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Cough Up For TB! The Underfunding of Research for Tuberculosis and Other Neglected Diseases by Germany

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Photograph by Brendan Bannon

In their work in field projects, MSF staff can only do so much, they frequently lack sufficient treatment possibilities to address diseases that primarily affect people in developing countries. Because research for neglected diseases, including tuberculosis (TB) and malaria, is typically not profitable, drugs, diagnostics and vaccines for these diseases are desperately lacking. 

For nearly a decade, MSF has been advocating for more efforts and resources to be invested into research and development for such diseases, and has even been supporting research itself. Last year, MSF contributed 5.8 million euros to fund the non-profit drug development partnership it co-founded in 2003, the Drugs for Neglected Diseases Initiative (DNDi). This is not enough. To secure long-term funding for research into neglected diseases, there needs to be far more public funding than today. This report analyses for the first time how much funding the Federal Republic of Germany is contributing towards research into TB, malaria and other neglected tropical diseases. More than 30 experts have been interviewed for this research, and more than 90 research projects examined. 

MSF’s analysis reveals that the total funding contribution stands at 20.7 million euros for 2007. This includes both project funding and institutional funding.  Of those 20.7 millions, 9.0 million euros went to malaria, 7.5 million euros to TB and 4.3 million to research into neglected tropical diseases such as leishmaniasis, sleeping sickness or worm-related diseases (Fig. 1, p9). Their respective figures were sent before publication to the relevant German funding and research institutions (federal ministries for research, for development and for health, the Bernhard-Nocht-Institut, the Forschungszentrum Borstel, and the Max-Planck-Institut für Infektionsbiologie). Their comments are included in this report.

Our conclusions are clear: the total sum of public research spending in Germany is utterly insufficient to meet the needs. A particularly detailed analysis was conducted for TB, where we looked at the amount of funding Germany should be giving so as to represent a fair contribution, as measured by shares of economic wealth. We found that Germany, even if you include funds spent by the country indirectly via the EU level, spends only 15 percent, - or one seventh - of the amount that could be deemed appropriate (Fig. 6, p18).  Robert Koch, who discovered the TB bacillus 130 years ago, would turn over in his grave if he knew how much his home country had given up the fight against this disease, compared to other industrialised countries! MSF feels that Germany, as the third largest economy in the world, and as a self-proclaimed centre of excellence for research and development, has an important responsibility to support this essential activity. Germany must use its capacity to address the global need for access to live-saving diagnostics, treatments, and vaccines.

Germany’s poor performance becomes especially apparent when one examines the German contribution to international product development partnerships (PDPs). In 2007, EU member states jointly contributed 27.3 million euros to PDPs relevant for diseases discussed in this report. The German contribution towards this new and important model for applied research and development was a shocking zero. MSF urges the German government to massively increase public research funding for TB, malaria and neglected tropical diseases. These funds must be earmarked so that this important research does not compete with projects in other research areas. MSF is pushing for research programmes that specifically address diseases that predominantly affect people in developing countries.

MSF’s demands are directed towards all institutions that fund such research, namely the three relevant federal ministries (for research, health and development), as well as the German Research Society (DFG), the Max Planck Society and the federal states (Bundesländer). Other research institutions that so far have not been active in this area at all are also urged to become involved, such as the Helmholtz Society of German Research Centres and the Fraunhofer Society. MSF urges for an increase in institutional funding for the relevant research institutes, and stronger participation of the German government in the creation of alternative mechanisms to support research and development, such as those currently under discussion at the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property of the World Health Organization.

Germany has to change its strategy in the fight against neglected diseases. The concerned federal ministries for research, health and development have to clarify their respective competencies in this area. The ball is in their court.

Desperately-needed tools must be developed if MSF is to be able to treat its patients, and that these are made affordable. Intellectual property protection should not stand in the way of access to innovations that are critical to people in the developing world. This is especially crucial for tools that are developed with public funding. Governments must ensure that patents do not lead to prices that are higher than production costs.

Cough Up For TB! The Underfunding of Research for Tuberculosis and Other Neglected Diseases by Germany