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Healthy Skepticism Library item: 11870

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: chapter

Light D.
Basic research funds to discover important new drugs: who contributes how much?
Burke MA, De Francisco A. Monitoring Financial Flows for Health Research 2005: Behind the Global Numbers Geneva: Global Forum for Health Research 2006


The 10/90 Report on Health Research 2003-41 and Monitoring Financial Flows for Health Research 2004 both highlight that “there are still major gaps in our knowledge and in the adequacy of the tools available to improve health and reduce inequities – gaps that are themselves reflections of past failures of health research to adequately address the health problems of a large proportion of the world’s population.”2,3 Fifteen years ago, the Commission on Health Research for Development estimated that less than 10% of the world’s resources for health research (which totalled US$ 30 billion in 1986) were being applied to the health problems of developing countries, where 90% of the avoidable burden of ill-health was to be found.4 Since then, global expenditure on health research has more than tripled, but a large imbalance remains in how it is applied and the closure of the ‘10/90 gap’ has been the focus of the work of the Global Forum for Health Research since its foundation in 1998.

Three themes are developed in the Global Forum reports concerning the pharmaceutical industry. First, the industry “funds almost half of global health R&D,” and consolidation into fewer global giants raises “concerns that drugs that are largely needed for [low- and middleincome country] LMIC ‘markets’ will simply not be developed.”5 Second, research on diseases in high-income countries will have a “trickle-down effect on LMICs, but often these outputs do not address the most pressing health issues in low- and middle-income countries…” Third, the private for-profit sector claims to be the largest investor in R&D globally, and the biggest actors are the multinational pharmaceutical companies. It follows that policy leaders must find ways to induce the
multinationals to do more research and development for diseases prevalent in LMICs to rectify the prevailing imbalance. This is the central focus of such new tools as advanced purchase commitments (APC) proposed for getting multinational companies to do research to discover new vaccines.6,7

This report focuses on basic research to lay the groundwork and discover new, effective drugs and vaccines. Equally important are applied, translational research to turn a discovery into an appropriate drug for human consumption, and development through trials to establish with greater confidence the safety and efficacy of a drug-candidate. All three elements together constitute one, albeit substantial, part of the larger landscape concerning research for health. This report uses information from a number of sources including industry critics to offer evidence that governments and the public provide the lion’s share of funds for basic research to discover new drugs and vaccines. Realizing the public’s role opens the door to new ways of thinking about how to close the
‘10/90 gap’…

The role of basic research

What matters is significant therapeutic gain

Global shares of basic research

Industry contribution to basic pharmaceutical research

Redirecting basic pharmaceutical research to greatest need

The new landscape of basic pharmaceutical research

Redirecting public funds to maximize new drugs

Complementing research with guaranteed purchasing


Full text available from U Penn Center for Bioethics site


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What these howls of outrage and hurt amount to is that the medical profession is distressed to find its high opinion of itself not shared by writers of [prescription] drug advertising. It would be a great step forward if doctors stopped bemoaning this attack on their professional maturity and began recognizing how thoroughly justified it is.
- Pierre R. Garai (advertising executive) 1963