Briefs

WHAT YOU SHOULD KNOW

Research and development (R&D) has been the bedrock of progress in global health. Past R&D investments have resulted in groundbreaking advancements — including antiretroviral treatments for HIV patients, Ebola diagnostics, insecticide-treated bed nets, and new vaccines to protect against meningitis and rotavirus — which have driven remarkable gains in global health over the past few decades.

Despite tremendous progress, there remains a significant need for global health research to deliver new and better tools to combat both longstanding and emerging threats. Millions of people around the world still suffer and die from HIV/AIDS, tuberculosis (TB), malaria, and other neglected diseases and health conditions, while new drug resistances, Ebola outbreaks, and other crises continue to emerge.

U.S. government investment in global health R&D is imperative for responding to market failures. Because the greatest threats to public health have the largest impact on the world’s poorest people, there is often insufficient commercial incentive to spur research in the private sector. Sustained U.S. support is vital to jumpstart research and advance products to market — a process that can take significant time and resources.[1]

Global health R&D is a “best buy” for the United States. These investments not only save lives in the world’s poorest places, they also generate direct benefits for Americans — creating jobs and economic growth within the United States, protecting Americans from external and internal disease threats, and saving costs and improving efficiency across domestic U.S. health and development programs.[1]

The United States must continue its leadership in health innovation by sustaining funding for research programs. Policy environments must be conducive to the discovery, development, and delivery of the next generation of global health breakthroughs.

RECOMMENDATIONS FOR CONGRESS

Sustain and — where possible — increase funding for global health research and product development. Policymakers must ensure federal budgets prioritize robust funding for global health R&D across all U.S. agencies engaged in this work, including the Biomedical Advanced Research and Development Authority (BARDA), Centers for Disease Control and Prevention (CDC), Department of Defense (DoD), Food and Drug Administration (FDA), National Institutes of Health (NIH), and U.S. Agency for International Development (USAID).

Where they have discretion, U.S. agencies should designate a percentage of global health and disease-related budgets for R&D. Given that most global health R&D programs are not directly appropriated by Congress, agencies must prioritize funding for developing global health technologies within existing programs.

Improve coordination, alignment, and transparency of global health R&D efforts across U.S. agencies, with the help of international partners, to incubate innovation, promote best practices, leverage funding and expertise, fill gaps, and facilitate effective partnerships and transfers of research. This can include establishing a coordinated, whole-of-government strategy for global health R&D; improving agency reporting of global health R&D activities; and incorporating R&D as a core component of existing cross-government and international health initiatives, such as the Global Health Security Agenda.

Support a portfolio of incentives and financing mechanisms to stimulate needed R&D at all stages of product development. Prizes, advanced market commitments, development impact bonds, and tax credits, among other incentive mechanisms, can generate greater private sector engagement in R&D, especially for neglected diseases and conditions, bridging the divide between need and resources.

Support local innovators in the end-to-end development of products that meet the health needs of their countries. Through new partnerships, leveraged funding, and technical assistance, the United States can help local innovators navigate R&D roadblocks and turn good ideas into lifesaving technologies. Local innovation is key to developing affordable, accessible, and community-appropriate products, plus builds sustainable pathways to create jobs, economic stability, and health systems after countries graduate from traditional aid programs.

Credit: PATH/Patrick McKern
Credit: PATH/Gabe Bienczycki

WHY THIS INVESTMENT IS IMPORTANT

While we have made tremendous gains in global health over the past 15 years, millions of people worldwide are still threatened by neglected diseases and conditions. In 2016 TB killed 1.7 million people, surpassing the number of deaths from HIV/AIDS.[2] More than 1.8 million people become newly infected with HIV annually.[3] Half of the global population remains at risk for malaria, with drug resistance growing.[4] An estimated 1 out of every 13 children in sub-Saharan Africa dies before the age of 5.[5] These statistics highlight the tremendous global health challenges that still remain, along with the need for new and better tools to combat endemic and emerging threats.

Unfortunately, diseases that strike the world’s poorest people also offer insufficient commercial incentive for R&D led by the private sector. Because of this market failure, U.S. investment is needed to catalyze research and advance lifesaving technology from discovery through implementation.

The United States has long played a leading role in R&D for global health, and this engagement has made an enormous impact. U.S. support has helped generate 42 new global health technologies since 2000 — including a more child-friendly malaria medicine that has so far saved the lives of 875,000 children, plus a low-cost meningitis vaccine that has prevented 378,000 deaths and is projected to save $9 million in treatment costs by 2020.[6] U.S. support has also helped move 128 promising products into late-stage development, where they are poised to drive further gains.[6] Any drawback of U.S. support would jeopardize these advancements and mark a retreat from the core American values of innovation and assistance to those in dire need.

Beyond supporting humanitarian goals, U.S. investments in global health R&D also yield direct benefits for the United States. The recent Zika and Ebola epidemics demonstrate how health crises abroad can quickly become health crises at home, while also underscoring how proactive investments in R&D can strengthen the security of health systems and protect Americans. Global health R&D is also a smart economic investment for the United States, as it drives job creation and economic growth. An estimated $0.89 of every $1 invested by the U.S. government in global health R&D stays in the United States, supporting American researchers. In addition, from 2007 to 2015, these investments generated an estimated 200,000 new U.S. jobs and $33 billion in economic growth.[6]

Through sustainable investment in global health R&D, Americans can lead the way in conquering the greatest health challenges of our times and building a healthier, safer world for all.

Resources

  1. Global Health Technologies Coalition (GHTC) http://bit.ly/2NHS5cd
  2. PATH Advocacy and Policy: Driving Innovation to Save Lives http://bit.ly/2fD9cJY

Contributors

Marissa Chmiola, Global Health Technologies Coalition, mchmiola@ghtcoalition.org
Emily Conron, Global Health Technologies Coalition, econron@ghtcoalition.org


Citations

[1] “Return on innovation: Why global health R&D is a smart investment for the United States,” GHTC, 2017. http://bit.ly/2w7kqOo.

[2] “Global Tuberculosis Report 2017,” WHO, 2017. http://bit.ly/2Datmrv.

[3] “Global HIV & AIDS statistics — 2018 fact sheet,” UNAIDS. http://bit.ly/2MLMkJi.

[4] “The Millennium Development Goals Report: 2015,” United Nations, 2015. http://bit.ly/2CTzYti.

[5] “Levels & Trends in Child Mortality Report 2017,” UNICEF. https://uni.cf/2zh7jM2.

[6] “Return on innovation: Why global health R&D is a smart investment for the United States,” GHTC, 2017. http://bit.ly/2w7kqOo.

©2019 Global Health Council