[LONDON] Global efforts to reform product development for neglected diseases are failing, a launch of a five-year review of funding of research and development for these diseases, heard today.
The report shows that overall funding has stagnated since 2007, at a time when increases are needed, the launch heard. In addition, a recent trend of higher industry funding for commercially viable diseases may lead to a two-tier, two-speed system, in which products for some diseases get left behind, according to Mary Moran, director of the Policy Cures think-tank and the report's lead author.
She presented findings showing that, while up to 70 per cent of global R&D funding for 'semi-commercial' diseases such as dengue and tuberculosis goes towards product development, only 45 per cent of such funding for diseases reliant on public funding goes on product development.
"Public funding continues to shift away from product development," she said, adding that there has been a disconnect between where such funding goes and actual need.
And some disease may be left behind: leprosy, trachoma, Buruli ulcer and rheumatic fever received less than US$10 million of R&D funding for each year between 2007 and 2011. Collectively, this accounts for less than one per cent of global funding on R&D for neglected diseases, according to the report, the fifth 'Global Funding of Innovation for Neglected Diseases' (G-FINDER).
Nevertheless, Moran tells SciDev.Net that the "funders are paying a lot more attention to diseases beyond HIV, TB and malaria, with the other neglected diseases seeing much better funding and funding share as a group over the past five years".
But she adds: "We're starting to hear alarm bells about how public funding is being invested, especially post-2008. The five-year funding trends show that public funding is increasingly moving away from product development and towards traditional, basic research … with shifts now in the hundreds of millions of dollars."
At around US$3 billion in 2011, global R&D funding for neglected diseases is now around US$440 million higher than it was in 2007, but lower than it was in 2009, and similar to that in 2010.
Bernard Pécoul, executive director of the Drugs for Neglected Diseases Initiative, said: "I am concerned about this stabilisation [of funding] because it's at a time when we need more money, more investment.
"A very critical part of the development of [a future drugs] portfolio is now, because we start with new candidates in preclinical or clinical development, and we know that the most costly part of development is when you enter large clinical studies," he added.
But while rising industry investment in diseases such as dengue and TB demonstrate that "things are improving for those diseases" thanks to a market-demand model, the framework for R&D for diseases with no market demand "has not changed", he said.
"We have failed, for the time being, to change, fundamentally, the environment to stimulate research and development," he concluded.
The report also shows that developing or emerging countries contributed almost four per cent of public funding for neglected disease R&D funding in 2011. The vast majority of these funds came from Brazil, India and South Africa and were mainly focused on HIV/AIDS, TB, diarrhoeal diseases and malaria.
But there were calls at the launch for emerging economies to invest more, as well as for reports such as the G-FINDER to highlight the investment that countries such as Ghana and Tanzania are beginning to make.
Emerging economies such as Argentina, Brazil, China and India "have lots of reasons to invest in this field: they have both the technical capacities and the needs", Pécoul said, and we "should expect more investment" from them.
Joe Cerrell, director of the Europe Office for the Bill & Melinda Gates Foundation, said he is working with a team to bring in funders from Gulf countries to help finance neglected disease R&D.
Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, United States, and co-editor-in-chief of PLoS Neglected Tropical Diseases, says: "As in past years, this year's report highlights our heavy reliance on the US government, less than a handful of European governments and two major philanthropies — the Bill & Melinda Gates Foundation and the Wellcome Trust — for just about all the global R&D funding for neglected diseases.
"It's a wake-up call that we need to engage new actors, including some new foundations, and we need to encourage some of the emerging market economies to become more involved," he adds.
The biggest losers in terms of global funding remain the helminth (parasitic worm) infections, Hotez says, adding that these are the most common infections of humans.