Research agencies in the US are spending far too little on neglected diseases with a high prevalence in the developing world, a recent report argues.

For example, notes healthcare consumer advocacy group Families USA, the National Institutes of Health (NIH) – which accounts for around 78% of public funding for medical research in the US – committed less than 1% of its budget for fiscal year (FY) 2007 to diseases common among more than a quarter of the world’s population.

For its report, The World Can’t Wait: More Funding Needed for Research on Neglected Infectious Diseases, Families USA looked at government research funding in FY 2007 by the NIH, the Centers for Disease Control and Prevention (CDC), the Department of Defense (DoD) and the US Agency for International Development (USAID) on eight diseases classed as “neglected” by the scientific community.

These were African sleeping sickness, Buruli ulcer, Chagas disease, cholera, dengue fever, leishmaniasis, malaria and tuberculosis. The researchers found that malaria and tuberculosis each attracted around 36% of total funding, while 12% went to dengue fever and less than 10% apiece to African sleeping sickness, Buruli ulcer, Chagas disease, cholera and leishmaniasis.

After duplicate funding was eliminated, a total of US$366 million was spent on the eight neglected diseases by the four US agencies during FY 2007. Expenditure varied considerably by disease, agency and research category. For example, the NIH put US$5.7 million into African sleeping sickness that year, while none of the other three agencies spent anything in this area.

The NIH also spent US$11 million and US$15.7 million respectively on Chagas disease and cholera; nothing was spent on these diseases by the CDC, the DoD or the USAID.

Moreover, the NIH was the only one of the agencies to fund all stages of research activity, with the heaviest emphasis (43% of total spending in FY 2007) on basic research.

By contrast, the DoD spent around 67% of its research funds for the neglected diseases on product discovery and preclinical product development, and nearly 24% of the funds on clinical product development and related clinical research. The USAID’s proportional outlays in these areas were around 29% and nearly 55% respectively.

Across all of the agencies, about 35% of research funding for the neglected diseases went on basic research and roughly 33% on product discovery and preclinical product development. No other research area received more than 10% of funding.

Not just altruism

The Families USA report “demonstrates in detail what we see on a larger scale in annual budgets”, commented the group’s executive director, Ron Pollack. “Government funding for agencies like NIH and CDC has not kept pace with biomedical research inflation. This shortfall crimps every agency function and eliminates any possible expansion of research on these neglected infection diseases.”

Nor, he stressed, was it just a matter of altruism. “An investment in stamping out disease can aid our own economy by strengthening the economies of other nations, making their societies more stable, and giving us a real return on our medical investment,” Pollack said.

He was backed up by Representative Jim McDermott (Democrat, Washington state), who added: “We live in an increasingly shrinking world; contact between Americans and the rest of the world via infection is increasing every day. The AIDS pandemic was the first shot across our bow; troops coming home from Iraq infected with leishmaniasis is the second shot, and drug-resistant TB strains [are] just over the horizon … we should increase government funding to combat these threats.”