D Dionisio

Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is reference advisor for “Medicines for the Developing Countries” for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). Starting February 2012, Dionisio is Head of the research project Geopolitics, Public Health and Access to Medicines (GESPAM). He may be reached at d.dionisio(at)tiscali.it

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Funding for R&D of products for poverty-related neglected diseases (PRNDs) is stagnating, whereas an increase is needed.

As recently highlighted in a report  “….At around US$3 billion in 2011, global R&D funding for neglected diseases is now around US$440 million; higher than it was in 2007, but lower than it was in 2009, and similar to that in 2010…”.

Stagnation is disappointing now that PRNDs cause 5 million deaths yearly in low income countries, while 3 billion people live on less than US$2 dollar a day,  key medicines protected by patents are unaffordable, and trade and governments are turning IP agendas into policies which back monopolistic interests.

Admittedly, last week two reports – one from WHO, another one from  London declaration partners including pharma, Gates and NGOs   –  came out which emphasized that some important progress has been made recently. Accordingly, “…In 2010 alone, 711 million people received treatment for at least one of the four diseases targeted for preventive chemotherapy (lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiases)…”, while “…29 countries began receiving albendazole or mebendazole to treat or prevent soil-transmitted helminthiasis, increasing treatments provided with those drugs to 238m last year from 46m in 2011…”.

Unfortunately, however, this positive momentum occurs at a time when the lack of a common agenda accounts for a highly fragmented landscape.

As such, although the European Union is a major funder of PRND R&D, its commitment in terms of PRND R&D only totals 0.0024% of EU’s combined GDP and is not spread evenly between Member States. Sweden, Ireland and the UK are investing over 0.0045% of their GDP, while others such as Finland and Italy contribute less than a tenth as much (0.0004% and 0.0002% of GDP respectively).  And only recently Germany has increased its commitments from initial 0.0007% GDP investing.

The EU should also link up more with partners’ relevant efforts, including the newly launched African Union’s Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa. Closer EU collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria is also awaited to join forces at this time of global economic slump. Last but not least, closer EU collaboration with the WHO is required as regards the models and sources  that WHO has called for to finance R&D for diseases of the poor   As such, a Financial Transaction Tax, now on track in the EU, would be fitting.

Meanwhile, the US substantially funds PRND R&D, also through the alliances the administration is boosting in the Asia-Pacific and Africa regions (see here,    here,   here & here).  At the same time, BRICS South-South cooperation spending, including on global health andPRND R&D, is steadily increasing through financing, capacity building, dramatically improved access to affordable medicines, and development of new tools and strategies for health (see here  and here).

From 2005 to 2010, Brazil’s assistance spending grew each year by around 20.4 %, India’s by around 10.8 %, China’s by around 23.9 % and South-Africa’s by around 8 %. And this occurs  at a time when the Gulf states, Turkey, Indonesia, Argentina, Mexico and South Korea are increasingly engaged in developing affordable health technologies.

While the good shifts highlighted here are a silver lining to PRNDs elimination goal, they are clearly not enough. More money is obviously a key issue, but a coordinated, collaborative effort from all the parties involved is equally vital. The London declaration was a start, but more is necessary.

As such, addressing the fragmented landscape above is a matter of urgency. To this aim, undisputed WHO leadership and a common agenda for shared health priorities are needed.

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