Statement by Dr Tido von Schoen-Angerer, Director of the Campaign for Access to Essential Medicines, Médecins Sans Frontières in response to the publication of the G-FINDER report
London, 4 February 2009 — The G-FINDER report provides welcome new data on how R&D funding is currently being allocated.
MSF has been calling for medical R&D to be steered according to real medical needs, so that the development of urgently-needed tools, such as a tuberculosis diagnostic test, are prioritised. The G-FINDER report suggests a methodology to determine how R&D should be prioritised according to potential health impacts. As such it provides a foundation for future work in order to ensure that R&D is driven by medical needs. But further work needs to be done to get behind top line figures and identify the needs and priorities within disease areas.
The G-FINDER report does not estimate the total funding needs. It thus fails to show the extent to which diseases are under-funded. All areas are under-funded, and it would be a mistake to start spreading the funds even thinner across more diseases. We need to look at how much is needed, not just how much is being spent.
Nor does the G-FINDER report look at how R&D funds should be disbursed. New approaches are necessary. We need to challenge existing thinking and broaden the field of researchers working on neglected disease research - R&D needs will not be met just by giving more money to PDPs. Alternative funding mechanisms are needed. Push funding through grants need boosting, but pull funding also needs to be rolled out and in a way that ensures access to products that answer medical needs. Mechanisms that separate the costs of R&D from the prices of the developed products, such as recent proposals for prize funds, have a crucial role to play.
The G-FINDER report confirms MSF analysis showing that European countries are not paying their fair share. Take tuberculosis research - how can it be that the contributions of the European Commission added to the EU member states are dwarfed by the US, only accounting for around 30% of what the US is investing? The G-FINDER comes as a confirmation to recent MSF analysis showing that Europeans are paying pitifully low amounts. In 2008, MSF called on the EC to increase its contribution to TB five fold. Their responsibility is clear: countries right on Europe’s doorstep – even within the EU – are struggling against resistant strains of TB. Tuberculosis is knocking loudly on the door, and the research pipeline is desperately insufficient, but the European Commission is playing deaf. This is all the more shocking given that the EC has already allocated over 8 billion euros to health research for 2007-2013. The money is there, but neglected diseases remain neglected.
The G-FINDER report does not address the important question of access to any developed product. Even if research does take place, the stark reality is that access to the fruits of innovation is far from a given because it depends on pricing or registration policies pursued. A pneumoccocal vaccine able to dramatically reduce the number of children dying, for example, was approved in 2000 by the U.S. FDA. Over nine years later, the vaccine remains expensive, is marketed in a highly impracticable form and is not available in the least developed countries where it could have made the biggest difference in reducing unnecessary death. Innovation is useless if people cannot benefit from the fruits of it.
The G-FINDER report comes at an important time. The World Health Organization is implementing a Global Strategy and Plan of Action to ‘secure an enhanced and sustainable basis for needs-driven, essential health research and development relevant to diseases that disproportionately affect developing countries, proposing clear objectives and priorities for research and development, and estimating funding needs in this area.’ It is important that before any conclusions of the report are adopted, the WHO and countries review its conclusions and assess whether they match their needs and priorities.