What is the future of funding into TB R&D?

RESULTS, vaccine, TB

By Shiva Shreshta, RESULTS Global Health Campaign Manager

In September 2018, the global tuberculosis (TB) movement had its most important political moment in recent history, when country leaders and Ministers addressed the first-ever United Nations High-Level Meeting (HLM) on tuberculosis (TB) in New York.

The meeting was a critical moment for TB more broadly, but also for TB research in particular—with the need for greater investment in TB Research and Development (R&D) standing out as one of the most prominent themes at the meeting. The Political Declaration commits to increasing overall global investments for TB R&D to US$2 billion annually.

Global survey on TB R&D

New findings recently released by the Treatment Action Group (TAG), an independent research and policy think-tank, have discovered that global funding for tuberculosis research and development (R&D) “has reached a new high of USD $767.8 million last year. This marks the second year in a row that funding for TB research has exceeded $700 million”. The global annual survey also revealed that the TB R&D has a funding gap of US $1.3 billion annually, as reported in their new brief, Funding for TB Research: Recent Momentum Must Inspire Bold Commitments

The key findings of the global survey are:

  • 66 percent ($510 million) of global TB funding in 2017 came from public sources
  • 19 per cent ($145 million) of global TB funding came from philanthropies
  • 11 per cent ($85 million) of global TB funding came from private industry, and
  • four per cent ($32 million) from multilateral entities.

Public funding showed the greatest growth over 2016 levels, with an increase of $27 million and demonstrates the role that public (government) funding has in meeting the funding gap in TB R&D. Such funding will help develop diagnostic tools, discover a new TB vaccine and produce newer drugs with shorter treatment plans.

The U.S. government remains by far the largest funder of TB research, having invested $312 million in 2017 through eight different agencies. This accounts for 40 per cent of global TB Research and Development funding and 62 per cent of all public funding—more than all other governments added together. Other major investors include the European Union ($37 million), the U.K ($36 million), Germany and Canada invested $19 million each, India ($17 million), South Korea ( $15 million) and Australia ($9.5 million).

Funding levels are low relative to the capacity of countries

But, according to the key findings of the report, “the spending on TB research relative to the capacity of states to invest in research and development is low. A country’s fair share of contribution is measured in percentage of ‘gross domestic expenditure on research and development’. Only three countries reported investing more than the target of 0.1% of ‘gross domestic expenditure on research and development’ on TB research in 2017. South Africa topped the list on this metric, exceeding its target by 83 per cent. The Philippines surpassed its target by 61 per cent and New Zealand by 14 per cent. Among countries that did not meet the 0.1% target, the United Kingdom came closest, investing 89 per cent of its target, followed by Canada with 73 pert cent and the United States with 70 per cent,” the report stated. Australia only invested 45 per cent (US $9.58 million) of its targeted amount US $21.2 million annually.

What next?

Its time to keep the promise. With the political momentum created by the UN High-Level Meeting and the focus on TB Research, the potential is now there for substantial funding increases this year and next.

Australia is well placed to meet these commitments. The avenue provided by the Medical Research Future Fund, (worth AU$ 20 billion when fully capitalised), can support Australian consortia to participate in and lead international research projects focusing on TB research.

Medical Research Future Funding can enable Australia to reap local, regional and global economic benefits and further raise Australia’s reputation as a health research powerhouse that ‘punches above its weight’.

The existing AU$300 million initiative Indo-Pacific Health Security Initiative managed by Department for Foreign Affairs and Trade (DFAT) provides the platform needed to make Australia a leader in TB research. While Australia already invests in Product Development Partnerships for TB drugs and diagnostic development, health systems research and multilateral funding to the Global Fund, there is room for more.

The TB vaccine development needs serious funding to develop a new vaccine and to scale the promising ones, like the GSK vaccine candidate from Aeras.

“There is a strong case for scaling up Australian support for global medical research: research leading to the development of new products, such as drugs, vaccines and diagnostic tests, to address health problems affecting people in the developing world,” reports Australian Funding of global medical research: how to scale up? by the Development Policy Centre at the Australian National University. 

At an Australian TB Caucus meeting last month, parliamentarians reviewed the UN High Level Meeting targets and discussed the need to advocate for Australia’s fair share contribution in TB R&D. In the past, the Caucus has successfully advocated for an increase Australia’s commitment to the Global Fund, the PDP funding on TB.

(Photo by Hyttalo Souza on Unsplash)