Despite increased investment of nearly $443.7 million in neglected disease R&D between 2007 and 2011, too much of the cash is going on basic research rather than developing desperately-needed drugs, vaccines and diagnostics for the world’s poor.

That is the key concern to come out of the latest G-Finder survey funded by the Bill & Melinda Gates Foundation and conducted by research group Policy Cures. It notes that governments are still by far the largest source of funding (nearly $2.00 billion a year or about two-thirds of the total) for neglected disease R&D, but while cash for basic research increased 28% over the five years, public product development investment actually slipped 1%; the former now accounts for nearly one-third of public funding, up from 26% in 2007.

The analysis notes that this trend is troubling because the sectors that traditionally fund product development – industry and philanthropy - have also cut or re-focused their budgets over the past five years. Big pharma's biggest investments are increasingly into late-stage studies for "a limited number of ‘semi-commercial’ areas such as dengue fever, bacterial pneumonia and meningitis and tuberculosis". These three diseases now account for two-thirds of all industry funding, up from half in 2008.

Philanthropic funding has dropped by a quarter since 2008, largely driven by "cyclical decreases" from the Gates Foundation, which provides over $0.80 of every dollar invested by the philanthropic sector. Product development partnerships - not-for-profit organisations that develop new neglected disease products - accounted for 40% of new global health products registered between 2000 and 2010. However, the G-Finder survey says "some critics point to these products as low-hanging fruits, saying PDPs have yet to prove themselves on more difficult innovations".

Better coordination needed

The report argues that "public funds will also continue to be wasted without much better coordination than we have seen to date". It calls for better collaboration between governments, philanthropy and industry, with World Health Organisation playing a significant role, "so that research dollars are devoted to making products the developing world needs, not simply research for research’s sake".

Report author Mary Moran, executive director of Policy Cures, said "some governments now appear to be in it for the long haul, which is great”, but "we’re worried that their investment model seems to be shifting back to the ‘bad old days’ where the public sector funded basic research leaving product development to industry or philanthropy".

Consequently, she added, "almost no medicines, vaccines or diagnostics for neglected diseases were developed. This model doesn’t and can’t work for truly neglected non-commercial diseases. It’s a bit like putting a man on the moon – yes, you need the scientists but you’ve also got to build the rocket or you’ll never get there."