THE IMPACT OF GLOBAL HEALTH R&D

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The Impact of Global Health R&D is a project led by Policy Cures Research, with support from the Bill and Melinda Gates Foundation, Wellcome and Open Philanthropy, and in partnership with the Centre for Global Development, Stanford University’s Innovative Medicines Accelerator, the African Population and Health Research Centre, Avenir Health, and Anthologie.

The insights in this milestone report, drawn from comprehensive literature reviews, sophisticated modelling, and extensive consultations with experts and stakeholders, underscore the considerable societal gains achieved through investments in global health R&D.

For more information about the project and its findings, visit impact.policycuresresearch.org.

The launch event can be viewed here.

The insights in this milestone report underscore the considerable societal gains achieved through investments in global health R&D. We encourage stakeholders to:

Overview

Investing in global health product R&D pays off, yielding a staggering health and economic return to society of $405 for every $1 invested.

This return stems chiefly from modelling the lives saved and, in turn, years of life saved (measured using Disability-Adjusted Life Years or ‘DALYs’ averted) by breakthrough drugs, diagnostics, vaccines and vector control products created to tackle poverty-related neglected diseases.

This $405 figure reflects the retrospective and prospective impact of products that have come to market in the last 20 years, as well as the anticipated impact of entirely new innovations that are expected to emerge from the pipeline between now and 2040. So we must continue to prioritise and expand funding for health innovation and solutions for neglected disease in the coming years to realise the full extent of this gain.

Our key findings include:

  • Millions of lives saved: Between 2000 and 2040, at least 40.7m lives will be saved, and 2.83bn DALYs averted, thanks to biomedical products for poverty-related neglected diseases. Most of these lives will be saved in the low- and middle-income countries (LMICs) whose populations are most affected by these diseases
  • High societal return: Every $1 invested in neglected disease R&D generates a return of $405.
  • Trillions of economic and societal benefits: Averting 2.83bn DALYs generates $49.7tn in net societal benefit.
  • Many gains are still to come: More than 70% of the health and economic impact is projected to occur between now and 2040. If this benefit is to be realised, there must be sufficient ongoing investment in R&D to progress the pipeline and deliver the next generation of breakthrough global health products, as well as sufficient programmatic and health systems investment to scale up existing and new tools.
  • Successful product and candidate development: 183 products targeting neglected diseases have been approved by a regulatory agency or prequalified by the WHO since 1999. Moreover, there are 752 active candidates in the neglected disease pipeline from which sustained investment is projected to deliver another 182 lifesaving products by the year 2040.

Calls to action

Over 70% of the benefit from the past 20 years of investment will occur between now and 2040.

If this benefit is to be realised, there needs to be sufficient ongoing investment in R&D to deliver the products that have not yet been approved, but which are expected based on the current state of the pipeline.

We also need to strengthen our healthcare systems and have the political commitment to rolling out and scaling up the health innovations that our model assumes.

As a global health community, we need to build a more efficient and equitable system:

  1. Pursue collaborative mechanisms for investment and financing of global health R&D.
  2. Focus on portfolio investment for greatest returns.
  3. Optimise efficiency of the regulatory and scale up pathways to reduce time from product approval to scale up.
  4. Recognise the strategic value of investing in impact assessment.
  5. And strengthen collaboration between R&D and access.

Why was 1994 chosen as the start of the backcasting funding period?

1994 was chosen as it enables us to account for investments that led to the launch of products in the early 2000s. We did reverse linear modelling of the historical G-FINDER data back to 2007 and compared it to investment figures we could find either reported in the literature or available in databases from 3 primary sources: the Bill and Melinda Gates Foundation, National Institutes of Health and the European Commission.

Why are the economic and societal returns so high?

Mostly, the scale of the return is driven by the 2.83 billion DALYs averted. We make a range of assumptions about how to convert these DALYs into dollars. Some of these, particularly our decision to use the full societal value of a life year rather than just the dollar value of what a person could have produced, push our estimated ROI higher; but under any plausible methodology, averting 2.83 bn DALYs by spending $123bn on R&D is going to look like a great investment.

So how did we end up with some many DALYs? We deliberately began this project with a wide lens, considering the impact of every product, across every nation, over a 41 year time horizon. These choices, particularly the last one, mean that we were able to capture a broader, longer-term picture of how R&D gradually but permanently lowers the burden of neglected disease.

Why are the total costs of R&D for future products so low?

We frontload our R&D cost measure, by using the full value of funding from 1994-2022, including basic research, funding for products that failed, will fail, or, those that launched pre-2000 or will launch after 2040. We view that as an overcount, including some funding going towards maintaining and/or replenishing the product pipeline.

To offset that overcount of the relevant funding through to 2022, we are a bit more conservative with what we count for 2022-2040. We no longer estimate full R&D funding, we instead just use a targeted estimate of the product-specific completion costs, which include the fact that a lot of the products we project to launch in the next 18 years are already relatively advanced in the pipeline. That slight undercount is mostly offset by having cast a very wide net for what we include 1994-2022, which, due to discounting, gets amplified in our final cost figures.

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