Sydney, Australia, 13 August 2020—A new G-FINDER report on the R&D landscape of sexual and reproductive health (SRH) highlights promising developments in the field, but finds the bulk of funding comes from a handful of investors, and relatively limited investment means that SRH R&D efforts in many areas are insufficient to meet theneed for new products in low and middle-income countries (LMICs).
“Many people, especially women, are dying and suffering from preventable and treatable issues of sexual and reproductive health, while the products currently available are not enough to change this,” said Dr Nick Chapman, CEO of Policy Cures Research. “There’s a clear gap in investment to research and develop new products to meet people’s needs in low-resource settings. With a few funders stepping in to fill this gap, there are missed opportunities to make a real impact on the lives of people in LMICs.”
HIV/AIDS dwarfs all other SRH R&D funding
Produced by the global health think tank Policy Cures Research, the report identified US$1.7 billion in 2018 funding for R&D relevant to the SRH needs of people in LMICs. However, US$1.4b of this total was for HIV/AIDS, dwarfing the $71m invested in R&D for all other sexually transmitted infections (STIs) combined.
“The scale of this difference is largely due to the unique position held by HIV/AIDS in the global health and R&D landscape versus other STIs because of its high morbidity and death rates, along with decades of strong global advocacy and sustained investment,” said Maya Goldstein, lead author of the report. “Plus, there are several advanced products for HIV/AIDS in the pipeline in late stage clinical trials that are typically more expensive.”
R&D for other SRH issues with potential wide-reaching impacts also received far less support. Human papillomavirus (HPV) and HPV-related cervical cancer, for example, is the fourth most frequent cancer worldwide and a leading cause of cancer death in women, but received just $52m in R&D funding in 2018. The pot is even smaller for post-partum haemorrhage (PPH) and pre-eclampsia, which are leading causes of maternal illness and death worldwide: PPH received just $4.4 million and pre-eclampsia just $12m
Strong support from a handful of funders
Based on responses from 129 organisations from government, non-profits, foundations and industry, the G-FINDER SRH report provides the most up-to-date, comprehensive look at the R&D landscape for products and technologies addressing SRH health issues affecting people in LMICs.
For most SRH issues covered in the report, the US National Institutes of Health (NIH) ($994m), the pharmaceutical industry ($273m) and the Bill & Melinda Gates Foundation ($185m) were reported as top funders of R&D. The US NIH ranked in the top three R&D funders for every SRH issue noted in the survey, except PPH, while the Gates Foundation featured as a top funder across several SRH issues, including contraception, HIV/AIDS, HPV & HPV-related cervical cancer and pre-eclampsia.
“While the contributions of these top funders are invaluable to SRH R&D, the magnitude of their investments compared with others signals perhaps too heavy a reliance on a few organisations to support SRH innovation,” said Goldstein. “There’s a clear need and opportunity for more private and public sector investors to contribute.”
Contraception R&D not yet meeting demand for new products
Despite significant improvements in availability of modern contraception, a major gap remains in LMICs, where more than 218 million women of reproductive age still have an unmet need. A major driver of contraceptive discontinuation and unmet need is dissatisfaction with currently available methods. While new products and technologies have the potential to bridge this gap, global funding for contraception product development in 2018 was just $64m, with $46m intended for female end-users compared to $9.2m for male end-users.
The promise of multipurpose prevention technologies
Multipurpose prevention technologies (MPTs) can simultaneously provide protection – in varied combinations – against pregnancy, STIs or HIV in a single product. Currently the only MPT available is the condom, and while highly effective, is not enough to meet the diverse SRH needs, particularly of women and girls, in LMICs. An equally diverse range of MPTs could be transformative. In 2018, $48m was invested in R&D for new MPTs, with some promising products in development.
“The potential benefits of effective MPTs would be huge in LMICs, where most STIs, HIV and unintended pregnancies occur,” Goldstein said. “MPTs that are appropriate for use in low-resource settings would allow sexually active people the ability to protect themselves against multiple SRH issues with the convenience of one product. This would increase efficiencies not only for users, but also for donors, procurers, and healthcare providers.”
Potential impact of COVID-19 on SRH R&D
While the report covers SRH R&D funding up to the end of 2018, Policy Cures Research has been tracking the COVID-19 R&D landscape since January 2020. There is global concern that the unprecedented focus on COVID-19 R&D funding may adversely impact future SRH R&D.
“Looking to the future, not only are unprecedented funding levels being funnelled towards COVID-19, but an impending global recession will undoubtedly have an impact on future development funding commitments and available funding to address other global health issues, like SRH,” said Dr Chapman. “Strategic, innovative, and well-coordinated mechanisms for SRH R&D funding will be needed, now more than ever, to close these widening gaps.”
The G-FINDER SRH project is part of Policy Cures Research’s flagship G-FINDER project, which tracks annual investment into R&D for new products and technologies designed to address persistent global health challenges disproportionately affecting people in LMICs.
About Policy Cures Research
Policy Cures Research is a global health think tank with a long and pioneering history in global health R&D data collection and analysis, securing our position as a trusted source of quality evidence within the sector.
Mr. Wynne Boelt
Strategic Communications Advisor
Policy Cures Research
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