Abstract
The Global Health 2035 report notes that the “grand convergence”—closure of the infectious, maternal, and child mortality gap between rich and poor countries—is dependent on research and development (R&D) of new drugs, vaccines, diagnostics, and other health tools. However, this convergence (and the R&D underpinning it) will first require an even more fundamental convergence of the different worlds of public health and innovation, where a largely historical gap between global health experts and innovation experts is hindering achievement of the grand convergence in health.
Highlights
Unless there is a dramatic change, and a far greater focus on new tools to manage common causes of mortality such as post-partum haemorrhage (PPH) (27% of maternal deaths) [14] and neonatal infections and asphyxia (59% of neonatal deaths) [15], the SDG maternal and child health goals are even less likely to be met than their Millennium Development Goal (MDG) counterparts
This is of particular concern given that the maternal health goal (Goal 5) is still the furthest from being reached of any of the MDGs [16]
These historical factors have sometimes led to an unproductive tension between global health and innovation, with an implicit view that scarce health funds should be spent on programmes and service delivery, not on developing new tools
Summary
Development agencies do spend on research (for example, the UK, Swedish, Swiss, Canadian, and Australian agencies spend between 2%–3% of their programmatic aid budgets in research and between 10%–40% of this on health research [10]), but their focus is often on operational and field research, not technology innovation or product development. The vast bulk of public funding for the new tools needed by public health programmes comes not from the public health field but from domestic science and research agencies (83% of public funding), with aid agencies providing only 10%. Doi:10.1371/journal.pbio.1002363.t002 funding into product development and less than 1% into basic research; by comparison, science agencies invested 35% into basic research—and close to 40% during the global financial crisis when spending at home was a priority
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