HEALTH: Research Benefits the Few, Overlooks Prevailing Diseases

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, May 20 2002 (IPS) - A sharp imbalance continues between the resources earmarked for researching diseases predominant in the industrialised world and for those prevalent in poor countries, but experts and activists are confident that the disparity can be reduced.

This gap has been dubbed 10/90 because 90 percent of the world’s disease burden draws just 10 percent of the 73.5 billion dollars spent each year on health research.

In other words, nearly all private and public scientific study of disease is aimed at providing relief for a minority of the world population, mostly in wealthy countries.

“The human and economic costs of such misallocation of resources are enormous, particularly for the poor,” says the Global Forum for Health Research, the international institution that is leading the way in resolving the 10/90 gap.

The Forum, which consists of public, private and civil society entities, has expressed confidence that the imbalance can be reduced.

Ten years ago, and even five, the existence of the 10/90 gap was almost unknown. But today the notion has gained greater prominence in political, academic and communications arenas, according to the Forum.

As a result, “we have reason to be optimistic,” said Forum president Richard Feachem, a scientist from the United States.

“When a problem has been widely recognised as a very serious one, it mobilises forces to find a solution,” he stated.

The objective of the Global Forum for Health Research is to correct the gap so that research focuses on the diseases that represent the greatest health burden worldwide.

Acute respiratory infections, diarrhoea-related diseases, cardiovascular problems and mental health illness are ailments that should be among the top health research priorities, says the Forum.

The Forum’s list highlights tuberculosis, tropical diseases, perinatal diseases and HIV/AIDS.

The Forum’s “10/90 Report on Health Research 2001-2002” states that just 13 of the 1,233 medications that were patented between 1975 and 1997 were intended to combat infectious tropical diseases that hit poor populations especially hard.

In another example, the Forum points out that in 2000 just 383 million dollars were invested in research related to the four predominant diseases affecting the countries of the developing South: malaria, tuberculosis, tripanosomiasis (sleeping sickness) and leishmaniosis (a parasitic disease).

But these four ailments together represent at least five percent of the global disease burden. As a proportion of the total sum invested in health research, that five percent should receive an investment of more than 3.5 billion dollars in research, more than nine times the current amount.

A one-percent redistribution of health research expenditures would provide 700 million dollars for priority activities, says the Forum in the report released this week.

The Geneva-based organisation states that correcting the 10/90 gap “would constitute a major contribution to growth, development and the fight against poverty.”

But success “requires the individual and concerted efforts of thousands of institutions,” says the document.

Otherwise, said Walter Fust, director of the Swiss Agency for Development and Cooperation, we will be confronted with universal threats.

“We know that without progress in health and development, there will be no global security, and industrialised countries will in turn be confronted with all the consequences of preventable man- made disasters,” predicted Fust.

The resources dedicated to health research in 1998 by public and private entities reached 73.5 billion dollars. The total in 1992, at the current dollar value, was 56 billion.

Governments were responsible for 37 billion dollars of the 73.5 billion spent in 1998, while the pharmaceutical industry provided 30.5 billion, and the remaining 6.0 billion came from private funds, non-profit entities and universities.

The Commission for Health Research and Development, which operates under the auspices of the World Health Organisation (WHO), has proposed that low- and middle-income countries “allocate at least two percent of national health expenditures and five percent of externally funded programmes to research and capacity strengthening.”

However, none of the countries included in that income range has achieved the goals suggested by the Commission.

Only Brazil and Cuba came close, in 1998, to the two-percent goal for investment in health research.

Luis Currat, executive secretary of the Forum, recommended establishing national and international priorities for health research.

“This is an absolute necessity if our limited health research funds are to have the greatest impact possible on the level of world health,” said Currat.