Coalition: Emerging diseases dictate need for extended R&D resources

Issue: May 2016

WASHINGTON — A group of more than 25 nonprofit organizations is urging the United States to enhance its role as a global leader in research and development to battle emerging diseases, but also is seeking more international help.

Erin Will Morton

The Global Health Technologies Coalition (GHTC) unveiled its seventh annual policy report on Capitol Hill on April 19 calling for, among other things, Congress to appropriate more than $48 billion in public funding for various government health agencies engaged in global health research and development.

“We need sustained funding and sustained investment in global health R&D,” GHTC Director Erin Will Morton, MS, told Infectious Disease News. “When funding is stopped or stalled, the challenge that presents to researchers, to moving products forward through the pipeline, is unsustainable. On top of that, sustained funding will make us better prepared for those next threats we don’t know.”

Funding stagnant or declining

According to the GHTC, the U.S. contributes around 70% of worldwide public investment in global health R&D, 45% in private and philanthropic funding, and is the lead funder for 26 of the 30 most neglected diseases — contributions that are crucial to containing or preventing outbreaks. Besides an uptick in 2014 linked to the Ebola virus outbreak, however, U.S. funding for neglected disease research and development has either declined or remained stagnant since a peak in 2009, the group said.

S. Patrick Kachur

“Many children’s lives have been saved because of U.S. government investments,” S. Patrick Kachur, MD, MPH, FACPM, acting principal deputy director of the CDC’s Center for Global Health, said. “We’re at the point now where we need to be looking forward to the next breakthroughs.”

In addition to calling for robust funding for global health R&D, the GHTC urged Congress to establish a mechanism combining public funding with matching investments from the private and philanthropic sectors, and to create new incentives, or reform existing ones, to encourage private sector investment in research projects.

In essence, public funding is not enough, according to David Shoultz, PhD, MS, MBA, PATH’s global program leader, drug development and devices and tools.

“While it’s very important for the U.S. and other governments to maintain and not decrease their funding,” Shoultz said, “I think it’s also important to think about what incentive mechanisms we can set free, whether they are tax credits or other incentives, so that we can pull in new participants to the global health product development sector.”

The group urged government agencies to set percentages of their budgets that can be directed to research and development for global health. It said the Department of Health and Human Services, USAID and the Defense Department should prioritize programs that support local research and development capacity-building activities for low- and middle-income countries when allocating funds.

David Shoultz

Beyond funding, the group said Congress should establish a coordinated global health R&D strategy for the entire government, possibly led by a coordinator. It urged the Senate to introduce and pass companion legislation to the Global Health Innovation Act, a bipartisan bill passed by the House of Representatives in December, so that it can be signed into law.

The GHTC laid out several other goals to improve the involvement of U.S. agencies in research and development for global health, both at home and in coordination with other countries, and to streamline and strengthen regulatory pathways for products dealing with global health.

According to Jimmy Kolker, MPA, assistant secretary for global affairs at the HHS, the amount being spent to fight terrorism and global climate change far outstrips what is devoted to outbreaks and epidemics.

“From the health side, we want to be sure that people are putting this in that perspective and paying attention to the potential consequences of failing to deal with what will inevitably be outbreaks of global importance, even if we can’t predict when they will occur, or where or what our response needs to be,” Kolker said.

U.S. instrumental in fight

The worldwide success in battling infections such as measles, tetanus, rotavirus, AIDS and malaria happened because the U.S. government appropriated funds aimed at fighting those diseases, according to Peter J. Hotez, MD, PhD, dean of the National School of Tropical Medicine at Baylor College of Medicine, and science envoy for the State Department.

Peter J. Hotez

“The problem is we need to continue those appropriations for these programs,” Hotez said. “But we also desperately need some new tools and technologies to expand our efforts and finish the job. … It would have been nice to have an Ebola vaccine in 2012. The technology sat there for more than a decade because the model is broken.”

Currently, the White House is waiting for Congress to act on a request for more than $1.8 billion to fight the spread of Zika virus. In the meantime, it has diverted around $589 million from other areas of the administrative budget to fuel ongoing preventive efforts, including $510 million that had been set aside for the recent outbreak of Ebola virus. According to Kolker, the request for money to battle Zika was based on “very realistic scenarios.”

“But money isn’t the only thing that’s going to matter,” he said, bringing the conversation back to R&D. “We need lots of creative responses on other things.” – by Gerard Gallagher

Reference:

Global Health Technologies Coalition. Achieving a bold vision for global health: Policy solutions to advance global health R&D. http://www.ghtcoalition.org/pdf/Achieving-a-bold-vision-for-global-health-Policy-solutions-to-advance-global-health-R-D.pdf. Accessed April 20, 2016.

Disclosures: Morton is director of GHTC. Hotez, Kachur, Kolker and Shoultz report no relevant financial disclosures.