The report of the Commission on intellectual property rights innovation and public health was an attempt to gather all the stakeholders involved to analyze the relationship between intellectual property rights innovation and public health with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines vaccines and diagnostic tests to tackle diseases disproportionately affecting developing countries. The report provides a resource for the public health community by clarifying the impact of institutions systems and policies outside the health sector on intellectual property rights and innovation policies. A key message of the report is that because the market demand for diagnostics vaccines and medicines needed to address health problems mainly affecting developing countries is small and uncertain the incentive effect of intellectual property rights may be limited or non-existent. Because intellectual property rights may not be an effective incentive in this area there is a need for other incentives and financial mechanisms to be put in place and for collaborative efforts between different stakeholders. Without access to the products of innovation there can be no public health benefits. Defining the conditions by which products can be accessed is therefore an important aspect of the report. After the preface and a first chapter looking at the health innovation cycle and how it can truly impact the health of the poor chapter 2 covers the discovery stage chapter 3 discusses the development stage and chapter 4 deals with the delivery stage. In each of these 3 chapters the specific scientific technical economic patent and resource issues that affect the innovation cycle are addressed. Chapter 5 considers policies to improve innovative capacity in developing countries and finally chapter 6 concludes and considers the need to move towards a better-financed and more sustainable system for promoting innovation directed at diseases that disproportionately affect developing countries. The report will succeed to the extent it makes a difference where it really matters - to the lives of poor and sick people in developing countries. It is hoped that the report will stimulate governments and other stakeholders to promote innovation relevant to the health of poor people in developing countries and their access to diagnostics vaccines and treatment.