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Chinese government support and 'sea turtles' are spurring the sector, but investors lack exits. Supplementary information The online version of this article (doi:10.1038/nbt0108-37) contains supplementary material, which is available to authorized users.

Although neglected tropical diseases (NTDs) threaten the health of those living in the developing world, innovation directed toward addressing NTDs is comparatively meager. Health biotechnology firms in rapidly growing economies in the global South are developing and selling vaccines, diagnostics, and therapeutics for these diseases to local markets. In this paper we identify a pipeline of sixty-two NTD products from seventy-eight "Southern" companies. We also propose creation of a Global Health Accelerator-a new nonprofit organization whose mission would be to support and help grow this Southern source of affordable innovation for NTDs.

India and China have made major progress toward establishing research- and innovation-based health biotechnology sectors. Local health needs, including diseases that predominantly affect the poor, have driven much of this success. We argue that emerging domestic firms can play an important role as reliable and high-quality suppliers of existing products and as innovators for global health needs. Indeed, these firms’ participation may make existing global health approaches more sustainable. However, global health stakeholders, including international donors and the Indian and Chinese governments, will need to fashion incentives for these companies to retain a strategic focus on the global poor.

Developing countries can benefit from conducting innovative research and development in science and technology prioritised to their own specific health and development needs. Here, the role of the domestic private sector in utilising its knowledge, expertise, resources and relationships is critical for translating R&D results into tangible health products and services for individuals. We have recently initiated a study to analyse how the domestic health biotechnology sectors of four developing countries - India, China, Brazil and South Africa - address local health needs. In this paper, we introduce the purpose, design and objectives of the study, describe our rationale for undertaking this research and present preliminary results from our analysis of health biotechnology firms in India.