Tropical Medicine & International Health
June 2011  Volume 16, Issue 6  Pages 661–772
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2011.16.issue-6/issuetoc

Maternal Health
Relative and absolute addressability of global disease burden in maternal and perinatal health by investment in R&D (pages 662–668)
Nicholas M. Fisk, Martin McKee and Rifat Atun
Article first published online: 7 APR 2011 | DOI: 10.1111/j.1365-3156.2011.02778.x

Summary
Maternal and perinatal disease accounts for nearly 10% of the global burden of disease, with only modest progress towards achievement of the Millennium Development Goals. Despite a favourable new global health landscape in research and development (R&D) to produce new drugs for neglected diseases, R&D investment in maternal/perinatal health remains small and non-strategic. Investment in obstetric R&D by industry or the not-for-profit sector has lagged behind other specialties, with the number of registered pipeline drugs only 1–5% that for other major disease areas. Using a Delphi exercise with maternal/perinatal experts in global and translational research, we estimate that equitable pharmaceutical R&D and public sector research funding over the next 10–20 years could avert 1.1% and 1.9% of the global disease burden, respectively. In contrast, optimal uptake of existing research would prevent 3.0%, justifying the current focus on health service provision. Although R&D predominantly occurs in high-income countries, more than 98% of the estimated reduction in disease burden in this field would be in developing countries. We conclude that better pharmaceutical and public sector R&D would prevent around 1/3 and 2/3, respectively, of the disease burden addressable by optimal uptake of existing research. Strengthening R&D may be an important complementary strategy to health service provision to address global maternal and perinatal disease burden.