ArticleThe Lancet. Global health2025
Development, launch, and scale-up of health products in low-income and middle-income countries: a retrospective analysis on 59 health products.
Article in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- Global disparities in regulatory approval of prophylactic vaccines, 2005-2024.Journal of global health · 2026Article
- From guesstimates to game changers: Introducing objective measurement of blood loss for timely postpartum hemorrhage detection in Nigeria, Zambia, and Kenya.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Preparing for Tuberculosis Vaccine M72/AS01Infectious diseases and therapy · 2026Article
- Advancing global health access through market shaping: Cases and learnings.PLOS global public health · 2026Review
- Achieving Equitable Access to Obstetric Devices Through Innovation, Improvisation and Off-Label Use.BJOG : an international journal of obstetrics and gynaecology · 2025Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-income and middle-income countries (LMICs) bear a heavy burden from communicable, maternal, and childhood diseases, yet access to health products addressing these burdens is lagging. We aimed to provide empirical evidence about the timelines, and influencing factors, of the end-to-end scale-up pathway of health products in LMICs.
methodsWe identified products that met our prespecified inclusion criteria. We documented the dates and intervals for five key milestones in the pathway: ideation, proof of concept, regulatory approval, first LMIC country launch, and at least 20% uptake across LMICs. We then explored the association between pace of this pathway and ten characteristics, such as product types, buying environment, and market type. We used robust regression models to test our hypothesis that multiple factors affect a product's pathway to scale-up in LMICs.
findingsAmong 59 included products, the median time to bring a product from ideation to at least 20% uptake in LMICs was 13·5 years (IQR 6·8-41·6). Ideation to proof of concept was the longest interval (median 6·9 years) for most product types, followed by the first country launch to at least 20% uptake in LMICs (median 3·8 years). Infectious disease products tended to need the longest time to launch, whereas maternal and child health products took the longest to scale up. Products with consumer or institutional markets launched and scaled up faster than those with global markets by 6 years and 2 years, respectively (p=0·012 and p<0·0001). Other factors, such as type of developer and buying environment, also had an effect on launch and scale-up timelines.
interpretationStakeholders should make long-term plans to introduce and scale up new products. Better coordination and planning across different stages and among different players could accelerate the process.
fundingBill & Melinda Gates Foundation.
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