New drugs, vaccines, and diagnostics for the diseases of the developing world could save millions of lives and prevent enormous suffering and economic loss. Despite substantial new funding from the Gates Foundation and other donors, financing for the development of these new health technologies remains inadequate. New approaches are needed to generate more resources, make funding more stable and flexible, and further engage the expertise of the pharmaceutical industry. Several new financing mechanisms have been launched recently, and others are being proposed. This paper summarizes some of the most promising new ideas and offers a framework for evaluating them. [Health Affairs 28, no. 4 (2007): 974-985; 10.1377/hlthaff.28.4.974] D e s pi t e p r o g r e s s i n r e c e n t y e a r s , the world still urgently needs new and improved health technologies-drugs, vaccines, and diagnostic tests-to prevent and treat the diseases that take a heavy toll on people in the developing world. These new technologies could save millions of lives annually and promote faster economic and social progress.n Need for vaccines. New vaccines are required to lower the burden of infectious diseases, including AIDS, TB, malaria, and other tropical illnesses. The potential of these vaccines is enormous. For each million people in malaria-endemic countries of Africa, a partially effective malaria vaccine could avert 10,000 deaths and 16,000 severe cases of malaria over a twenty-year period.1 A vaccine to prevent dengue fever, a mosquito-borne viral disease that causes tens of millions of cases of illness and thousands of deaths annually in all regions of the tropics, could reduce the 9 7 4 J u l y /A u g u s t 2 0 0 9