The Novo Nordisk Foundation, Bill & Melinda Gates Foundation, and Wellcome Trust have announced a new partnership, committing $300 million over three years to stimulate innovative research in developing countries into three of the world’s most critical global health challenges and their interlinkages – including climate change, infectious diseases and antimicrobial resistance (AMR).

An additional funding stream would aim to support research for greater understanding of the interplay between nutrition, immunity, infectious and non-communicable (NCDs), and developmental outcomes. 

All of the challenges disproportionately affect people in low-and-middle income countries (LMICs).  Consequently, funding will be directed mainly to LMIC countries and communities to strengthen research and development capacities and scale “equitable access to existing tools and technologies,” the partners said. 

The announcement by the world’s biggest health philanthropy heavyweights also aims to signal the urgency of making bigger global health investments more broadly to face new and emerging threats. 

“We face huge challenges to protecting and improving physical and mental health, compounded by vast inequities globally,” said John-Arne Røttingen, CEO of Wellcome, speaking at a two-day “Global Science Summit” in Helsingør, Denmark, where the initiative was announced. 

The most effective solutions to pressing challenges often emerge from the very communities they affect,” said Dr. Catherine Kyobutungi, executive director of the African Population and Health Research Center, one of the scientific research institutions that will collaborate in the new effort. “I’m encouraged that this new partnership seeks to unlock novel ideas and support the scientists working directly with the communities that stand to benefit the most.”

Climate change, infectious disease, and nutrition-disease interactions

The initiative will support interdisciplinary initiatives that advance, for instance, better collection and use of climate data, innovation in more sustainable agriculture and resilient food systems, and other measures protecting  people from climate change, according to a press release by the Bill and Melinda Gates Foundation. 

“We’re on the cusp of so many scientific breakthroughs in agriculture, health, and nutrition, and with the right support these innovations will save and improve lives around the world,” said Mark Suzman, Gates CEO. “Every sector has a critical role to play, and we hope this collaboration opens the door for other funders and partners to contribute to scaling up existing innovations and developing the tools of tomorrow.”

“Many of these challenges are overlapping and intersecting, with profound impacts on human health,” said Dr Tedros Adhanom Ghebreyesus in remarks at the two-day summit, hosted by Novo Nordisk Foundation, which ended Tuesday.  

Since the late 1990s, NCDs have overtaken infectious diseases as the world’s leading cause of premature mortality on every continent, except Africa, Tedros noted, while big gains against HIV, malaria and TB have plateaued recently. 

“NCDs can weaken the immune system, making people more vulnerable to infectious diseases. In turn, infectious diseases can exacerbate the progression of NCDs and cause complications. And the climate crisis exacerbates both of them.”

More equitable use of available tools also are needed

But while research and innovation have always been the “engine of improvements in public health”, Tedros also reminded his audience of donors and philanthropists that available solutions to NCDs, infectious disease and climate change also are not being harnessed. 

“The health challenges we face globally are not fundamentally scientific challenges; they are largely political, economic and social challenges,” the WHO DG asserted. “Of course, we need more technologies, but using the existing ones to the maximum is important.

“Many NCDs can be prevented through healthier diets, physical activity or by stopping smoking. Premature deaths from NCDs can be prevented with the right diagnosis and treatment.

“Most cases and deaths from infectious diseases can be prevented with vaccines, prophylaxis, bed nets or other tools to prevent exposure.

“And climate change can be reversed, and its impacts mitigated, by weaning ourselves off our addiction to fossil fuels.

“The problem is not that we don’t have the tools or the knowledge to address these threats; the problem is that those tools are not equally available, for multiple reasons.”

Emphasis on AMR

The partnership will also channel funding to infectious disease research, with an emphasis on addressing AMR, advancing disease surveillance, and developing vaccines for respiratory infections. 

Supporting new advances in detection and the development of vaccines and other tools should  help “reduce the burden of disease in LMICs and prevent outbreaks from turning into global crises,” the partners said. 

An overarching aim of the initiative is to “break down barriers between often isolated areas of work—between cardiometabolic and infectious diseases, or between scientific discovery and delivery of solutions, for example,” said Mads Krogsgaard Thomsen, CEO of the Danish-based Novo Nordisk Foundation.

Both over and under-nutrition continue to burden countries in both the global North and South. In that context, the partnership aims to support advances in nutritional science and the microbiome – the trillions of micro-organisms that co-exist in our bodies – as an avenue to tackle nutrition-related diseases. 

“It’s kind of mind-blowing how little research was going into understanding malnourishment,” remarked Bill Gates. “In some cases, for things like the microbiome, we had to fund scientific research because it was just an ignored area.” 

Faltering global health investments

The new initiative aims to signal that renewed global health investments are all the more important in the current post-pandemic context. 

“We have a challenging macroeconomic situation,” said John-Arne Røttingen, Chief Executive Officer at Wellcome. “We also see that the major part of global health financing is really not for science and innovation.”

After the surge in funding during the COVID-19 pandemic, national investments in health have since faltered. Governments face competing budgetary priorities in the wake of inflation and debt crises.

A recent World Health Organization (WHO) analysis of global health expenditures found that most governments fail to meet the global targets for spending of 5% of GDP and 15% of national budgets on health care. Meeting those two benchmarks indicates if a country is on track to achieve universal health coverage. Many low-and-middle income countries spend even less on health today than they did  in 2000. 

“Funding and attention for global health and development is faltering, putting progress at risk. Debt crises are forcing governments to cut funding for essential health programs; climate change and conflict are shattering communities; and progress to protect lives from diseases known and unknown is under threat. Across all of these challenges, it is the world’s poorest who are most affected,” said the Gates Foundation announcement.

New obesity drugs filling Novo Nordisk philanthropy’s coffers  

Ironically, the Novo Nordisk Foundation’s participation in the new partnership comes on the heels of the recent landslide success of the pharmaceutical firm Novo Nordisk A/S – which  Novo Nordisk Foundation controls – with the sale of two new drugs Ozempic® and Wegovy® to control obesity..

“The booming market for weight-loss drugs has pushed the assets of the Novo foundation to more than double those of the Gates foundation,” noted Bloomberg Law in a recent article.  

“In turn, the Danish organization is broadening its giving and its footprint outside its home market. The Novo foundation already backs 27% of Danish medical research, awarding a record $1.3 billion to projects related to innovation and science last year.

The partnership may be extended beyond the initial three years if successful, Novo Nordisk Foundation CEO Thomsen was quoted as saying. “To be honest, three years is a short time for making a change on global climate, agri-food systems, human health.” 

If early results are positive, he said, “the most natural thing is to continue such a relationship, of course.” 

Image Credits: CDC.