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Progress on some important neglected diseases could founder during the global financial crisis because it is reliant on too few funders, a major new study has found.

Researchers from the Australia-based George Institute for International Health, who launched their analysis of research into 30 neglected diseases this week (4 February), said they feared the lack of diversity of funding for some diseases could be an Achilles' heel in the financial crisis.

"This 'eggs in one basket' approach to funding is a little bit scary," said Mary Moran, director of health policy at the George Institute and the lead author of the report, at a launch meeting.

For example, nearly 90 per cent of funding for the blinding bacterial eye infection trachoma comes from the Wellcome Trust and research into the debilitating Buruli ulcer relies on just three donors.

"Where you do rely on one, or two or three donors clearly it's much more risky than something like HIV/AIDS where pretty well everyone in the world provides some funding."

Moran told SciDev.Net that she was aware of governments within the top 12 public funders of neglected diseases research that were planning to cut their funding in 2009.

The issue emerged as a part of the 'Global Funding for Innovation in Neglected Diseases: G-FINDER' study, which calculated the total investment in 2007 for research and development (R&D) in 30 neglected diseases — diseases that most affect developing countries. The work is the first of five annual assessments to track investment in the field.

The authors found that much of the US$2.5 billion invested in that year came from just two funding sources, with the US National Institutes of Health and the Bill and Melinda Gates Foundation accounting for 60 per cent of overall funding.

And 80 per cent of total investment was targeted to HIV/AIDS, tuberculosis and malaria, with some diseases, such as Buruli ulcer, receiving just 0.1 per cent of funds.

The authors also found that investment tends to be skewed towards certain products. Drugs and vaccines are prioritised over diagnostics for example, while 'platform technologies' such as new methods for delivering vaccines — which don't tend to be disease specific — receive only 0.4 per cent of the pie.

Commentators praised Moran's report, the results of which were discussed in a PLoS Medicine article published yesterday (4 February).

"Now we know how much is being spent by whom and on what. It's a major accomplishment. It informs a policy debate that has been lacking in data," said Guy Willis, director of communications at the International Federation of Pharmaceutical Manufacturers.

But others stressed that while it is a great starting point, more information is needed about actual funding needs.

Tido von Schoen-Angerer, director of the Médecins Sans Frontières Campaign for Access to Essential Medicines said further work is required to estimate the total amount of necessary investment and define funding priorities. He added that 'pull' mechanisms like prize funds should be explored to encourage investment into neglected disease R&D.

Link to full article in PLoS Medicine

Link to full report on George Institute website[2.16MB]