Despite the strains of COVID-19, global funding for poverty-related infectious diseases, such as HIV/AIDS, TB, and malaria, remains virtually unchanged at US $3.937 billion, with investment dropping only 4% in 2020, according to the fourteenth annual G-FINDER Report.

The report, released by Australia-based Policy Cures Research group on Thursday, showed a drop of only US $172 million from 2019. This year’s funding remains the third highest ever seen by the group for neglected diseases. 

But though the decline may be a marginal one, funding for neglected tropical diseases (NTDs) continued a decade of relative stagnation, with only snakebite envenoming seeing an increased investment in 2020. 

Resilient funding may be impacted by COVID-19 in the future 

The G-FINDER report is a comprehensive analysis of global investment of R&D for poverty-related neglected diseases. It is widely used by national governments, industry, civil society, and the World Health Organization to identify gaps in progress and areas where investments would be needed.

Reactions to the report were cautiously optimistic regarding the sustained investment in global R&D, with concerns that COVID-19 still could shift the direction of funding. 

“These figures are reassuring for the neglected disease research and development community as they indicate continued commitment to advancing health innovations for some of the world’s most vulnerable populations,” said Nick Chapman, CEO of Policy Cures Research.

“However, we can’t assume that resilient funding in the first year of the pandemic means that we are safe from impacts on funding in the future.”

Paul Barnsley, senior analyst at Policy Cures Research, also expressed his concerns during the Thursday launch event of the report. 

“We’re still worried that a focus on COVID might capture some of the attention and resources of traditional funders, and that the cost of stimulus during the pandemic will lead to future reductions in overall government spending flowing through to neglected disease R&D,” he said. 

Funding for top three infectious diseases declines 

The top three infectious diseases – HIV/AIDS, tuberculosis, and malaria – received the largest shares of funding, as they have every year, accounting for more than two-thirds of reported global investment. 

However, funding for all three of these diseases fell in 2020, taking their share of global funding to 68% to the usual annual average of 75%. 

In the case of HIV/AIDS, the vast majority of the decline was attributed to decreased investment from the US National Institutes of Health (NIH), the Gates Foundation, and industry. 

Tuberculosis also experienced a decrease in funding from the NIH, but recond-high funding from the European Commission, a result of new funding for the European Regimen Accelerator for Tuberculosis, an initiative dedicated to new treatments for TB. 

Disruptions in clinical trials due to pandemic 

While investments in neglected disease R&D stayed near their historic highs, despite the turbulent first year of the COVID-19 pandemic, the pandemic hindered product developers’ ability to conduct clinical trials in 2020. 

Barnsley anticipates these disruptions to have continued into 2021. 

In line with this trend, multinational pharmaceutical companies’ (MNC) investments in clinical development decreased for the second consecutive year in 2020. 

The previous G-FINDER report attributed this to normal fluctuations and the conclusion of late-stage trials in treatments. However, the report does warn that “another year of decreases in MNC funding could signal a trend.”

“Although the 2020 decline is most likely due to pandemic-disrupted trials, it could indicate that half a decade of soaring MNC funding is coming to an end.”  

Philanthropic funding increases

Contributions from public and private sectors both dropped slightly in 2020 but funding from philanthropies saw record high levels of funding, an increase of US $28 million over the previous year.

Both established and new philanthropies such as Wellcome Trust and Open Philanthropy, were the primary reason for this new increase, with Open Philanthropy nearly tripling its funding for neglected disease R&D between 2017 and 2020. 

Increased investment in platform technologies 

A key reason that overall funding to infectious diseases remained relatively stable, despite cuts to clinical development, was the US $33 million increase in total funding in platform technologies.

The Bill and Melinda Gates Foundation was the largest funder of platform technologies, providing 40% of investment, followed by US government agencies, the US NIH and the US Department of defense. 

Though the increase predates the pandemic, a number of grants for platform technologies in fact cite COVID-19 as the reason for accelerated interest. 

“In light of that, we predict that the already hastened pace of investment in platform technologies we saw in 2019 and 2020 will continue in the neglected disease R&D space, at least in the immediate years to come,” said Chapman. 

Funding cannot rely on ‘coattails of the pandemic’ 

Though the response to COVID-19 has demonstrated the potential for new funding mechanisms, strategies, and technologies, the report does note that this is a “stark reminder that neglected diseases persist because of insufficient funding and momentum”. 

“The next challenge for global health stakeholders will be to ensure that neglected diseases benefit from opportunities and innovations that have emerged from the pandemic.” 

Barnsley pointed out how it “may be tempting to ride on the coattails of the pandemic” in order to increase investment, and instead addressed the need to craft a message of genuine self-interest in eliminating neglected diseases. 

“We need to be able to defend neglected disease funding during periods of austerity.”

Image Credits: Policy Cures Research, Policy Cures Research.