Research investment in infectious diseases poorly matched to burden of disease

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UK funding of research into infectious diseases is overlooking some of those with the highest burden of death and disability

UK funding of research into infectious diseases is overlooking some of those with the highest burden of death and disability, a study published Online First in The Lancet Infectious Diseases shows.

The study, which was performed by researchers at Imperial College London, University College London, and the London School of Hygiene and Tropical Medicine, is the first ever detailed analysis of investments in infectious disease research made by funding organisations to UK institutions.

Focusing on data from 1997 to 2010, the study shows that gastrointestinal infections, antimicrobial resistanceand some neglected tropical diseases such as trachoma, the commonest infectious cause of blindness globally, receive particularly low levels of investment, including that from UK funders of research institutions based in the UK, relative to the disability and death that they cause.The UK is the second largest investor in health research worldwide.

Professor Rifat Atun at Imperial College London, UK, an author of the paper said that it revealed: “unacceptable disparities in research funding for infectious diseases, especially for conditions affecting children and the elderly.” He says: “Research funding from public sources must follow transparent criteria to ensure fairness and alignment with the current and emerging problems faced by the UK and the global community. The UK is a major funder of infectious disease research globally and be investing effectively can make a difference to diseases that affect millions of people globally.”

Over the study period, non-commercial funders such as the Wellcome Trust and Medical Research Council (MRC) invested £2.6 billion in research into infectious diseases. 

The results of the current study found a series of inconsistencies between investment and disease burden, which are highlighted here.

Investment was low in research specifically targeting infections in children and elderly people. For instance, search covering infections in children received only about 3 per cent (£87.1 million) of total funding, while research into infections in elderly people received just 0.3% (£7.2 million) of total funding.

Gastrointestinal diseases received less than10 per cent (£254 million) of overall funding, although analysis of data from 2004 suggested that they accounted for more than 22 per cent of infectious disease-related deaths.  By contrast, HIV, which causes a comparable number of deaths to gastrointestinal disease, received almost twice the amount of funding (£460 million or about 18 per cent of the overall amount).

Overall, the highest proportion of funding into infectious diseases research between 1997 and 2010 was invested in HIV, blood infections (such as malaria), and respiratory infections (such as tuberculosis), which together received almost half (over 49 per cent) of the total money invested.  In 2004, these three disease areas were estimated to have contributed to about 72 per cent of deaths caused by infectious disease, and respiratory infections specifically were estimated to have caused about 44 per cent of infectious disease-related deaths. The proportion of deaths that resulted from respiratory infectionswas higher than that resulting from either HIV or blood infections, but received just 16 per cent (£410 million) of total UK research funding.

Likewise, antimicrobial resistance, which is a rapidly growing problem and described by WHO as “a global public health emergency affecting all countries”, received just under 4 per cent (£96 million) of funding in the period 1997 to 2010.

Professor Atun notes: “Ourresearch is very timely as it comes just before November when the Chief Medical Officer will release the ‘UK FIVE Year Antimicrobial Resistance Strategy and Action Plan 2013-2018’. I hope that our results will have a positive influence on this strategy and action plan.”

Co-author Michael Head, at University College London, UK, said: “Infectious diseases account for 15 million deaths per year worldwide and disproportionately affects young people, elderly people and the poorest sections of society.  The investments in research for these diseases warrant further attention.”

The authors recognise that a key limitation of their study is that it does not include analysis of funding from the UK pharmaceutical industry, thought to contribute considerable sums to research in this area, since the investments from these companies are not clearly documented to protect commercial sensitivity. The authors encourage public documentation of awards from other funding agencies. Mr Head explained: “Funding agencies and industry need to openly document their research investments to help redress any inequities in resource allocation. We should also be documenting investments from other countries in a similar manner, in order to assess the total global investment in each disease against the burden it poses.”

By Cher Thornhill