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Tens of billions of dollars for research and public health initiatives have hugely boosted efforts to tackle diseases affecting the world's poor in recent years. But, asks Jon Cohen in Science, what progress is being made — and are the goals even achievable?

Cohen reports that despite good intentions, the situation on the ground in developing countries can hamper progress. And the lack of coordination between initiatives encourages bureaucracy, wastes time, and leads to overlapping efforts.

The different parties involved often disagree about how funds should be divided. Some think priority should be given to costly, long-term research and development that might come to nothing. Others prefer to focus on more immediate public health interventions such as distributing existing drugs and vaccines, or bednets to protect against malaria.

And while funding for HIV/AIDS programmes in developing countries reached US$8 billion in 2005, spending on the next two biggest killers — malaria and tuberculosis — was only US$2 billion each.

Cohen notes the ongoing efforts to address some of these issues and improve coordination between organisations — but concludes that the challenge of battling infectious diseases in developing countries is as great as ever.

Link to full article in Science

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