REWARD will open up new horizons in complementing the international intellectual property rights (IPR) system. The project's ambitious output is an ethically and legally sound performance-based reward mechanism for pharmaceutical innovation, which complements the existing patent regime, yet mitigates its considerable disadvantages for the global poor.The current IPR system impedes access to life-saving medicines for the poor in two main ways. First, high prices for pharmaceutical innovations are required to recoup research and development costs through time-limited patent protection. Whilst high price levels maintain incentives for pharmaceutical innovation, they price new medicines beyond the range of the poor creating an accessibility problem. At the same time, diseases that burden the poor are often not worthy of investment for pharmaceutical innovators, creating an availability problem ('neglected diseases').Many international research groups are working on IPR reform plans based on performance-based rewards for pharmaceutical innovation. However, their efforts are disparate and lacking a guiding vision. REWARD will use world-class ethics research as the steering force to determine which performance-based reward mechanism for pharmaceutical innovation is the most promising. In an interdisciplinary collaboration of ethicists, lawyers, economists, and statisticians, with experts in medicine, science and technology policy and gender studies the selected mechanism will be tested in a developed and a developing country.