Donor governments stop short of crossing the ‘finish line’ in global health

Over the last decade, great progress has been made in developing new global health technologies that show potential to transform the deadliest diseases on earth. This progress has been delivered largely by Product Development Partnerships (PDPs), with critical support from the public, private and philanthropic sectors, which have filled the gap by developing new technologies to prevent, diagnose and treat diseases affecting the world’s most underserved populations. 

Despite the urgent need for new tools, the recently released G-FINDER report reveals that overall global investment in the research and development (R&D) of such products has declined for the first time since 2007, when the tracking of such funding began. This decline is especially troubling given that there are more than 100 products in PDPs’ pipelines. In the case of tuberculosis, novel vaccines are undergoing testing in clinical trials and new treatments are in late-stage development, giving promise to the availability of new solutions in the near term.

The public sector plays a significant role in investing in and supporting R&D of new, more effective technologies, from basic research through to clinical trials and licensure. G-FINDER shows significant reductions in investment in 2010 by eight of the top 12 public funders of neglected disease R&D, including the United States. Since the end of 2010, the year for which these figures were reported to G-FINDER, there have been rapid changes in the funding landscape resulting in even further cuts to product development by public funders. This worrisome trend will likely be confirmed in next year’s G-FINDER report. In the meantime, product developers will be forced to scale back otherwise successful programs delaying the delivery of urgently needed tools to the world’s poorest populations. 

Many are quick to cite the global financial crisis as a justification for these cuts. This perspective ignores an immutable reality – diseases of poverty rob millions of health, hope, and prosperity, prevent global economic development, and will not simply go away. At any given moment, more than 12 million people suffer from TB and in 2010, TB killed 1.4 million people. With the deadly interaction between TB and HIV, the rise and spread of drug resistance to today’s available therapies, including MDR-TB and XDR-TB, and the lack of an effective vaccine to prevent the most infectious form of the disease, TB will continue to ravage the world’s poor, and pose increasing threats to global health. 

We have made huge progress over the last decade but will not reach the finish line without urgent action. Governments must seize the chance to invest in these critical life-saving technologies and ensure that drugs and vaccines developed with a decade of public investment won’t stall in late stage development. They should consider how investment in new tools, especially those for TB, will save money over the long term. However, cash-strapped governments need not focus only on direct funding alone. They should drive also the development of innovative approaches that leverage existing research infrastructure as the National Institutes of Health is doing by expanding its existing HIV/AIDS clinical trial network to research on other diseases, and provide incentives to increase private sector involvement. 

High-income countries should view these findings as a wake-up call and work to put product development for diseases of poverty back on track.  Now is a time of tremendous opportunity, with dozens of potential products within the reach of patients. Donors must commit to take them across the finish line or lose a historic opportunity to impact global health.

Christenson is the Coalition Director of the Global Health Technologies Coalition; Connolly is President and CEO of Aeras; and Spigelman is President and CEO of the TB Alliance

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