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Phil Carroll is PATH’s Senior Policy Communications Associate. He spent two weeks in India last fall visiting PATH programs related to maternal and child health, tuberculosis, immunizations, and safe water and diarrheal disease. India is a country that changes dramatically from place to place, something I experienced firsthand while on a two week trip there this past fall. One day I was listening in on a mothers’ group meeting in one of the poorest villages in Uttar Pradesh state, and less than 24 hours later I was standing in one of the world’s most technologically advanced airports in Hyderabad—often referred to as the ‘Silicon Valley’ of India. It was during this leg of my journey where I was further convinced of the need for sustained investment in research and development. In a laboratory on the outskirts of the city, I met a handful of Indian doctors and researchers who are doing some pretty amazing, albeit subtle, things in health. Thanks to a small, less than $100,000, investment by the US Agency for International Development (USAID), the Blue Peter Public Health & Research Centre upgraded its tuberculosis (TB) lab to a higher level of biosafety. Improvements like better equipment and infrastructure and enhanced safety measures have enabled researchers here to diagnose a case of multi-drug resistant tuberculosis (MDR-TB) in a matter of days, a process that used to take the same team several months. Click on the photo to look at the full “Fast TB diagnosis helps save lives in India” slideshow. Photo: PATH/Gabe Bienczycki This is significant for a host of reasons. Diagnosing TB on the early side can help get patients on treatment faster, thereby reducing further deterioration of their lungs and other organs and ultimately save their lives. Catching TB early on can also curtail the spread of this incredibly contagious disease to others. India, which has the highest incidence of TB in the world, and 20 percent of the world’s burden, needs these sorts of advancements now more than ever. Currently, the government of India, as part of its National TB program, is only reaching 25 percent of MDR-TB patients with diagnosis. However, by 2013, it is aiming for 100 percent coverage, or around 2 million TB patients. While this goal might appear daunting, it should hardly be seen as insurmountable. As evidenced by its incredible response to polio in the last few years, the Indian government—with the help of key partners like PATH—is capable of pulling off some amazing global health feats when it resolves to do so. The government of India, under its National TB Laboratory Scale-Up plan, is in the process of upgrading other labs like the Blue Peter Public Health & Research Centre lab throughout the country. PATH is helping to make these labs airborne infection control compliant, thereby reducing the spread of TB. This, combined with other TB-control interventions and sustained advocacy at the national level, has the promise to one day make this disease a distant memory for the people of India. Look at the full “Fast TB diagnosis helps save lives in India” slideshow.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. President Obama releases his fiscal year 2013 budget with mixed reviews for global health research and development. The Centers for Disease Control and Prevention is making headway in tuberculosis research in Kenya. New ways of preserving vaccines are about to enter field trails in Vietnam. This technology could be used around the world. Data sharing can be the catalyst to more research and development for neglected tropical diseases. Scientists show how some cells in the body can repel attacks from HIV.

Research!America, a member of the GHTC, recently conducted analyses in target states to measure the health and economic impact of global health research and development (R&D), highlighting its benefits for states across the nation and strengthening the evidence base for Congress’ support of federal investments in global health R&D. Mandy Goldberg, Global Health R&D Advocacy intern, shares the organization’s findings in Illinois. This is the fourth post in a series. “The world is interconnected, and that demands an integrated approach to global health,” President Obama stated when he announced the US Global Health Initiative on May 5, 2009. His former neighbors in Illinois agree. More than 50 percent of Illinoisans think more about global health today than they did five years ago, and for good reason. In addition to innumerable health benefits worldwide, global health research and development (R&D) has an important economic impact on the state of Illinois. Illinois boasts more than 200 academic, government, and nonprofit research institutions, as well as seven research and technology parks, all of which contribute significantly to employment within the state. Illinois is one of the top 10 bioscience employers in the United States, with more than 57,000 people working in the industry. For each bioscience job, almost six additional jobs are created on average, according to a 2010 analysis by Battelle and BIO. Dollar for dollar, global health is one of Illinois’s best investments. Photo: Evelyn Hockstein/PATH Spending on global health R&D not only adds jobs to the market, it also directly contributes to state economic growth. In 2010, Illinois received more than $700 million from the National Institutes of Health (NIH), the world’s largest funder of global health research. Every $1 million that the NIH invests generates more than $2 million in new state business activity. Public-sector investment provides important economic incentives to stimulate private-sector investment. One private-sector partner doing notable work in global health is Abbott, an Illinois-based healthcare company. Abbott invested $4.1 billion in R&D in 2011 and generated $38.9 billion in revenue, a great boost to the state economy. Just last week, Abbott announced a new joint research agreement with the Drugs for Neglected Diseases initiative (DNDi), a product development partnership dedicated to developing new drugs for patients suffering from the most neglected tropical diseases. Abbott and DNDi will work together to discover and advance new antimicrobials that fight disease, leading to the end-goal of finding new treatments for several of the world’s most neglected diseases, including Chagas disease, helminth infections, leishmaniasis, and sleeping sickness. Dollar for dollar, global health is one of Illinois’s best investments. Illinoisans recognize its value: 92 percent of state residents believe it is important for Illinois to be a leader in health R&D. However, Illinois ranks only 8th in R&D investment and 13th in federal funding despite ranking 5th in the nation in population. Increased investment is needed to secure this economic pillar and produce further growth in one of Illinois’s most rewarding economic sectors.

On Monday, President Obama released his Administration’s much-anticipated FY 2013 budget request to mixed reviews. In his introduction to the overall budget request, Obama emphasized that research and development (R&D) programs are essential to the US economy and the country’s future. He even highlighted the work of the National Institutes for Health (NIH) and the Food and Drug Administration (FDA) in this area. When looking at the budget numbers for global health, Obama’s emphasis on R&D in his introduction played out in various ways, with some good and bad news. Overall, the President’s request was in line with the rumors that preceded its release. Global health numbers faced nearly across-the-board decreases when compared with FY 2012 levels, although the broader State and Foreign Operations account did receive an increase. Under the State and Foreign Operations account: The Global Fund To Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance received major increases. The President’s Emergency Plan for AIDS Relief (PEPFAR) saw funding cuts. Most global health line items in the budget for the US Agency for International Development (USAID)—aside from family planning and reproductive health—received reductions in funding, some by as much as 25 percent. These funding cuts could drastically affect USAID’s ability to support global health R&D projects. Global health R&D funding under the Department of Health and Human Services (HHS) account saw additional inconsistent results, with some good and bad news. The FDA received an $11 million increase. However, this increase relies on the collection of user fees, which has some constraints. Overall NIH funding remained at FY 2012 levels, with essential programs at National Institute of Allergy and Infectious Diseases and the Fogarty International Center receiving small, but welcome, increases. The Office of AIDS Research stayed the same as last year, as did the new National Center for Advancing Translational Science (NCATS). More flat-funding was seen at the Centers for Disease Control and Prevention (CDC). HIV and AIDS and polio stayed essentially the same as FY 2012, with malaria receiving a small increase. Otherwise, global health programs at CDC were requested at last year’s levels. Further drastic cuts at crucial Department of Defense research programs on malaria, HIV and AIDS, and neglected diseases add to the concerning budget slashing. It is important to note that the President’s Budget Request is not the last word on global health R&D funding. Congress has the authority to change the funding levels as it sees fit. However, it could be difficult to justify spending above what the Administration views as appropriate, especially given the current fiscal crisis and the shortened election-year appropriations process. Although some of the proposed reductions may appear to be minor, given the larger picture of the federal budget, they will certainly have serious effects on R&D projects—both for those now on the cusp of groundbreaking results, and for those in the future. The Administration has tried to soften the blow of these budget reductions by pointing out that cost-savings can be found in global health scientific advances like newer HIV drugs, inexpensive diagnostics, and streamlined vaccine delivery devices. It’s absolutely true that these new tools can save dollars while they save lives. The question is, if we cut US global health R&D funding now, will we have these urgently-needed advances to rely on five or ten years down the road? More information on the President’s budget request can be found at the following links: Kaiser Family Foundation Budget Tracker White House Office of Management and Budget Website and blog post