The Drugs for Neglected Diseases Initiative (DNDI) is a collaborative, patients’ needs-driven, non-profit drug research and development organization. It could be dubbed a Commons Public Private Partnership. (see: CPPP)

DNDI develops treatments for neglected diseases, notably leishmaniasis (wiki ), chagas disease, malaria, paediatric HIV, and specific helminth infections.

Over time, DNDI came to realize that "neglected diseases" as a term which clearly reflects a South-North-divide, is not encompassing enough. In fact, both phenomena, neglect and "exagerated research" are a "consequence of commercially driven drug policies": with disheaerthening effects all over the world.

In other words: the flipside of "neglected deseases" are "superficially researched lucractive deseases" (my term... we obviously need to find sth. else). Think about cancer and drug research in oncology. "Fatal imbalances" in drug research refer to both phenomena: that there is virtually no research being done about deseases that affect the poor on the one hand, and that billions are spilled for research that doesn't produces useful results on the other. Thus, an adapted R&D response is required.

"Adapted" means: adapted to the real needs of people and not to commercial interests and adapted in the way drug research is governed. (see features below)

YOUTUBE aSU4y-DFwt8 Documentary by Fréderic Laffont

# Aspirational Goals

Neglected patients deserve the best science.

The ambition is to deliver 16 to 18 treatments with EUR 650 million by 2023.

DNDI aspires to influence the R&D landscape for neglected patients all over the world through political leadership for needs-driven R&D, the creation of a global fund for drug R&D and providing evidence on alternative R&D models

As an example DNDI aspires to develop and deliver 16-18 treatments (mid-term), installing 3 new chemical entities (NCEs), covering ~10 disease areas and focussing on access and impact-measurement [ ADD CONTEXT; WHERE DOES THIS HAPPEN]

DNDI aspires to strengthen Research Capacity led by Regional Offices through R&D platforms in disease-endemic countries, regionally-driven initiatives and technology-transfer.

# Legal Status and Location?

headquarters in Geneva, Switzerland, with offices in Kenya, India, Brazil, Malaysia, Japan, the Democratic Republic of Congo, and an affiliate in the USA, transnational

DNDi`s malaria activities were transferred to Medicines for Malaria Venture

# When did it start?

POST http://image-transporter.apps.allmende.io/image

# How do they work?

DNDI forges 'inventive partnerships', in 2017 - 160 organisations, community based, public and privat, local and global have been part of the network.

YOUTUBE tulpS871MwA DNDI Business Plan 2015-2023

Lessons Learnt:

- Careful selection of industrial partners matters for all stages of the R&D process

- End-to-end access safeguards are crucial, that is from molecule selection to post-delivery usage access needs to be guaranteed -> external policy frameworks must also include these access safeguards (cf. recommendations of the UN HLP on Access to Medicines)

- building national network of partners or regional consortia is necessary but time-consuming

- Commitment from government and including affected communities is indispensable

# How are they financed?

DNDi depends on donors. It seeks different sources of funding from governments and international organisations, Founding Partners who provide ongoing support, private foundations and large donors, and individuals. According to its website "DNDi is well-positioned to obtain the funds necessary to sufficiently support its mission, vision, and objectives, and to maintain independence."

The Friends of DNDi, a group of individuals from around the world committed to DNDi’s vision and mission, give DNDi an additional tool to strengthen and support the fundraising strategy, as well as raising awareness of the need for R&D for neglected diseases.

# Which Dimensions of Commoning are fostered?

R&D platforms in disease-endemic countries Regionally-driven initiatives Patient access to treatments Transfer of technology

DNDI underlines three aspects for successful partnerships: to share the same vision, to focus on mutual understanding and to guaranteee involvement throughout the whole process. This enables them to Cultivate Shared Purpose & Values, Trust Situated Knowing and Creatively Adapt & Renew

# Peer Governance

- perpetually royalty-free, non-exclusive, sub-licensable licenses in the specific disease areas determined in the contract

- Worldwide research and manufacturing rights are guaranteed

- partners commit to make the final product available at cost, plus a minimal margin, in all endemic countries, regardless fo their income level

- Non-exclusivity, enabling technology transfer and local production to multiply sources of production and decrease cost of product

# How does Provisioning in the Commons work.

DNDI integrates, according to Spring Gombe, access to knowledge and access to treatments while delinking the costs of R&D from the price of the final product. This is the key strategy.

# Features of a Commons Based Drug Research The following features of a Commons Based Drug Research help identify commons based governance regimes of R&D in drug research and elsewhere.

- therapeutical progress (Fortschritte) - "realistic" costs for R&D (not profit driven but cost based) - focus on real medical need rather than on "what sells": this will prevent the development of so called "Me-Too-"agents/drug - transparency regarding the costs for R&D including clinical studies and price-negotiations

# Sources

Spring Gombe (2017): Globale Konsequenzen Kommerzieller Arzneipolitik, Contribution to Hearing of Die Linke, Deutsche Bundestag, June 28, 2017. DNDI Website, html

1 USD for 1 Life, documentary by Fréderic Laffont, 2016