions required for basic science on neglected diseases. The results indicate an increase in basic science on neglected diseases and in applied science on nonneglected diseases as countries became TRIPS compliant. In newly TRIPS-compliant, low-income countries, scientists intensified basic research on locally relevant diseases. We call for the application of management theories to grand challenges, and to the evaluation of policies such as TRIPS.