Introduction The Health Impact Fund (HIF) is a publicly funded international agency proposed to enable pharmaceutical innovators to register a product for health impact rewards in exchange for selling it worldwide at cost. Supplementing the current patent regime, the HIF would improve incentives to research diseases concentrated among the poor. A workable HIF presupposes a consistent, predictable, and contractible method of health impact assessment.

Methods We reviewed the literature using search terms,“health impact assessment tools” and an exploratory workshop for all stakeholders was held at the National Institute for Health and Clinical Excellence in April 2010.

Results Although there are many challenges with the nature of current epidemiological data and their application to global health, there is scope for improvement and the HIF may help to trigger and sustain such enhancements. Moreover, the HIF would use much more information than the present system. The following steps in health impact assessment need to occur for each registered product: defining subgroups, establishing baseline treatments, defining incremental health impact by subgroup, measuring the numbers of patients treated in each subgroup, and a process of appeal.

Conclusion Health impact assessment is a new science, and complexities involved in assessing new drugs in the global context are formidable. However, initial models suggest that the HIF could significantly change the focus of drug innovation. Only pilot studies will properly test the HIF's underlying principles and uncover the practical challenges which will determine its implementation and effectiveness. The creation of the HIF could bring great advances in epidemiological data collection and its application.