WHO: Top epidemic-prone diseases without sufficient counter measure :: One year on, Global Observatory on Health R&D identifies striking gaps and inequalities

Milestones :: Perspectives

Top epidemic-prone diseases without sufficient counter measures – WHO
12 February 2018 – WHO releases its 2018 list of priority pathogens that have the potential to cause a public health emergency and which have no, or insufficient, countermeasures. WHO calls on the medical community to unite in greater R&D efforts for these 8 diseases to develop treatments and vaccines to help control outbreaks.
List of Blueprint priority diseases
2018 annual review of the Blueprint list of priority diseases
For the purposes of the R&D Blueprint, WHO has developed a special tool for determining which diseases and pathogens to prioritize for research and development in public health emergency contexts. This tool seeks to identify those diseases that pose a public health risk because of their epidemic potential and for which there are no, or insufficient, countermeasures. The diseases identified through this process are the focus of the work of R& D Blueprint. This is not an exhaustive list, nor does it indicate the most likely causes of the next epidemic.

The first list of prioritized diseases was released in December 2015. Using a published prioritization methodology, the list was first reviewed in January 2017.

The second annual review occurred 6-7 February 2018. Experts consider that given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated research and development for*:

:: Crimean-Congo haemorrhagic fever (CCHF)
:: Ebola virus disease and Marburg virus disease
:: Lassa fever
:: Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute   
  Respiratory Syndrome (SARS)
:: Nipah and henipaviral diseases
:: Rift Valley fever (RVF)
:: Zika
:: Disease X

Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible.

A number of additional diseases were discussed and considered for inclusion in the priority list, including: Arenaviral hemorrhagic fevers other than Lassa Fever; Chikungunya; highly pathogenic coronaviral diseases other than MERS and SARS; emergent non-polio enteroviruses (including EV71, D68); and Severe Fever with Thrombocytopenia Syndrome (SFTS).

These diseases pose major public health risks and further research and development is needed, including surveillance and diagnostics. They should be watched carefully and considered again at the next annual review. Efforts in the interim to understand and mitigate them are encouraged…
One year on, Global Observatory on Health R&D identifies striking gaps and inequalities – WHO
February 2018
Each year, hundreds of billions of dollars are spent on research and development (R&D) into new or improved health products and processes, ranging from medicines to vaccines to diagnostics. But the way these funds are distributed and spent is often poorly aligned with global public health needs.

One year ago, the World Health Organization launched a new initiative to gather information and provide an accurate picture of where and how R&D monies are being spent, helping governments, funders and researchers to make better decisions on investment and policy making priorities.

Ensuring that decision-making about which diseases, countries and products receive investment funds is not entirely reliant on market forces is critical. The 2014 outbreak of Ebola virus disease in West Africa, which left more than 11,000 dead, dramatically exposed the lack of investments in products and approaches to prevent and minimize the impact of pathogens with epidemic potential. And gaps in R&D investments in the pipeline for antimicrobial medicines are a cause of global concern in the context of rapidly increasing antimicrobial resistance.

The Global Observatory on Health R&D has identified striking gaps and inequalities in investment both between countries and between health issues, with frequent disconnects between burden of disease and level of research activity.

:: High income countries have an average of 40 times more health researchers than low income countries. Based on data from 60 countries:
…The disparity in investment means the number of health research workers per million inhabitants in countries ranges from 1140 in Singapore to 0.2 in Zimbabwe.
…Women health researchers are underrepresented in low income countries. While the average number of female researchers in high income countries is approximately 51%, this drops to just 27% in low income countries.

Explore health researchers by country income group and by WHO Regions:
Health researchers data
:: Serious imbalances in funding flows mean countries with comparable levels of poverty and health needs receive strikingly different levels of Official development assistance (ODA) for medical research and basic health sectors (health ODA).
…In 2016, among low income countries, Liberia received the highest health ODA per capita – 3 times more than the weighted average amount received by other low income countries and 3.5 times more than Madagascar, which suffered from a serious outbreak of pneumonic plague this year.
…In 2016, Tuvalu, an upper middle income country, received the highest health ODA per capita (60.03 US$) anywhere in the world, 286 times more than the weighted average for the upper middle income group it belongs to, 39 times more than South Africa and 95 times more than Albania.
….Amongst countries in Africa, the Seychelles, a high income country, received the highest amount of health ODA per capita in 2016. At 34.17 US$ per capita, the country received almost 8 times more per capita than the weighted average for this region.

Explore ODA for medical research and basic health sciences per capita, by recipient country:
ODA data
:: As little as 1% of all funding for health R&D is allocated to diseases such as malaria and tuberculosis, despite these diseases accounting for more than 12.5% of the global burden of disease.
…Public sector governments contributed almost two thirds of investments on product-related health R&D for neglected diseases, followed by philanthropies.
….The United States of America continues to be the lead country in investments on neglected diseases from public and philanthropic sources. Over 10 years of investments, USA has contributed almost two thirds of the total investments, followed by the United Kingdom of Great Britain and Northern Ireland and the European Union.
…Investments by the private sector in neglected diseases have increased since 2012, mostly due to investments in HIV/AIDS and malaria.

Explore the distribution of R&D funding flows for neglected diseases by country, funder and recipient organizations:
R&D funding flows by country, funder, and recipient organizations and R&D funding flows by source and type of funding
Investing in R&D to discover and develop medicines and vaccines is key to improving access to medicines and quality health care for people across the world and to achieving universal health coverage. The Global Health Observatory on Health R&D builds on existing data and reports from a wide range of sources as well as newly gathered information to provide an accurate picture of the current investment situation and enable informed decision making on priorities.