Mary Moran criticizes plans by the World Health Organization (WHO) for tackling neglected diseases in the developing world (Nature 506, 267; 2014). Her arguments are misleading and trivialize global efforts to fix the research and development (R&D) system that is failing to address the health needs of people in these countries.

After 10 years' effort by WHO member states, the WHO Consultative Expert Working Group on R&D Financing and Coordination has proposed a framework to tackle these R&D shortcomings. This aims to promote and coordinate needs-driven innovation, sustainable funding mechanisms and patient access to health technologies.

Moran contends that the current drug pipeline for neglected diseases is “successful”. In the past ten years, however, only 4% of all new drugs and vaccines and 1% of all new chemical entities were for neglected diseases — and none was suitable for the 17 neglected tropical diseases (B. Pedrique et al. Lancet Glob. Health 1, e371–e379; 2013). Increased funding and better coordination will help, but what is really needed is a greater global incentive for needs-driven R&D.

To fulfil the working group's criteria, the WHO pilot projects need better coordination, optimization of research and accelerated delivery of health tools. This will be achieved only by strengthening capacity, testing innovative or pooled financing, developing an open-knowledge approach, and unlinking R&D costs from the end price of products.