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The private sector is the primary investor in health research and development (R&D) worldwide, with investment annual investment exceeding $150 billion, although only an estimated $5.9 billion is focused on diseases that primarily affect low and middle-income countries (LMICs) (West et al., 2017b). Pharmaceutical companies are the largest source of private spending on global health R&D focused on LMICs, providing $5.6 billion of the $5.9 billion in total private global health R&D per year. This report draws on 10-K forms filed by Pharmaceutical companies with the U.S. Securities and Exchange Commission (SEC) in the year 2016 to examine the evidence for five specific disincentives to private sector investment in drugs, vaccines and therapeutics for global health R&D: scientific uncertainty, weak policy environments, limited revenues and market uncertainty, high fixed costs for research and manufacturing, and imperfect markets. 10-K reports follow a standard format, including a business section and a risk section which include information on financial performance, investment options, lines of research, promising acquisitions and risk factors (scientific, market, and regulatory). As a result, these filings provide a valuable source of information for analyzing how private companies discuss risks and challenges as well as opportunities associated with global health R&D targeting LMICs.
The review consists of a summary of the emergence of agribusiness clusters, SEZs and incubators since 1965 (with a focus on smallholder agriculture-based economies in Latin America, Africa, and Asia), followed by a series of brief case studies of example programs with particular relevance for guiding proposed clusters/incubators in the countries of Ethiopia, Tanzania, Nigeria and the Eastern Indian states of Uttar Pradesh, Bihar, and Odisha. Summary conclusions draw upon published reports and primary analysis of case studies to highlight apparent determinants of success and failure in agribusiness investment clusters and incubators, including characteristics of the business environment (markets, policies) and characteristics of the organizational structure (clusters, accelerators) associated with positive smallholder outcomes.