Market Devices and the Assetization of Neglected Diseases: A Case Study of Leishmaniasis Drug Development

This article examines the market devices designed to address the “market failure” surrounding neglected diseases, focusing on international drug-development activities for leishmaniasis. Using public-private partnerships and the US Food and Drug Administration's Priority Review Voucher as key examples, the article explores how these initiatives have transformed drug development for neglected diseases over time. By tracing the history of two drug candidates for leishmaniasis—miltefosine and Anfoleish—the analysis reveals how the market devices initially intended to de-risk drug development have been turned into financial assets, aligning with the profit-driven imperatives of large pharmaceutical companies. This process, known as assetization, is examined through a long-term perspective that highlights the interaction between global health actors, pharmaceutical firms, and regulatory frameworks. The case of leishmaniasis offers a nuanced understanding of how commercial interests have shaped the market for neglected diseases, despite efforts to make them less neglected.