10/90 gap

The 10/90 gap is the stark misallocation of global health research spending: approximately 90% of research investment targets diseases that affect only 10% of the global population, while the diseases that burden the remaining 90% receive less than 10% of funding. This is not a temporary market inefficiency but a structural feature of the pharmaceutical research feedback topology, where return on investment is maximized by directing research toward wealthy markets that can pay premium prices. The gap reveals that global health equity is not a matter of insufficient resources but of misaligned incentive structures that make the health of the poor systematically unrewarding to research.

The 10/90 gap is not a scandal to be solved by outrage. It is a systems attractor to be solved by redesign.