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This post, written by John Donnelly, originally appeared in the GlobalPost. Donnelly is a Washington, DC based writer. For those in the global health world—and there are many in the nation’s capital—one common question is why in tight budgetary times should Congress support spending on research and development (R&D) to fight diseases around the world. At a congressional briefing today put on by the Global Health Technologies Coalition (GHTC), a group that represents 40 global health research and advocacy organizations, several experts gave a variety of answers to that question. Katherine “Kemy” Monahan, deputy executive director of the Obama administration’s Global Health Initiative, said, “These global health programs are literally saving lives, and not just a few lives, lots of lives … We are [also] protecting Americans at home and traveling abroad from infectious diseases.” Col. Peter J. Weina, deputy commander of Walter Reed Army Institute of Research, said, “We protect soldiers’ lives … Infectious diseases have ravaged military forces operating worldwide. … It also ravages populations we’ve worked with.” From 2003 to 2008, for instance, US troops in Iraq and Afghanistan had roughly 2,000 confirmed cases of leishmaniasis, a disease transmitted by the bite of a tiny sandfly. The disease causes a broad range of outcomes, some of them fatal. Then US Sen. John Boozman, a Republican from Arkansas, took the microphone from the back of the Kennedy Caucus Room at the Russell Senate Office Building, and gave his case for ongoing global health research. “It’s achievable stuff,” he said. “It represents real calamity. These are difficult problems, but they are very, very solvable. … You have a lot of support on Capitol Hill. We can be very, very proud of what has been accomplished so far.” A GHTC analysis of the Obama administration’s global health budget found a large number of decreases in funding compared to the previous year’s budget. Funding cuts were most glaring in the President’s Emergency Plan for AIDS Relief (PEPFAR), neglected tropical disease programs, and several other programs at the US Agency for International Development (USAID). But the budget also included increases to The Global Fund to Fight AIDS, Tuberculosis, and Malaria and the GAVI Alliance. The National Institutes of Health and the Centers for Disease Control and Prevention (CDC) were funded at the same level. “It’s a time of fiscal austerity,” Kevin De Cock, the director of CDC’s Center for Global Health, said in an interview after the briefing. “The cuts for global health programs might have been less than many people feared. There’s a need now for everyone in government to strive for greater efficiency and to find savings wherever they can in their budgets.” Karen A. Goraleski, the executive director of the American Society of Tropical Medicine and Hygiene who was the moderator at the event, said global health R&D also has economic benefits at home, including the creation of thousands of jobs. “It’s fueling our economy,” she said. For Marc LaForce, director of the Meningitis Vaccine Project, the importance of research could be seen in the story of the fight against meningitis. He said last year’s results were enough to show how US research can have a major impact in saving lives. In West Africa, the often-fatal disease has been so prevalent that the area is referred to by the name of the disease. It’s the Meningitis Belt. His project, a partnership between the World Health Organization and PATH, which included earlier research done by the Walter Reed Army Institute of Research, produced a vaccine that cost less than 50 cents a dose. It was administered to 19 million people last fall in three West African countries. Usually, the countries report thousands of cases of meningitis. Last year, the countries reported fewer than a dozen—all from children who were not vaccinated. “The coverage rates with the vaccine have been extremely good,” LaForce said. “We are probably at the beginning of the end. With sufficient funding, this epidemic is likely to be pretty much over in the next 10 years.”

Kim Lufkin, GHTC’s communications officer, writes about the coalition’s upcoming third annual policy report. The report will be launched today at a Capitol Hill briefing. Today, the GHTC will release our third annual policy report. This year’s report will continue the tradition for which we’ve become known in the world of global health research and product development—releasing recommendations for how US policymakers can continue to advance innovation and save lives around the world. The recommendations are backed by the collective voice of our strong membership of nearly 40 nonprofit groups working to advance new vaccines, drugs, diagnostics, and other products that change the course of global public health. GHTC releases policy report to provide recommendations for sustaining progress in global health research When I began the process of writing the report back in December, I initially struggled with how to make this year’s report unique. I soon realized that I didn’t need to worry on this front, as there have been several exciting research breakthroughs—such as new results from the RTS,S malaria vaccine trials and using HIV treatment as prevention—in the past year. The past 12 months have also seen some notable achievements in the realm of US policies for global health innovation. The report celebrates these successes, and urges US policymakers to maintain this recent momentum: "In recent years, the global public health landscape has seen incredible progress. Scientific leadership and a commitment to research have led to the development of game-changing innovations—including new vaccines, drugs, and diagnostic products—that are transforming global public health. Other groundbreaking health tools are closer than ever before, like the first-ever malaria vaccine,new HIV prevention options,desperately needed tuberculosis (TB) therapies,and drugs to treat neglected tropical diseases (NTDs) that affect the poorest of the poor. … US investments in global health research can produce real results, and the nation must persist in our efforts to develop the next generation of lifesaving health products.” On a more somber note, the report recognizes that the United States is facing severe economic constraints. The tight budgetary times have already impacted programs and funding for global health and research: “Today’s budget constraints mean that even the most essential programs are at risk, and over the past year, Congress has reduced funding for foreign affairs and international aid programming. Amidst these drastic cuts to broader international aid efforts, some global health and R&D [research and development] programs have seen slight increases or flat funding levels. However, these increases are not enough to make up for the huge disparity in current funding levels for global health R&D and what is actually needed to fully fund these lifesaving efforts. While support for some global health and R&D programs has modestly increased or remained flat-funded, support for other global health R&D programs—including funding for some key product development partnerships—has been severely cut.” It would be an incredible loss if widespread cuts in global health and research were to take place just as science is on the cusp of remarkable breakthroughs for new products. By following the recommendations in the GHTC’s third annual policy report, US policymakers can help take the next generation of lifesaving global health products over the research finish line. Even in this constrained fiscal environment, US leaders cannot lose sight of the end goal—saving lives worldwide. You can read the online version of the GHTC’s third annual policy report on our website.

The prospect of deep cuts in the federal budget threatens to reverse the dramatic progress of a bipartisan US commitment to defeat neglected diseases in developing countries, according to a new report released today by the Global Health Technologies Coalition (GHTC). Federal investments in global health research and development (R&D) programs that span multiple agencies have helped nurture an array of new vaccines, medicines, diagnostics, and other health products needed to combat diseases like HIV/AIDS, malaria, tuberculosis (TB), and childhood killers like pneumonia and diarrheal diseases. Despite these advances, President Obama's budget request for 2013 calls for several decreases for global health when compared with last year's levels. Several global health R&D programs at US agencies also saw drastic funding cuts. There are widespread concerns that cuts to global health R&D programs, which support critical efforts to develop the next generation of lifesaving health products, could grow even larger, given the pressure to reduce the US budget deficit. "[T]he budget climate in the United States continues to be severe, and US policymakers are beginning to implement austerity measures that could impact funding for global health R&D," the GHTC report stated. "Indeed, the continuing fiscal situation undoubtedly puts these programs at risk in the future, when global health R&D programs could see even more severe funding cuts than have already occurred." According to the GHTC report, global health R&D projects are among the best investments US policymakers can make, which would make funding cuts even more devastating. Last year alone produced multiple research breakthroughs, including results from a trial showing that early antiretroviral treatment can prevent HIV transmission to uninfected partners and results from a Phase III malaria vaccine trial showing that the vaccine candidate known as RTS,S can provide young African children with significant protection against clinical and severe malaria. "It would be ironic if widespread and unprecedented cuts in global health R&D were to take place just as past investments begin to bear fruit," said Kaitlin Christenson, MPH, GHTC's director. "US commitment was instrumental in eradicating smallpox and conquering polio and is now helping achieve unprecedented reductions in deaths from malaria and diarrheal diseases. Equally dramatic breakthroughs can be expected for a variety of other diseases if we continue to invest in research for new lifesaving health products." GHTC, which represents 40 nonprofit organizations focused on developing new vaccines, drugs, and other disease-fighting tools for the developing world, warns that the future could look far different from the progress being made today. Its report, Sustaining Progress: Creating US policies to spur global health innovation, found that while the US commitment to global health R&D has bridged deep political divides in Congress and garnered particularly strong support from the last two presidential administrations, it is now confronting a major test. The report notes that in the 2012 budget process, some individual global health R&D programs experienced reductions, alongside cuts to what are known as product development partnerships (PDPs)--relatively new and innovative types of public-private partnerships focused on developing drugs, vaccines, diagnostics, and other products specifically for patients in low-income countries. In addition, the report found that overall investments in global health R&D remained far short of what is actually needed. Global health R&D is spread throughout the US government and includes research and product development efforts supported through a variety of programs at the US Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Defense (DoD), and the US Agency for International Development (USAID). The GHTC report points out that the US is not alone in trying to balance the need to address fiscal constraints with maintaining a commitment to reducing global health disparities. The report cites the recent "Global Funding of Innovation for Neglected Diseases" survey, which found that in 2010, investments in R&D from all sources worldwide, public and private, fell by 3.5 percent. Public sector investments declined the most, dropping by 6 percent. According to the GHTC report, "The rest of the world is struggling with the same global financial crisis that is challenging the United States." Further, "other major donors could be inclined to maintain their commitments if the United States persists." GHTC also recommends an increased emphasis on health-related R&D in major international development programs, such as the President's Emergency Plan for AIDS Relief (PEPFAR). According to the report, "US investments in global health research can produce real results, and the nation must persist in our efforts to develop the next generation of lifesaving health products. US leaders have the opportunity to seize on this bipartisan legacy and recent scientific advancements and stay focused on the end goal--saving lives around the world. The United States cannot give up now."