The GFC and global health: why Australia needs to step up to the plate

The global financial crisis has hit promising work tackling the neglected diseases that affect the world’s poor, according to a new report.

Australia could be doing more to assist, argues Mary Moran, Executive Director of Policy Cures, a not-for-profit which provides analysis and decision-making tools for those involved in creating new pharmaceuticals for neglected diseases.

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So many reasons Australia should be doing more on the world’s neglected diseases

Mary Moran writes:

There’s been no shortage of news about the ‘neglected diseases’ of poverty lately – diseases like HIV, tuberculosis, malaria and sleeping sickness. Some of it – like the finding that early treatment of HIV dramatically cuts transmission rates, or that the world is soon likely to have its first-ever vaccine against malaria – has been good.

More recently, the news that the Global Fund to Fight AIDS, Tuberculosis and Malaria has been forced to cancel its next funding round has sent shockwaves through the global health community.

Now a new report suggests that the last decade of progress in developing new tools for these diseases may also be under threat. The 2011 G-FINDER report, in its fourth year of publication, is produced by the independent, Sydney-based research group Policy Cures and funded by the Bill & Melinda Gates Foundation.

This year the impact of the global financial crisis became evident for the first time, with a fresh round of funding cuts from most rich nations threatening the development of a new generation of lifesaving medicines and vaccines just as they are on the verge of reaching patients in the developing world.

In 2010, funding for new neglected disease products fell by 4% to US$3.06 billion, and public funding from the world’s richest nations fell by US$125 million (down 6%). If it hadn’t been for a substantial (US$107 million) increase in investment from multinational pharmaceutical companies, the impact would have been far worse.

Diseases that rely heavily on public funding were hardest hit, with a US$70 million cut in HIV R&D funding alone. Also bearing the brunt were Product Development Partnerships (PDPs), who account for some of the most advanced products in development but have seen their funding cut by nearly US$100 million in the past two years.

So what does all of this mean?

The neglected diseases are desperately in need of new tools, whether it be new drugs, an effective vaccine or cheap and accurate diagnostics.  But innovation comes at a cost. And – because these diseases overwhelmingly affect the poor – there has traditionally been no-one to foot the bill. Without a market to drive R&D, many neglected diseases saw no new products registered for over 30 years.

Within the last decade though, growing awareness and the concerted efforts of funders, researchers and product developers have delivered a neglected disease product pipeline larger than ever before:  we’ve seen a new meningitis vaccine that cancelled this year’s meningitis epidemic in several African countries, a new test that can diagnose drug-resistant TB in two hours instead of six weeks, and the world’s first malaria medicine for children, who account for 85% of all malaria deaths in Africa.

Many more new products are now nearing the end of the development process and nearly ready to benefit patients – including a much more effective TB vaccine, a new malaria vaccine and easier to use, more effective drugs for TB, malaria and sleeping sickness.

But in order to keep the product pipeline moving and to get these new products over the line, we must have continued funding; a drop in funding now risks blowing the gains of the last decade out of the water.

Australia gave $25 million to neglected disease R&D in 2010 – just over 1% of total global funding. Along with the UK, it was one of the few countries to increase investment in the wake of the global financial crisis (up $3 million, or 14%).

However, this contribution is still relatively low compared to many countries, and Australia spends less on making new products (as opposed to basic academic research) than any other OECD funder.

Australia has good reasons to step up to the plate. Australia directly feels the impact of malaria, HIV, dengue and rheumatic fever through its regional military and business presence (particularly mining), proximity to South-East Asia and Indigenous health issues. Papua New Guinea, Australia’s second-largest aid recipient, is in the midst of a tuberculosis epidemic, as well as being home to 99% of all HIV cases in the Pacific. Sixty percent of the population in South-East Asia is at risk of malaria, and its incidence in the Solomon Islands and Vanuatu is among the highest in the world outside of Africa.

The good news is that the Australian government has committed to doubling its aid budget over the over the next 5 years, and the recent Independent Review of Aid Effectiveness suggested this increase should include investment into R&D for neglected disease.

Coupled with a strong and thriving research community, the commitment to increasing aid funding means Australia can play a lead role in this field.

And with serious doubt over the willingness and capacity of many other countries to maintain their investment in neglected disease R&D, this role is likely to be doubly crucial in the next few years as products in development near completion.  Let’s see the good news on combating neglected disease continue.

• Mary Moran is the Executive Director of Policy Cures, an independent, not-for-profit group providing analysis and decision-making tools for those involved in creating new pharmaceuticals for neglected diseases