New report from the Global Forum for Health Research
Susan Jupp Ip-health
2006-05-05
Behind the Global Numbers: the Real Costs of Research for Health
GENEVA, April 2006-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, asserts Professor Stephen Matlin, Executive Director of the Geneva-based Global Forum for Health Research.
Despite
new knowledge and technologies that health research has created and which have
led to improvements in average life expectancy and health status over the past
century, there is still an enormous mismatch between how research resources are
used and the burden of diseases affecting less developed countries, he says. The
Global Forum's mandate is to highlight these and advocate for change.
Since its foundation in 1998, the Global Forum has been tracking flows of
funding for health research. The latest figures, published in 2004 but
based on 2001 data, gave an annual total of approximately US 106 billion.
Monitoring Financial Flows for Health Research: behind the global numbers, a new
study just published by the Global Forum, looks at some of the elements
making up that global total. Where exactly does the money come 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?
How to ensure that attention is paid to people in developing countries.
While data from the pharmaceutical industry itself maintain that, globally, it
makes the largest contribution of any sector to health R&D, amounting to
more than US 50 billion annually, little is known about the exact components of
this total - including how much is spent on basic research as opposed to applied
R&D for the later stages of drug development, testing, introduction and
monitoring.
Professor Donald Light of the
University
of
Medicine
and Dentistry of New Jersey provides a critical assessment of the real costs to
industry of the basic research it conducts. Light says that it is not the
pharmaceutical industry but "the public sector (which) is the largest
investor globally in basic research to discover important 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 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 US1 billion in
2005.
Light, who is a member of the Business Advisory Council of the Republican Party
and of the President's Business Commission, disputes these figures. In his
estimate, which takes tax savings into account: "One gets down to a net
average cost of R&D of about one-tenth the amount widely claimed."
Matlin says: "This is certainly a controversial paper and the potential for
dispute serves to highlight the fact that extremely little data are available to
the public. We welcome the reactions of other analysts and of industry itself.
The debate may encourage industry to develop more transparency about its funding
of research while preserving the confidentiality of commercially sensitive
information." If the pharmaceutical industry is not investing as much as
was thought or is needed, governments must take up this challenge, Matlin
comments. Even middle- and low-income countries need to spend more on research
for health but it is hard to track this because of poor statistical systems an
d lack of a globally recognized set of definitions of 'health research'.
During the last decade, there has been an explosive growth in the number of
public-private partnerships (PPPs) in the health field, some of which are
engaged in the development of new drugs for neglected diseases. This changing
landscape is surveyed by Mary Moran of the Pharmaceutical R&D Policy Project
now housed at the George Institute at the University of
Sydney, Australia. In this report, she highlights the considerable
progress that the PPPs have already achieved in creating a steady pipeline of
potential new drugs moving into clinical trials. If the pipeline is not to run
dry soon, governments must play a more direct role in the financing of key PPPs
if they are to complete clinical trials with their candidate drugs.
Other
chapters of the report look at funding for HIV/AIDS and malaria which are among
the leading causes of death in many developing countries,
especially in sub-Saharan
Africa
but increasingly in other regions as well. The two diseases are given specific
attention in the Millennium Development Goals, but 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 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 head of the Global Forum expressed the 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."
Later in the year the Global Forum for Health Research expects to publish an
update on global spending on health research. It seems likely to exceed the US
106 billion spent in 2001.
Meanwhile,
IMS Health, the world's leading provider of market intelligence to the
pharmaceutical and healthcare industries, announced in early April (2006) that
world sales of drugs rose to over US 600 billion in 2005, up 7% from 2004.
The full Monitoring Financial Flows for Health Research report and all Global
Forum publications can be downloaded free of charge at www.globalforumhealth.org.
Susan Jupp, Head, Communications and Information, Global Forum for Health
Research
www.globalforumhealth.org
Tel
+ 41 22 791 3450
Fax +
41 22 791 4394
Forum
10,
Cairo
29 October - 2 November 2006
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