Because research is concentrated in rich countries, both what we know and what gets made are skewed away from the diseases of poor ones.

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• Economic development happened once in each country, which is why the big theories of why nations get rich cannot be tested. NSNoah Smith6 May 2026
• Rich governments need to spend more on research and development, and health and education need better measurement BGBill Gatesc. 2010
• Labour-saving innovation in rich countries is aimed at the only asset most of the world’s poor have to sell. LPLant Pritchett2 Mar 2023
• Drug research is heading, at speed, for a world in which fewer and fewer useful medicines are discovered while more and more people want them. DLDerek Lowe8 Mar 2012
• Infectious diseases get far less industry R&D per death than non-communicable ones, because they mostly kill people in countries where a cure pays less. JTJacob Trefethen29 May 2025

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