eglected disease research and developmentA

Neglected disease research and development: how much are we really spending? .

The need for new pharmaceutical tools to prevent and treat neglected diseases is widely accepted. However, funders wishing to invest in this vitally important area currently face an information gap. In order to address these information deficits, the Bill & Melinda Gates Foundation commissioned the George Institute for International Health to conduct five sequential annual surveys of global investment into research and development (R&D) of new pharmaceutical products to prevent, manage, or cure diseases of the developing world. This article summarises key data from the first G-FINDER report. G-FINDER was designed to include all neglected diseases and products of significance to developing countries, seeking to capture 2007 data from more than 500 funders and countries. Just over US$2.5 billion was invested into R&D of new neglected disease products in 2007. Funding was highly concentrated, with AIDS, TB, and malaria receiving nearly 80% of the total. Overall, product R&D investment was heavily focused on drugs and vaccines. Investment in new diagnostics was patchy, while platform technologies applicable to many diseases, for instance vaccine adjuvants, diagnostic platforms, and delivery technologies, received less than 0.4% of total R&D investment. Neglected disease funding remains primarily the realm of public and philanthropic donors, who collectively invested US$2.3 billion or 90% of the total funding in 2007. Several major OECD ( Organisation for Economic Co-operation and Development) governments were missing in action from the top 10, top 20, or even the top 50 funders of R&D for neglected diseases . It is also remarkable that investment by some private firms is now rivalling or exceeding spending by many public organizations. While the authors commend these companies and philanthropists, their efforts are meant to support, not replace, those of wealthy governments around the world. A broadening of funding efforts so that all who are able to contribute do so, and all diseases receive the attention they deserve, would lead to a dramatic positive impact on the health of developing country patients afflicted with these diseases.

Neglected diseases were defined in this survey research as diseases that disproportionately affect people in developing countries for which there is a need for new products and for which there is market failure, i.e. there is no commercial market to attract research and development by private industry. This survey, which included a wide range of funders and countries, found little correlation between research funding and burden of disease, as measure by disability-adjusted life years (DALYs). This suggests that beyond scientific and epidemiological considerations, investment decisions may be influenced by donor perceptions and preferences, the presence of policy frameworks and funding mechanisms that prioritise specific diseases, the possibility of product development partnerships, and the influence of civil society advocacy. However, the overall pie is too small for the task and it is clearly time for those who can contribute to step forward now.