Strengthening the United States Government’s Role in Product Development for Global Health

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Despite recent progress in global health, poor populations in low-and middle-income countries (LMICs) continue to be disabled or die disproportionately from neglected diseases and conditions of poverty. While some of this burden of disability and death could be averted by improving the delivery of existing health tools, new technologies to address unmet need are also urgently needed.

A major barrier to investing in the research and development (R&D) of new products for diseases of poverty is the lack of sufficient incentives. The time, cost, technical challenges, and risk of failure during product development create a formidable disincentive to product developers. Furthermore, existing technologies may not account for contextual factors in LMICs that may hinder the uptake and use of these innovations. As a result, research on the regulatory approvals of new drugs and vaccines since 1975 has shown that few of these new products are for neglected diseases and conditions of poverty.

The United States government (USG) is the world’s largest funder of product development for global health, but as we show in this report, its funding for such research and development (R&D) is in decline. The report aims to identify opportunities to strengthen USG’s role in supporting global health product development. It does so by examining the landscape of USG funding for such global health R&D; describing catalysts and barriers to increasing USG funding and coordination of global health R&D; providing perspectives from both USG and private actors (e.g., industry and foundations); and proposing initial ideas for reform. We use the term “global health R&D” to refer to product development for new medicines, vaccines, diagnostics, and other health technologies to tackle a specific list of poverty-related and neglected diseases and conditions (adapted from the G-FINDER surveys produced by Policy Cures Research).

We based our study on a desk review and 36 key informant interviews with senior representatives from government and private sector (for-profit and non-profit) organizations.