Governments fail to keep promises on boost for TB research funding, survey finds

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Most governments have failed to keep promises made last year to boost funding for research into new TB drugs, vaccines and diagnostics, according to a survey carried out by the Treatment Action Group, published this week to coincide with the 38th World Lung Health conference in Cape Town, South Africa.

The Global Plan to Stop TB 2006-2015, developed by the World Health Organization (WHO) and the Stop TB Partnership, estimated that $9 billion would be needed during the coming decade to advance new drugs, diagnostic and vaccines. The plan was endorsed at the UN General Assembly Special Session on AIDS in June 2006.

However the Treatment Action Group survey, which questioned governments, research institutions, philanthropic foundations and the private sector on TB research and development, found a picture of stagnation in funding.

Glossary

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Booster drugs are used to ‘boost’ the effects of protease inhibitors and some other antiretrovirals. Adding a small dose of a booster drug to an antiretroviral makes the liver break down the primary drug more slowly, which means that it stays in the body for longer times or at higher levels. Without the boosting agent, the prescribed dose of the primary drug would be ineffective.

TB research and development investments were nearly stagnant in 2006, the report states, rising just $20 million to $413 million, or less than 5% above the 2005 $393 million tally. This means that, given inflation and reporting changes (China and South Africa reported this year, but the French research body INSERM did not), there was no significant growth overall.

The proportion of public sector investment retreated from 68.5% of the total in 2005 to 59% in 2006. The US National Institutes of Health (NIH), the world’s largest health research investor, reported an $8 million decline in TB R&D funding from 2005 to 2006. This reduction reflects the impact of NIH’s overall flat funding since 2004, which, when considering inflation, amounts to an effective 12.4% decrease in NIH support.

The UK’s Medical Research Council (MRC) contribution collapsed by 73.7% from 2005 to 2006, but the UK Department for International Development increased its investment from $2 million in 2005 to $12.6 million in 2006.

Philanthropies, principally the Gates Foundation, substantially boosted their contributions, increasing this sector’s proportion of total investment from 20% to 27.7%.

Reported industry investment grew nearly 2% (from 11% to 12.9%).

Investment in research on diagnostics, drugs, and vaccines increased, while basic science and operational research funding declined.

Measured against the Global Plan’s 2006 targets for new tools research funding, TAG’s report reveals that actual investments fell short by half a billion dollars. The 2006 funding gap for TB diagnostics research was $18 million, for drugs $275 million, and for vaccines $213 million.

TAG recommends that TB R&D investment should increase fivefold, from approximately $400 million per year to $2 billion per year, for basic science, applied research, and operational research in order to meet the ambitious goals set by the Global Plan.

In addition, a comprehensive global TB R&D agenda that includes basic and operational research must be developed, TAG argues. TB research requires better coordination, both globally and nationally.