The need to align investments in health research and development (R&D) with public
health demands is one of the most pressing global public health challenges. We aim
to provide a comprehensive description of available data sources, propose a set of
indicators for monitoring the global landscape of health R&D, and present a sample
of country indicators on research inputs (investments), processes (clinical trials),
and outputs (publications), based on data from international databases. Total global
investments in health R&D (both public and private sector) in 2009 reached US$240
billion. Of the US$214 billion invested in high-income countries, 60% of health R&D
investments came from the business sector, 30% from the public sector, and about 10%
from other sources (including private non-profit organisations). Only about 1% of
all health R&D investments were allocated to neglected diseases in 2010. Diseases
of relevance to high-income countries were investigated in clinical trials seven-to-eight-times
more often than were diseases whose burden lies mainly in low-income and middle-income
countries. This report confirms that substantial gaps in the global landscape of health
R&D remain, especially for and in low-income and middle-income countries. Too few
investments are targeted towards the health needs of these countries. Better data
are needed to improve priority setting and coordination for health R&D, ultimately
to ensure that resources are allocated to diseases and regions where they are needed
the most. The establishment of a global observatory on health R&D, which is being
discussed at WHO, could address the absence of a comprehensive and sustainable mechanism
for regular global monitoring of health R&D.
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