Research does not reflect global disease burden

Less than 10% of the world's health research budget is spent on conditions that account for 90% of global disease, a report from an international research foundation claims this week. The Global Forum for Health Research has called for a reallocation of the estimated $56bn (£35bn) spent annually on health research by the public and private sectors to improve global health.

"The world's two biggest killer diseases - pneumonia and diarrhoeal disease - illustrate the extreme mismatch between the disease burden and the funding of research and development," said Professor Adetokunbo Lucas, the forum's chairman. "Although these two killers represent about 11% of the total global burden of disease, only about a fifth of 1% of health research funding is spent on them."

Individual countries tend to give priority to their own health research needs, he added, as they are unaware of the magnitude of problems beyond their borders and the impact of these problems on their own country. Many factors interact to make such information vital, such as increasing travel, re-emerging diseases, and the development of antimicrobial resistance.

>Research by the WHO shows that malnutrition and poor water quality and sanitation contribute most to global ill health

The driving force behind the creation of the forum's main initiatives is the need for multiple agencies and partners to generate new funding for priority diseases. For example, the Medicines for Malaria Venture aims to register one new antimalarial drug every five years. As a result of joint undertakings by the public and private sectors this initiative has generated $13.7m since November 1999.

The World Health Organization has ranked the contributions of selected risk factors to the global disease burden. It has used the concept of a disability adjusted life year (DALY) as an indicator of the burden of disease, combining time lost due to premature death and time lost to disability. Malnutrition, poor water and sanitation, and unsafe sex are the biggest contributors to the global disease burden.

Some organisations have already pledged long term supportfor example, the Gates Foundation has committed itself to spending several million dollars for at least five years. One of the major financiers of the Global Forum is the World Bank, which contributes a fifth of the core budget, as well as extra funds for specific initiatives. The initiative is also supported by the World Health Organization, the Rockefeller Foundation, and the governments of Canada, the Netherlands, Norway, Sweden, and Switzerland.

An annual forum for discussion is an essential part of the strategy and this year will take place at the international conference on health research for development in Bangkok in October. A forum in Geneva is planned for 2001. This will allow interested groups to discuss past achievements and future actions in trying to close the "10/90" gap.

The 10/90 Report on Health Research 2000 can be accessed on the web at http://www.globalforumhealth.org/.

Jason O'neale Roach, studentBMJ


studentBMJ 2000;08:175-216 June ISSN 0966-6494