Research and development expenditure for poverty-related and neglected diseases: an analysis of economic and epidemiological data

Abstract Background Research and development (R&D) for poverty-related and neglected diseases falls short of their global public health importance. Several major global health initiatives aim to address this shortfall. We analysed the degree to which diseases are related to poverty and whether they are neglected by R&D at present. Methods We measured how diseases were related to poverty with the ratio of disability-adjusted life-years (DALYs) per 100 000 inhabitants in low-income and middle-income countries versus that in high-income countries. We termed this ratio the poverty relation factor (PRF), which we calculated for all 240 causes of death and disability in the Global Burden of Disease Study 2010. We classed each cause as strongly or moderately related to poverty or affluence on the basis of a WHO background report. We measured neglect in R&D by the ratio of disease burden in DALYs (as a percentage of the total global disease burden) versus R&D expenditure (as a percentage of total global health-related R&D expenditure). We termed this ratio the neglect factor, which we assessed for 26 diseases commonly considered neglected and listed in the 2012 G-FINDER report. We estimated total global health-related R&D expenditure from data from official statistical databases and reliable private sources (OECD.stat, UNESCO Institute for Statistics, Eurostat, EP Vantage, Research!America). Research expenditure data for specific diseases were taken from the 2012 G-FINDER report. Findings 28 of 240 (12%) causes of death and disability were strongly related to poverty (PRF >35), 53 (23%) were moderately related (PRF 3–35), 117 (49%) were unrelated to economic development (PRF 0·66–2·99), 27 (11%) were moderately related with affluence (PRF 0·33–0·65), and 16 (7%) were strongly related with affluence (PRF Interpretation A large shortfall exists in global R&D spending for poverty-related and neglected diseases, with huge variations between individual diseases. Funding None.