Research and Development

Research and development (R&D) is the bedrock of progress in global health. Past R&D investments have led to groundbreaking advancements—antiretroviral treatments for HIV, vaccines for Ebola and malaria, insecticide-treated bed nets, and more effective tuberculosis (TB) treatments—which have and will continue to drive remarkable progress in global health. 

There is still a tremendous need for global health research to deliver new and better tools to combat long-standing and emerging threats. Millions of people around the world still suffer or die from HIV/AIDS, TB, malaria, and other neglected diseases and health conditions, and new threats—like extensively drug-resistant TB and COVID-19—continue to emerge. 

U.S. government investment in global health R&D is necessary to solve for market failures. Private-sector companies lack the incentive to invest in research, because these health issues affect the world’s poorest (or in the case of emerging threats, future populations). Sustained U.S. support in all stages of research are critical to make new discoveries and advance products to market for these conditions—a process that requires continued time and resources.

Investments in global health R&D not only save lives in the world’s poorest places, they also directly benefit the United States—creating jobs and economic growth, protecting Americans from disease threats, promoting cost savings, improving the efficiency of U.S. health and development programs, and building a foundation to respond to future infectious disease threats.  

The United States must continue its leadership in health innovation through sustained funding and supporting a policy environment conducive to discovering and developing the next global health innovations.

RECOMMENDATIONS FOR CONGRESS

Sustain or increase funding for global health research and product development. Policymakers must ensure future federal budgets prioritize robust and sustainable funding for global health R&D across 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 the U.S. Agency for International Development (USAID).

Where they have discretion, U.S. agencies should set a percentage of disease- or global health-related budgets to be directed to 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 and with international partners. This could include establishing a whole-of-government, coordinated global health R&D strategy; improving reporting of agencies’ global health R&D activities; and incorporating R&D as a core component of existing cross-government and international health initiatives like the Global Health Security Agenda.

Support the end-to-end product development capacity of local innovators to meet the health needs of their own countries. Through new partnerships, leveraged funding, and technical assistance, the United States can support local innovators to navigate R&D barriers and turn good ideas into lifesaving technologies. Local innovation is key to developing locally appropriate products and building sustainable pathways for countries to graduate from traditional aid.

R&D AND COVID-19

COVID-19 is likely to leave slow-healing scars across the global health R&D ecosystem without additional investment. Infectious disease research has experienced major disruptions and countless clinical trials have been paused or delayed as resources have been redirected towards the pandemic. These disruptions delay new life-saving innovations and strain already tight resources. Without consistent, robust funding for global health R&D, society is unlikely to end, in our lifetimes, the world’s most pressing global health challenges. Funding for global health R&D must keep pace with our unprecedented scientific capacity as the world recovers from COVID-19 and looks towards a future where science, applied to the most important problems, can end unnecessary suffering.