Despite an increase in R&D activities for a range of poverty-related diseases primarily affecting low and middle-income countries (LMICs) significant gaps remain. Evidence-based priority setting at the global level is required in order to overcome the fragmentation of the current R&D landscape. “As companies are developing products, the global goals are not clear: do we want to prevent disease, severe disease or death?” asked Martin Howell Friede from WHO at the World Health Assembly’s side event “Global Health R&D: How can we best set priorities based on evidence?”, organised by Switzerland, South Africa and the Euoropean Commission, and hosted by the Global Health Centre on 25 May 2017.
The WHO has taken some steps to address this fragmentation. In particular, the newly established Global Observatory on Health R&D – the first of its kind – offers the most comprehensive source of R&D mapping and standardised information, which enables comparative and evidence-based priority setting at a global, regional and local level. Focused on high burden diseases, the Observatory builds on existing data harvested by a wide range of collaborators. As highlighted by WHO Research Coordinator Vasee Moorthy, “a credible, coherent, comprehensive, independent process, which lays out at the global level what the R&D priorities are, would allow each individual funder – within the scope of their activities - to have more confidence that they are really adding to the bigger picture”.
Furthermore, the TDR (Special Programme for Research and Training in Tropical Diseases) Product Profile Directory was established with the aim to explore the potential of a financing mechanism for product R&D. Robert Terry from WHO explained that this tool illustrates areas where R&D is currently underway and where gaps remain, thereby contributing to a better understanding of global efforts and enabling greater precision in priority setting “across technologies, diseases and countries” through a collection of standardised health product profiles. This represents, in the words of Robert Terry, “a step towards global coordination” that will be sensitively useful “regardless of whether a fund finally comes into being”.
Complementing these global efforts, countries are cooperating internationally to promote evidence-based R&D priority setting. Switzerland as the first country to adopt a foreign health policy at a governmental level is actively engaged to harmonise medicine regulatory systems and to strengthen health financing strategies. South Africa, leader of HIV and Tuberculosis R&D, counts on first-hand experience in the area and, represented by Lindiwe Makubalo, expressed its political to cooperate in this field to foster further progress.
At the regional level, the European Commission (EC) is currently the second world’s largest R&D funder for poverty-related and neglected infectious diseases. Within the framework of H2020, it supports partner countries to improve their health systems, collaborates with diverse entities, such as the European Developing Clinical Trials Partnership, and advocates for a better global health priority setting agenda in the G7. Kevin McCarthy from the EC expressed that from a development funder’s perspective, however, “more needs to be done on the innovation side, in particular on what we mean by innovation, to go beyond a market driven approach and to target diseases that disproportionately affect people in some countries”.
Despite the diversity of initiatives emerging to promote evidence-based priority setting in R&D for health, Tania Dussey-Cavassini, Swiss Ambassador for Global Health, stressed that we are still only in the first stages of addressing challenges in the area of R&D, neglected tropical diseases and the related fragmentation. Hoping that the event served as a wake-up call, Ambassador Dussey-Cavassini urged governments and all stakeholders to continue the discussion and to use the data provided by the Global Observatory and other initiatives for better informed decision-making on R&D.
Further information
Global health R&D: How can we best set priorities based on evidence?