New report warns of setbacks in global health progress due to current budget climate

The prospect of deep cuts in the federal budget threatens to reverse the dramatic progress of a bipartisan US commitment to defeat neglected diseases in developing countries, according to a new report released today by the Global Health Technologies Coalition (GHTC). Federal investments in global health research and development (R&D) programs that span multiple agencies have helped nurture an array of new vaccines, medicines, diagnostics, and other health products needed to combat diseases like HIV/AIDS, malaria, tuberculosis (TB), and childhood killers like pneumonia and diarrheal diseases. Despite these advances, President Obama's budget request for 2013 calls for several decreases for global health when compared with last year's levels. Several global health R&D programs at US agencies also saw drastic funding cuts.

There are widespread concerns that cuts to global health R&D programs, which support critical efforts to develop the next generation of lifesaving health products, could grow even larger, given the pressure to reduce the US budget deficit.

"[T]he budget climate in the United States continues to be severe, and US policymakers are beginning to implement austerity measures that could impact funding for global health R&D," the GHTC report stated. "Indeed, the continuing fiscal situation undoubtedly puts these programs at risk in the future, when global health R&D programs could see even more severe funding cuts than have already occurred."

According to the GHTC report, global health R&D projects are among the best investments US policymakers can make, which would make funding cuts even more devastating. Last year alone produced multiple research breakthroughs, including results from a trial showing that early antiretroviral treatment can prevent HIV transmission to uninfected partners and results from a Phase III malaria vaccine trial showing that the vaccine candidate known as RTS,S can provide young African children with significant protection against clinical and severe malaria.

"It would be ironic if widespread and unprecedented cuts in global health R&D were to take place just as past investments begin to bear fruit," said Kaitlin Christenson, MPH, GHTC's director. "US commitment was instrumental in eradicating smallpox and conquering polio and is now helping achieve unprecedented reductions in deaths from malaria and diarrheal diseases. Equally dramatic breakthroughs can be expected for a variety of other diseases if we continue to invest in research for new lifesaving health products."

GHTC, which represents 40 nonprofit organizations focused on developing new vaccines, drugs, and other disease-fighting tools for the developing world, warns that the future could look far different from the progress being made today. Its report, Sustaining Progress: Creating US policies to spur global health innovation, found that while the US commitment to global health R&D has bridged deep political divides in Congress and garnered particularly strong support from the last two presidential administrations, it is now confronting a major test.

The report notes that in the 2012 budget process, some individual global health R&D programs experienced reductions, alongside cuts to what are known as product development partnerships (PDPs)--relatively new and innovative types of public-private partnerships focused on developing drugs, vaccines, diagnostics, and other products specifically for patients in low-income countries. In addition, the report found that overall investments in global health R&D remained far short of what is actually needed. Global health R&D is spread throughout the US government and includes research and product development efforts supported through a variety of programs at the US Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Defense (DoD), and the US Agency for International Development (USAID).

The GHTC report points out that the US is not alone in trying to balance the need to address fiscal constraints with maintaining a commitment to reducing global health disparities. The report cites the recent "Global Funding of Innovation for Neglected Diseases" survey, which found that in 2010, investments in R&D from all sources worldwide, public and private, fell by 3.5 percent. Public sector investments declined the most, dropping by 6 percent.

According to the GHTC report, "The rest of the world is struggling with the same global financial crisis that is challenging the United States." Further, "other major donors could be inclined to maintain their commitments if the United States persists." GHTC also recommends an increased emphasis on health-related R&D in major international development programs, such as the President's Emergency Plan for AIDS Relief (PEPFAR).

According to the report, "US investments in global health research can produce real results, and the nation must persist in our efforts to develop the next generation of lifesaving health products. US leaders have the opportunity to seize on this bipartisan legacy and recent scientific advancements and stay focused on the end goal--saving lives around the world. The United States cannot give up now."