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TDR recently published an historical review of three decades of the organization's activities since its establishment as the Special Programme for Research and Training in Tropical Diseases in 1978 [1]. There have been four external reviews of TDR during this time, each followed by reorganization, institutional-fine-tuning, and adaptation to changing circumstances in the world of science and research. Independent external review has thus been integral to TDR, supporting its mission as a steward in forwarding public research interests, most particularly research on infectious diseases affecting the world's poorest and most disadvantaged populations.  The Fourth External Review [2], conducted between February 2005 and May 2006, was thus received as a core element of TDR's process of periodic institutional evaluation and adjustment. The findings of the review are summarized in an article in this issue of PLoS Neglected Tropical Diseases [3]. Ultimately, the review contributed to key elements of a new TDR Ten Year Strategy [4] and business plan [5] approved by TDR's Joint Coordinating Board in June 2007 and endorsed by the World Health Organization (WHO) (see Box 1). That strategy is now in the first stages of implementation.   Box 1. TDR's New Ten Year Strategy Vision: To foster an effective global research effort on infectious diseases of poverty in which disease-endemic countries play a pivotal role.  Key TDR Strategic Functions:   Stewardship for research on infectious diseases of poor populations: as facilitator and knowledge manager to support needs assessment, priority setting, progress analysis, and advocacy, and to provide a neutral platform for partners to discuss and harmonize their activities.    Top level objective is to bring about greater harmonization of global research efforts.   Empowerment of researchers and public health professionals from disease-endemic countries, moving beyond traditional research training to build leadership at individual, institutional, and national levels so countries can better initiate and lead research activities, develop a stronger presence in international health research, and effectively use research results to inform policy and practice.    Top level objective is to promote disease-endemic country leadership in research.   Research on neglected priority needs that are not adequately addressed by other partners. This will focus on three research functions:   Foster innovation for product discovery and development,   Foster research on development and evaluation of interventions in real-life settings,   Foster implementation research for access to interventions.      This strategic function will be managed through a limited number of well-defined and coherent activities termed business lines.  Top level objective is to bring about enhanced access to superior interventions.

Two Years after the Fourth External Review: TDR Moves Forward with a New Vision and Strategy