Drug discovery presents some of the hardest innovation problems facing society. This is particularly true in the developing world, where patients do not have enough money to cover R&D costs. Not surprisingly, conventional patent incentives have done almost nothing to combat tropical disease. I will discuss recent proposals to design new, non-patent incentives to fill this gap. Surprisingly, one proposal would organize on-line R&D teams modeled on the collaborations that produce "open source" software. I will describe one such collaboration and ask whether similar methods could improve drug discovery for rich nation diseases.