Ebola funding boost hides ongoing decline in neglected disease R&D
In this guest post, Anna Doubell, an analyst at Policy Cures, writes about the findings of this year’s G-FINDER report on neglected disease research and development (R&D). Supporting data from the report was released this week and is now available online through the G-FINDER public search tool.
- Photo: PATH/Patrick McKern
The West African Ebola outbreak featured prominently on the front pages of newspapers globally in 2014, reminding us of the devastating impact that an infectious disease can have on communities when the required vaccines, treatments, and diagnostic tools don’t exist, and the health systems to utilize them are severely lacking.
However, Ebola is only one of many infectious diseases for which there are a lack of adequate products. The G-FINDER survey, conducted by Policy Cures, collects data about funding for neglected disease R&D from over two hundred organizations each year. This year’s report, published in December, and the supporting data, released this week, highlight funding trends and gaps for R&D to develop new health technologies for neglected diseases, which can help governments, philanthropic organizations, and industry make informed decisions.
Expansion of scope to include Ebola
In response to the 2014 outbreak, we included Ebola in the 2015 G-FINDER survey scope for the first time, and the data published this week provides the first detailed picture of global funding for Ebola R&D. In many ways Ebola is a prototypical neglected disease: low-income countries (Sierra Leone, Guinea and Liberia) bore the brunt of the epidemic; no proven vaccines, antiviral drugs, or field-suitable diagnostic tests existed for Ebola when the outbreak began; and despite the existence of some bioterror-related research programmes, there had been insufficient commercial incentives to attract enough R&D investment from industry to develop products through to registration. But the rapid spread and potential global impact of Ebola led to unprecedented levels of attention and new investments in R&D.
Grounds for optimism?
The response to the outbreak showed that funders can rapidly mobilize money for R&D into neglected diseases in times of crisis. The 2015 G-FINDER survey found that US$165 million was invested in Ebola R&D in 2014, which is remarkable given that the outbreak was only declared a public health emergency in August of that year. This investment made Ebola the fifth best-funded neglected disease, behind only HIV and AIDS, malaria, tuberculosis (TB), and diarrheal diseases. Nearly three quarters of Ebola investment came from the public sector (most of it from the US government), followed by the pharmaceutical industry, providing 21 percent of all funding.
The mobilization of resources, both human and financial, resulted in clinical trials for drugs and vaccines being launched in record time,1 showing what might be possible for other neglected diseases, many of which cause more deaths in developing countries every year than did Ebola. Bacterial pneumonia and meningitis, for instance, kill more than 750,000 people in the developing world each year—compared to just over 11,000 deaths in two years from the recent Ebola outbreak—and yet in 2014 these diseases received less than half the R&D funding that went to Ebola.
Caution still required
This impressive response raises a number of questions. Will investment in Ebola R&D continue as the epidemic comes to an end, and will this funding be sufficient to support the products currently in development through to registration? And was this investment in Ebola R&D from entirely new funding, or was it diverted from other neglected diseases?
Declining public funding
One of the key findings of the 2015 G-FINDER report was that public funding for non-Ebola neglected disease R&D in 2014 fell to its lowest level since 2007. In this case, the US government again, unfortunately, led the way: US government year-over-year investment in non-Ebola neglected disease R&D fell by just over 2 percent in 2014, following even larger sequester-related cuts the previous year, to be nearly a quarter of a billion dollars lower than its peak in 2009. Public funding from other countries has remained steady, but ongoing cuts from the United States, the world’s biggest funder of neglected disease R&D, are cause for concern.
Increasing industry investment
In contrast to the decline in public funding, industry investment in neglected disease R&D reached its highest level in the history of the G-FINDER survey. Importantly, this reflected not only the sector’s Ebola R&D activity, but also significantly increased investment in R&D for malaria drugs and vaccines and HIV and AIDS vaccine research. More concerning was the fact that industry funding for TB fell for the fourth year in a row (down $10m or 8.7 percent)—an alarming trend, given the need for new vaccines, drugs, and diagnostics to combat the increasing threat of multidrug-resistant TB and extensively drug-resistant TB.
Solidifying funding for PDPs
In positive news, funding for product development partnerships (PDPs) rose for the second year in a row, driven by increased funding from the Bill & Melinda Gates Foundation. PDPs are instrumental in the development of new tools to fight neglected diseases, and are involved in the development of 40 percent of products in the neglected disease pipeline, despite accounting for just 16 percent of global funding in neglected disease R&D.
The system failures in the global response to the Ebola outbreak have been well documented over the past months. But there should also be recognition of the successes and surprising rapidity with which R&D investment was mobilized. If we could translate this political and financial commitment to other neglected diseases, the impact would be huge.
- Moon S, Sridhar D, Pate MA, Jha AK, Clinton C, Delaunay S, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. The Lancet. 2015 Dec 4;386(10009):2204–21.