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As health leaders pressed their case for more money from policymakers and business at this week's World Economic Forum in Davos, a new report showed annual funding for research and development in neglected diseases had hit a record $3.6bn.
But the G-Finder data highlighted the continued reliance on the US government and the Gates Foundation for the largest share of support. Two-thirds of the global total came from the public sector, with notable increases from the UK and the EU.
Despite the overall increase in funding, not one government met the World Health Organization goal that richer member states dedicate at least 0.01 per cent of GDP for research to benefit developing countries.
As our report into the future of health R&D demonstrates — particularly our visit to Cambridge's “Nobel Prize factory”— science is forging ahead. The question is: can the financing keep up?
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Has Europe got better in tackling rare diseases over the past five years?
I see progress with a number of innovative products, and attempts at testing them in countries trying to do better, like Germany, France, Denmark and the UK. But I see growing difficulties of access to medicines because of divergent opinions, a lack of trust in the data and growing concern by society about how much they will cost. There is a tension between the hope of science and the reality of access. We need to find better ways or patients will be extremely disappointed.
What is the problem with access?
The mindset has evolved but the situation has not changed. Market authorisation [regulatory approval] is good but it’s not enough. We see diverging capacity by different countries in health technology assessment [to judge value for money] of new therapies with very slow progress on negotiations. Because the targeted population is so small, the conversation is poor.
What should be done about the high price of orphan drugs?
We want to see companies giving important discounts for uncertainties over three to five years, in exchange for a post-launch research plan showing real-world evidence of their effectiveness. We also want to see the creation of an EU fund that would pay half the cost of innovative medicines while they are tested in more patients. Then companies could receive more if the drugs are proven to work, using a combination of the value they provide and the costs of development and production.
Davos disease warning The World Economic Forum's own report said the business community needed to play a greater role in the fight against infectious disease. Failure to act could knock global GDP by an average $570bn a year, it said. (WEF)
Migrant health The WHO highlighted health risks for refugees and migrants in Europe, who now make up 10 per cent of the region's population. Contrary to some popular opinion, they pose a very low risk of transmitting infectious diseases but are more likely to become ill through poor living conditions and diet in their host country. (WHO)
WHO in spotlight Big issues at the WHO's board meeting included the price of cancer drugs and how the organisation should engage with civil society. Separately, the WHO launched an investigation into whistleblower claims of alleged misconduct. (Devex, WHO)
Mental health matters Another Davos announcement was an extra £200m for mental health research from Wellcome, focusing on therapies for the young and for those in the early stages of illness. The WHO published new snapshots of mental health provision: the number of mental health workers in poorer countries can be as low as two per 1,000 population, compared with more than 70 in their richer counterparts. (Big Issue, Wellcome)
Gene-editing furore continues He Jiankui, the Chinese scientist said to have made the world’s first genetically-modified babies, is expected to face criminal charges after a government investigation found that he falsified ethical review documents. The case highlights the gap between China's scientific prowess and its system of regulation. (FT, Bloomberg)
Superbug battle The UK is giving incentives to the pharma industry to develop drugs to help fight resistance to antibiotics. It aims to “contain and control” anti-microbial resistance by 2040 and address the “market failure” that means companies have an incentive to sell as many antibiotics as possible at the same time as government tries to reduce their use. (FT)
Drug dealing Fears of a “no-deal” Brexit in the UK are leading to medicine stockpiling. Here's a guide to how the UK supply system works. In the US, the government shutdown is slowing the release of new drugs. In South Africa, drug dispensing machines are helping ease pressure on the health system. (Guardian, Fortune, FT)
Digital ding-dong The behaviour of NHS England's digital chief was labelled “jaw-droppingly inappropriate” after she extolled the virtues of a Swedish doctor app without disclosing she had been hired by the company. The incident fuelled unease about the “revolving door” between public and private sectors. (FT)
Tackling tobacco A Guardian investigation showed how free-market think tanks around the world have supported tobacco companies in their fight against government controls and public health measures such as plain packaging. The US national academies assessed the health risks of ecigarettes. (The Guardian, National Academies)
Inoculating against anti-vaxxers Addressing “vaccine hesitancy” is one of the WHO's top ten tasks for 2019: the measles outbreak in New York shows why. “Thwarting this danger will require a campaign as bold and aggressive as the one being waged by the anti-vaccination contingent,” says one editorial. UK public health specialists highlighted misconceptions spread by social media. (WHO, Forbes, NYT, Royal Society for Public Health)
Playing the long game Longevity is a rapidly expanding sector of the biotech industry, as scientists learn more about the way biological pathways fail in old age. Investors in the sector are often ageing millionaires, keen to put some of their money into longevity research. (FT)
Fizz fight A hard-hitting Australian campaign is targeting fizzy drinks' effect on teeth. British youth are drinking less of the stuff but still aren't too fond of fruit and vegetables. In the US, drinks companies are taking a leaf out of the tobacco industry's book by thwarting taxation at local level. (ABC News, BBC, Jama)
The Pope and the pill Standard contraceptive pills are designed to be taken for 21 days, followed by a seven-day break. But this pause — which can lead to unplanned pregnancies — was designed not for reasons of women's health but because of pressure from The Vatican. (The Conversation)
'Wellness' comes of age Jacinda Ardern, New Zealand's prime minister, wrote for the FT of her plans to present the world’s first “wellbeing budget” with a focus on areas such as mental health for young people. (FT)
Best from the journals
Climate change and health The increasing number of extreme weather events causes disproportionate harm to children, including the threat of malnutrition, respiratory illnesses, malaria, and diarrhoea, as well as drowning. This interactive graphic shows the links between climate change and health, as do these five charts. (The Lancet, NEJM, FT)
Action in Asia South Asia is a hotspot for infectious diseases but despite notable public health success stories, the region still suffers from poor surveillance data, weak health systems and poor availability of drugs. (BMJ)
Air quality and happiness A new study suggests a link between levels of pollution and happiness. The experiment showed levels of happiness in Chinese cities, calculated via social media posts, declined as air pollution increased. (Nature Human Behaviour)
Armed for health The use of armed forces to support global health efforts can be a real boon for logistics and security, but can sometimes clash with humanitarian objectives. This study suggests policies to improve co-ordination between civil and military participants. (The Lancet)
NHS conflicts A new study reveals the financial interests of patient organisations involved in assessing NHS treatments. Industry-funding is often needed to sustain charitable activities but can lead to conflicts of interest. (BMJ)
Genetic advantage A new study highlights the role of our genes in whether we become thin or overweight. (PLoS Genetics)
Podcast of the week
Malaria endgame What are the next steps in the fight against malaria as recent gains start to slow down? (CSIS Take as Directed 32m)
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Sniff before you order Next time you rush to that junk food outlet, linger a while and take a deep breath before you order — new research says the scent of indulgent food could pique that craving. (Time)
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