WHO-Led Efforts To Boost R&D In Neglected Diseases Jeopardised By Funding Gap

Finding resources to fund research and development for diseases primarily affecting developing and least-developed countries is a continuous challenge. Hopes were raised in 2015 with projects to launch a Global Observatory on Health Research and Development, and a voluntary pooled fund for research and development projects. However, the lack of funding is jeopardizing those initiatives despite some contributions by developed and middle-income countries.

The WHO Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) was set up to find ways to fund research on medicines for diseases affecting poor populations, which have little commercial prospect for the private sector.

This week at the WHO Executive Board (EB), taking place from 23 January to 1 February, Board members were expected to consider a follow-up [pdf] of the report of the CEWG, and terms of reference [pdf] of an expert committee on health research and development.

Following the report of the CEWG, five “demonstration projects” were established, which are expected to be funded through the voluntary pooled fund.

[Clarification: Originally six demonstration projects had been considered. The sixth demonstration project was only recognised as a demonstration project in April 2016 and is expected to receive funding subject to approval by the Ad-hoc Committee for the demonstration projects, and availability of funds, according to the WHO.]

Funding Gaps, Over US$70 Million Needed

According to the WHO follow-up, “the estimated total financial requirement over the period 2014–2017 for the implementation of the demonstration projects and establishment of the Global Observatory is US$ 85 million.”

However, the document said, as of “30 September 2016, a total of US$ 2.26 million over the four years had been contributed or pledged by France, Germany, Switzerland, the United States of America and the European Commission to the Global Observatory, and a total of US$ 7.17 million had been contributed by Brazil, India, Norway, South Africa and Switzerland to the voluntary fund designated for demonstration projects.”

“Another US$ 1.18 million has been contributed or pledged by Norway and Switzerland as matching grants for contributions from developing countries on the basis of half a dollar for each dollar contributed, and US$ 1.40 million of Swiss matching funds are still available, pending developing country contributions,” it said.

In total, some US$72.99 million are needed to complete the demonstration projects and finalise the development of the global observatory, said the document.

Many Deplore Funding Gap; US Suggests Discontinuing if No Funding

A number of countries deplored the lack of funding for the demonstration projects and the global observatory.

The United States expressed “deep disappointment” that the projects received so little funding and efforts at encouraging contributions from non-traditional donors have so far failed.

Although the US said it would be eager to see the project succeed and attract new contributions for neglected diseases, the delegate said, if there is no viable path to do so in the near future, it may be considered “cutting this line of work within the WHO.”

“We are concerned that without a dramatic improvement in fundraising, these projects may distract attention and resources away from more viable work WHO could be doing,” he said.

Germany announced that in addition to earlier contributions, the country contributed €2 million euros in support of demonstration projects at the end of 2016.

India also remarked on the financing gap, and said the report by the secretariat should have elaborated on how the observatory, the expert committee on health research and development, and the voluntary fund are going to adhere to the principles of affordability, effectiveness, efficiency, equity and the principle of de-linkage of the price and the cost of research and development of medicines.

The expert committee on health research and development is expected to “provide technical advice to the Director-General on the prioritization of health research and development” for diseases affecting primarily developing countries, according to the WHO.

India suggested establishing a new open-ended group to address the remaining issues not tackled by the CEWG, in particular the establishment of a binding R&D treaty.

WHO’s Kieny’s Special Plea for Project in Africa

Marie-Paule Kieny, WHO assistant director general, Health Systems and Innovation, said the global observatory went live last week and provides data from a wide range of sources and input processes such as clinical trials.

She made a special appeal for one of the demonstration projects: the African Network for Drugs and Diagnostics Innovation (ANDI) for the establishment of a regional coordination mechanism for demonstration projects and product R&D in Africa.

She said ANDI, located in Addis Ababa, Ethiopia, if no funding comes shortly, will have to close doors, and asked WHO members to help ANDI as it is promoting innovation in Africa for Africa.

 

Image Credits: Catherine Saez