Can India lead the way in neglected diseases innovation?

India is one of the top global funders of research and development (R&D) into neglected diseases. With a promising scientific base built on the foundation of an expanding science and technology workforce,1 the country is well placed to make a substantial contribution to innovation in neglected tropical diseases. A third of new drugs (six out of 18) and two thirds of new vaccines (six of 10) for neglected diseases registered since 2000 have had Indian involvement. Nearly 12% of drug, diagnostic, and vaccine candidates for neglected diseases in the R&D pipeline are from India.1 The world’s first leprosy vaccine was developed in India and is expected to accelerate eradication efforts.2 India has successfully eliminated certain infectious diseases—such as guinea worm, trachoma, and yaws—in recent years.345 Yet, neglected diseases such as leishmaniasis, filariasis, leprosy, snakebite, and soil transmitted helminthic infections still pose a challenge. There persist challenges in the implementation of new technologies and major research gaps. The current model of innovation is driven by market forces and is failing to deliver a steady stream of products that reach patients through adoption into treatment programmes.67 Neglected diseases predominantly affect poor and marginalised populations and do not constitute a market that is attractive enough to stimulate private sector investment. As such, the Indian government must step in with appropriate policies and investments to support innovation. In this article, we review existing policies and mechanisms, and propose actions to create an enabling environment for neglected diseases research in India.