GHTC Report Urges Congress to Increase Funding for Global Research and Development

The US government must allocate additional resources toward global research and development (R&D) efforts working toward solutions for historically “neglected” diseases such as malaria, tuberculosis, and HIV/AIDS in order to meet the challenges posed by them, a new report has concluded.

The Global Health Technologies Coalition (GHTC), an advocacy group of more than 25 non-profit organizations involved in healthcare formed under the auspices of the Program for Appropriate Technology in Health (PATH) in Washington, DC, issued its seventh annual report—which, this year is entitled “Achieving a bold vision for global health: Policy solutions to advance global health R&D”—in April, and its assessment of the current landscape is blunt: “US government year-over-year spending on neglected disease R&D has been largely stagnant or declining since peaking in 2009… Public funding of global health R&D is critical because neglected diseases and other global health conditions offer limited commercial incentives for the private sector. Cuts in US investment can interrupt research programs and delay the development of urgently needed health technologies, creating a negative ripple effect at a time when we need to mobilize greater multisector and international investment in R&D to advance the next generation of health technologies to reach development objectives.”

To date, the report has received a fair bit of attention in the mainstream press, with coverage from the likes of CNN and Telemundo, among others. Erin Will Morton, GHTC director and a senior policy and advocacy adviser with PATH, believes this is because crises concerning diseases such as Ebola and Zika have highlighted the importance of fast-tracking R&D efforts toward solutions.

“This is my second year involved with this report,” she told Contagion. “We received a lot of coverage for the report last year, which came out right after the Ebola scare, and this year Zika has been in the news. In general, in part because of these issues, we are seeing greater attention being paid to research and development, and rightly so, as we seek to find solutions to these challenges.”

In spite of the report’s somewhat gloomy outlook, GHTC does emphasize that the US remains the lead funder of neglected disease R&D globally, contributing around 70 percent of public investment and 45 percent of total investment, including private funding; at present, the country is the lead funder of R&D for 26 of the 30 most neglected diseases. Still, since leading efforts to virtually double funding for global health R&D between 2000 and 2010, US investments in neglected disease R&D (excluding Ebola) in 2014 actually fell 2 percent from 2013 and nearly 13 percent from their 2009 peak.

To reverse this trend, the report offers three recommendations to federal officials—both in the White House and on Capitol Hill. First, GHTC urges Congress to “sustain robust funding” for health initiatives in the 2017 budget, and provides suggested funding levels—totaling nearly $50 billion—for neglected disease-related R&D efforts at USAID, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the Department of Defense. In addition, it asks Congress to investigate the feasibility of “public-private” funding partnerships for global R&D. As part of this effort, GHTC advises the federal government to establish a “grant-making foundation” (i.e., the National Endowment for Democracy) that would “leverage US government investment in the fund by requiring [that] it be matched at least dollar-for-dollar with private and philanthropic funding.”

Second, the report urges legislators to foster enhanced cooperation and coordination across US agencies involved in the R&D process to streamline the development of drugs, vaccines and other resources. It pushes for a “national R&D strategy” designed to coordinate this unified effort.

Finally, the GHTC report pushes for regulatory reform that will, ideally, allow new drugs and devices to get to the physicians—and patients—who need them faster. Infectious disease specialists at the frontlines of public health emergencies have, over the years, lobbied for an accelerated approval process within the Food and Drug Administration for special circumstances. GHTC would like to see this taken one step further to address challenges facing countries and/or regions where regulatory structures are already insufficient for addressing the needs for new, approved drugs, vaccines, and devices during emergencies. It asks Congress to direct the FDA to establish a protocol for offering scientific opinion on medical drugs/devices intended for countries outside the US, thereby providing them with reliable scientific guidance.

“We believe strongly that all of these recommendations must be implemented in order to best position the US and the global community to meet the current health challenges,” Morton said. “This is an election year, which makes it a perfect time to put policy front and center and initiate real reform.”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.