[Unknown type: UNSPECIFIED]
Abstract
Background: Each year, billions of dollars are spent globally on infectious disease research and development (R&D). However, there is little systematic tracking of global R&D.
Methods: The study examined research awards made between 2000 and 2017 for infectious disease research from G20-based public and philanthropic funders. Research databases were searched using a range of keywords, and open data was extracted from funder websites. Awards were categorised by type of science, specialty, and disease/pathogen. Data collected included study title, abstract, award amount, funder, and year. Descriptive statistics and regression analyses were used to investigate the relationship between research investment and disease burden, using Global Burden of Disease 2017 study data.
Findings: There was $104.9 billion (b) investment across 94 074 awards (annual range $4.1 to $8.4b). Pre-clinical research received $61.1b (58.2%) and public health research $29.5b (28.1%). HIV/AIDS received $42.1b (40.1%), tuberculosis $7.0b (6.7%), malaria $5.6b (5.3%) and pneumonia $3.5b (3.3%). Funding for Ebola ($1.2b), Zika ($0.3b), influenza ($4.4b) and coronavirus ($0.5b) was typically highest soon after a high-profile outbreak. There was a general increase in year-on-year investment between 2000 and 2006, with decline between 2007 and 2017. Funders based in the United States of America provided $81.6b (77.8%). On the basis of funding per 2017 disability-adjusted life years (DALYs), HIV/AIDS received greatest relative investment ($772/DALY), compared with tuberculosis ($156/DALY), malaria ($125/DALY), and pneumonia ($33/DALY). Syphilis and scabies received the least relative investment ($9/DALY). There was a weak positive relationship (Spearman’s correlation coefficient [r] 0.30) between investment and 2017 disease burden.
Interpretation: HIV research received highest amount of investment relative to DALY burden. Scabies and syphilis received lowest relative funding. Investments for high-threat pathogens (e.g. Ebola, Coronavirus) were often reactive, following outbreaks. There was little evidence that funding is guided by global burden or pandemic risk. The study findings show how research investments are allocated currently and how these relate to disease burden and to conditions with pandemic potential.
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