Trends in TB R&D investment: Where is funding most needed? Lindsey Wu Policy Analyst Policy Cures [email protected] .

Trends in TB R&D investment:Where is funding most needed?

Lindsey WuPolicy Analyst

Policy [email protected]

ABOUT POLICY CURES

• An independent not-for-profit research group

• Innovative ideas and accurate analysis to accelerate development and uptake of new products for neglected diseases of the developing world • Previously at the London School of Economics and the George Institute for International Health

Global Funding of Innovation for Neglected Diseases (G-FINDER)

•Project funded by the Gates Foundation

•Tracks global investments into R&D of new products for neglected diseases • 31 neglected diseases (including TB)• 134 products areas, including drugs, vaccines, diagnostics, microbicides,

vector control products and platform technologies

•Includes analysis of funding trends for TB R&D since 2007

TB R&D funding, 2007- 2009

Increase of $113m (25.4%) from 2008 to 2009

Increase share of global neglected disease R&D funding from 15.1% in 2008 to 17.6% in 2009

TB R&D funding by product, 2007-2009

Basic research investments increased in 2009 (up $63m, 47%) Drug investments increased in 2009 (up $33m, 22%) Moderate increase in diagnostics (up $7.5m, 17%), and vaccine

investment remained steady

TB R&D funding by funder type, 2009

90% of TB R&D funding provided by only 12 funders Public funding comprised over half of TB R&D funding (~60%) BUT.. Substantial private sector involvement ($123m 22% in 2009) Shift towards public funding

Public (up $108.5m from 2008) – mostly US NIH Philanthropic (down $30.6m from 2008) – mostly Gates Industry (up $36m from 2008)

Fund received by TB PDPs, 2007-2009

Substantial share of total TB R&D funding (20% or $109m in 2009) Decrease of 12% ($15m) since 2008, despite overall increase in TB funding

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WHERE IS TB R&D INVESTMENT MOST NEEDED?

Global Plan to Stop TB 2011-2015

$9.8bn estimated to be needed from 2011-2015

Published by the Stop TB Partnership

Even though figures have been contested, this is the only benchmark currently available

Consensus on figures important so funders to know that funding for TB is not a blank check – it is results oriented

Global Plan to Stop TB targets, yearly projections

Basic research need•Improved characterisation of human TB•Address key molecular features of host/pathogen interactions•Allowing discovery of new biomarkers and new drug and vaccine candidates

Drug product needs•New four-month TB regimen for drug-susceptible TB•Nine-month regimen for MDR-TB, including new drugs for MDR-TB•Safer, shorter, higher efficacy treatment for latent TB infection

Basic research$200m in 2009

Increase of $200m needed

by 2011

Drugs$180m in 2009

Increase of over $400m needed

by 2011

PROJECTIONS CONT

Vaccine product needs•Safe and effective vaccine•Assay to determine biomarkers and correlates of immunity

Diagnostic product needs•Detection of TB in all age groups•Detection of MDR-TB and latent TB•Detecting latent TB infection at risk of progression to active TB•Rapid and reliable diagnosis of TB for use at peripheral level of health systems

Vaccines$113.4m in 2009

Increase of $100m needed initially by

2011, then up another $200m by

2013

Diagnostics$52m in 2009

Increase of $250m needed

by 2011

Key messages

Impact of the global financial crisisRisk of funding cutbacks ARRA programme ($19m for TB)Public focus on funding for domestic researchers

Shift in focus from product development to basic researchBasic research funding up 47% from 2008-2009Product development funding up 14% from 2008-2009

Looking forward

TB R&D funding needs a solid investment strategies

More funding is both vital and welcome, BUT

Funding must be strategically targeted

Funding must be coordinated and diversified across a larger number of organisations and sectors

Funding for product development should be protected and prioritised – PDPs can be a good vehicle to achieve that

Thank you