Is funding into Neglected Diseases being misdirected?

Yesterday I attended the launch of the third G-FINDER report on Global Funding of Research and Development into Neglected Diseases. The report, produced by Policy Cures, headed by Mary Moran, takes a wide view of what is a neglected disease, including as it does HIV and TB in the developing world, as well as diseases such as leprosy.

The findings, from 218 funders, from 2009, are intriguing, coming as they do at the beginning of the global financial crisis. Perhaps unexpectedly the report sees a shift from philanthropic funding to public funding (though as pointed out by Joe Cerrell from the Gates Foundation at the launch this may have been an effect of some unusually large outlays in 2008). The effect of more public funding is important as public funders traditionally fund more basic research and less product development – and as the report argues overall this may be problematic since for a number of these diseases  basic research is not the bottleneck: many of these diseases are well understood – what’s needed is products targeted to these populations.

As the report also points out however the magnitude of funding does not necessarily have to correlate with disease burden. For some diseases what is really needed is quite a small amount of money, appropriately targeted.

For example – “investment of a few million dollars to create a successful diagnostic may be all that is needed to dramatically improve patient outcomes.”  That this is not happening is often a reflection of a lack of strategic oversight of required funding. This is coupled with lack of coordination between funders. As the authors say “ This is particularly the case for the most neglected diseases, which are seeing a highly scattered approach with multiple small funders disbursing grants that, although considerable for them, are not appropriately sized or targeted to the products needed for that disease (such as for leprosy, rheumatic fever and Buruli ulcer) – although collectively they could have a significant impact.”

And of course there is the even bigger issue of what investment is needed into implementation and health systems in order to finally get the products to the communities that need them;  this is outside of the scope of this report, though clearly important.