Sleeping sickness is one of the neglected diseases that had a new treatment approved in 2018.Credit: Dieter Telemans/Panos

Research funding for diseases that predominantly affect people living in poverty hit a record high in 2017, according to a report released on 23 January by Policy Cures Research, a global-health think tank in Sydney, Australia.

At US$3.6 billion, investments into ‘neglected’ diseases were higher than in any year since 2007 (See ‘Neglected no more?’). A surge from 2016 to 2017 included a rise in funding to fight neglected diseases generally, as opposed to targeting individual maladies.

Source: G-FINDER/Policy Cures Research

Anna Doubell, director of research at Policy Cures Research, says that the launch of several trials testing new Ebola drugs, diagnostics and vaccines in response to the Ebola crisis in West Africa between 2014 and 2016 might be giving donors hope that investments into neglected diseases pay off. “The amount of progress made in a short period of time after the Ebola outbreak might have brought in optimism about what is possible,” Doubell says.

Still, the authors of the report, called the G-FINDER survey, say that total funding falls short of the desired $8 billion — an estimated annual target thought sufficient to cover the development of products that could reduce deaths and disabilities caused by dozens of neglected diseases. This figure could be achieved if high-income countries were to allot at least 0.01% of their gross domestic product to research into the health needs of low-income countries. Currently, only the United States and the United Kingdom even approach that goal set by the World Health Organization’s Global strategy and plan of action on public health, innovation and intellectual property.

Early﻿ wins

For over a decade, the WHO has pushed for governments, organizations and companies to invest in neglected diseases, given that these maladies afflict an estimated one billion people — mainly in tropical and subtropical countries. The report suggests that some of that advocacy has begun to pay off.

The biggest change in 2017 was that funders put more money into research on drugs, vaccines and other technologies that combat a range of diseases at once, including diagnostic platforms that detect various fever-causing viruses, and into core operations at development organizations, such as the Drugs for Neglected Diseases initiative (DNDi) in Geneva, Switzerland . Funders invested a total of $382 million into these activities — a 51% increase over 2016 that was largely driven by the Bill & Melinda Gates Foundation in Seattle, Washington.

There was also a slight increase in funding for HIV, malaria and tuberculosis research, which received about 70% ($2.5 billion) of the investments for 2017. And funding for diarrhoeal diseases, a category that includes cholera and giardia, increased by 6.3%.

Gaining approvals

But money for research into some diseases declined, even as overall funds increased. There was a $32-million loss for dengue fever, partly owing to a decrease in funding from the US National Institutes of Health and the expiry of a Gates Foundation grant.

And investment into the three types of hepatitis C infection that disproportionately affect people in low-income countries dropped by $13 million, a nearly 50% decrease from 2016 levels. The report authors suggest that this is due to the changing nature of investments into the disease after the approval of powerful new drugs for hepatitis C. Doubell says that funds are now shifting from drug development to research into how to help people in low-income communities access the drugs.

Almost two-thirds of overall funding came from the public sector, which stepped up its support by $181 million over 2016 levels, thanks to increases from the UK government, the European Commission, Germany, India and South Africa. Meanwhile, funds from multinational pharmaceutical companies fell by 1.5% from 2016, and those from small and medium companies were down by 3.9%.

Rising investments into neglected-disease research are starting to yield concrete results, say the authors. In 2018, the European Medicines Agency approved the first oral treatment for early and late stages of sleeping sickness, fexinidazole, and the US Food and Drug Administration approved the first new drug for river blindness in 20 years, moxidectin.