Report: $46 billion US investment in global health generates 'blockbuster returns'

Public Health
Research and development

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From 2007 to 2022, the $46 billion in US investment in global health research and development (R&D) produced dozens of vaccines and drugs, gave rise to $104 billion in economic activity, created 600,000 new jobs, and is expected to spur another $102 billion in industry investments in the United States and beyond.

The funding, which is projected to ultimately generate $255 billion for the US economy, is detailed in a report released last week by the Global Health Technologies Coalition (GHTC) and Policy Cures Research in Australia.

"Public funding for global health R&D is small, relative to the incredible returns it provides for fighting neglected and emerging diseases like malaria, HIV, tuberculosis, Ebola and COVID-19—and for stocking the pipeline with many promising new technologies," Kristie Mikus, DrPH, MPA, GHTC executive director, said in a news release from the Washington, DC–based organization.

Funding helps overcome barriers in poor countries

The report, "Doing Well by Doing Good," examines the return on investment of US funding in global health technologies through agencies such as the National Institutes of Health, the Biomedical Advanced Research and Development Authority, the Agency for International Development, and the Centers for Disease Control and Prevention.

"The report notes that new tools are urgently needed, because these challenges cause a massive loss of life around the world, impede economic progress in low- and middle-income countries, and pose a growing threat to Americans—especially with climate change facilitating the spread of disease," the release said

Public funding for global health R&D is small, relative to the incredible returns it provides for fighting neglected and emerging diseases like malaria, HIV, tuberculosis, Ebola and COVID-19—and for stocking the pipeline with many promising new technologies. 

Kristie Mikus, DrPH, MPA

With climate change leading to warmer temperatures with fewer freezing days, many organisms, ticks, mosquitoes, larger animals, and their related illnesses are encroaching on new geographic areas, where they can affect more people. For example, insect-borne pathogens such as dengue, Zika, chikungunya, malaria, and Chagas disease have expanded into the United States.

In 45 low- and middle-income countries (LMICs), the funding described in the report supported development of 67 approved tools, including 12 products for fighting Ebola, 12 for tuberculosis (TB), and 11 for malaria, and is enabling the development of 261 tools now in late-stage development.

Needs outstrip R&D capacity

Examples of the currently available or late-stage technologies are:

  • The drug pretomanid, which has substantially improved TB outcomes and reduced the costs of treating patients infected with drug-resistant bacterial strains when added to the traditional treatment regimen.
  • Two long-acting HIV drugs, cabotegravir and dapivirine, which offer alternatives to daily dosing regimens for at-risk groups. Cabotegravir, which is given via bimonthly injections, could prevent 45% of infections in the United States and up to 28% of HIV cases in LMICs. Dapivirine, a vaginal ring used monthly, helps avert infections in women.
  • Operation Warp Speed funded rapid US development of four COVID-19 vaccines, which have been credited for saving 14.4 million lives around the world in the first year of the pandemic alone. From December 2020 to March 2022, the vaccines were estimated to have saved $895 billion in direct healthcare costs. 
  • Two approved monoclonal antibodies (mAbs) for treating Ebola have been shown to reduce deaths to 11% and 6%, respectively, compared with 54% with no treatment. And three mAbs in clinical development may cut malaria infections by up to 75% in endemic regions.

Yet, more funding is needed. "The irony is that despite producing blockbuster returns, public funding for global health R&D is not keeping pace with growing needs and rising risks," Mikus said.

"R&D funding for emerging threats largely has been reactive—mainly focused on emergencies like Ebola, Zika and COVID-19—and R&D budgets for neglected diseases actually dropped 11% in 2022," she added. "We encourage policymakers to look at global health R&D as one of the best investments a government can make, right up there with roads, schools and national defense."

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