One year on, Global Observatory on Health R&D identifies striking gaps and inequalities

February 2018

A woman and a man are talking in front of a board pinned with some diagrams and informative papers

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.