US$106 billion is spent annually on research for health. It seems like a colossal amount, however what is really interesting is where this money is spent. Despite new technologies and knowledge which offer the potential to vastly improve health and life expectancy worldwide, only 10% of global health research is devoted to conditions that account for 90% of the global disease burden. (read more about the 10/90 gap)

Professor Stephen Matlin, Executive Director of the Geneva-based Global Forum for Health Research says, “The rich and the privileged enjoy much better health and live much longer than their poorer neighbours, especially those discriminated against because of their caste, class, ethnicity, race or religion,” The Global Forum for Health Research aims to highlight these discrepancies and bring about change.

Their new report, Monitoring Financial Flows for Health Research: behind the global numbers, looks at exactly where this $106 billion comes from:

• Public or private sector in low-, middle- and high-income
  countries?
• How much does each source provide, where does the money go and how well are the allocations aligned with health research priorities at global and local levels?

Are we getting our priorities right? Cureable communicable diseases like TB and malaria are still the biggest killers worldwide and resistance to old treatments is increasing, while only 10% of resources are invested in research for new treatment.

The pharmaceutical industry itself maintain that it makes the largest contribution of any sector to health R&D, more than US $50 billion annually. They have in the past justified their high prices for essential medicines, as developing new drugs is so expensive. The pharmaceutical industry estimates that it cost an average US $802 million in 2000 to create a new drug and bring it to market, and about US$1 billion in 2005.

$US 106 billion spent on drug research each year - where are all the medicines?

Professor Donald Light of the University of Medicine and Dentistry of New Jersey says that it is not the pharmaceutical industry but “the public sector (which) is the largest investor in the work for new drugs and vaccines.

“Governments and the public contribute 84.2% of the world’s basic research budget for health, industry contributes 12%, and private non-profit sources (such as the Gates and Rockefeller Foundations) 3.8% …

“That the public finances most basic research can be regarded as no news at all. But for less seasoned readers and policy-makers who believe the industry’s emphasis on their dominant role in research is to discover new drugs, it is news.”

The costs given by the drug companies, says Light, under closer scrutiny do not add up. Taking into account tax savings, he says, “One gets down to a net average cost of R&D of about one-tenth the amount widely claimed.”

The report looks also at the roles of PPPs (public private partnerships) such as the high profile 3x5 Initiative and Roll Back Malaria. Malaria and HIV/AIDS are given specific attention in the Millennium Development Goals, but, the report says, there is little evidence that at present rates the goals will be met with both the 3x5 Initiative and the Roll Back Malaria campaign failing to meet their targets so far.

“For both diseases the tools available are limited and increasingly the available drugs are being compromised by problems of resistance. New knowledge and technologies (drugs, vaccines, diagnostics and, in the case of HIV/AIDS, microbicides) are required,” says Matlin, a former university professor of biological chemistry.

More focus on basic preventive interventions rather than expensive medicines is needed

“More research is necessary on upstream interventions needed to keep people healthy and prevent infection in the first place. Downstream interventions aimed at treatment are much more costly, and with increasing rates of infection, they represent a potentially bottomless pit for funding. We also need information on how funding resources are being spent to discover these new technologies.”

The Global Forum hope that “the provocative opinions in this report will stimulate more debate and more action that will lead ultimately to greater resources for health research to focus on neglected diseases. For millions of people whose deaths and burden of ill health are avoidable every year, this is the bottom line that counts.”

Read the report

Contributions include:
Chapter 1: Building robust, sustainable systems of data collec-
tion, by Mary Anne Burke and Andrés de Francisco

Chapter 2: Drug R&D for neglected diseases by public-private
partnerships, by Mary Moran and Javier Guzman

Chapter 3: Basic research funds to discover important new drugs,
by Donald Light

Chapter 4: Brazilian health technology and innovation, by Re-
inaldo Guimaraes, José da Rocha Carvalheiro amd Wim Degrave

Chapter 5: Malaria research and development, by Malaria R&D Al-
liance

Chapter 6: Resource flows for HIV vaccines and microbicides, by
HIV Vaccines and Microbicides Resource Tracking Working Group

More information (press release, press statement by Stephen Mat-
lin) and pdfs are available online at:
http://www.globalforumhealth.org

Hard copies are available from the secretariat.
Contact: info@globalforumhealth.org.

2006. 90 pages. ISBN 2-940286-39-6