Volume 10 Supplement 8

Resource allocation for infectious disease R&D and the Research Investments in Global Health study: a report of three workshops

Open Access

The activity of the Research Investments in Global Health study and ways forward within the global funding and policy landscape

BMC Proceedings201610(Suppl 8):59

DOI: 10.1186/s12919-016-0065-2

Published: 10 October 2016

Abstract

The Research Investments in Global Health (ResIn, www.researchinvestments.org) study analyses funding trends in health research, with a predominant focus on infectious diseases. Since October 2015, the project is funded by the Bill & Melinda Gates Foundation and is now based at the University of Southampton in the UK. In 2016, Public Policy@Southampton provided ResIn with a small grant to explore developing links with policy, funding and research stakeholders with an interest in global health. Three meetings were organised in London (Wellcome Trust, 25 May 2016), Brussels (UK Research Office, 2 June 2016), and Geneva (WHO R&D Observatory, 8 June 2016). In total, 45 stakeholders attended and provided comment and critique on the study methodology and potential expansion into other disciplines. A theme that emerged across all three meetings concerned the use of a standardised categorisation system. A key benefit of the ResIn study is the ability to present granular detail in precise areas. Further work packages that could enhance the use of the collected R&D data included integration with geospatial, policy and scientometric methodologies. There was broad enthusiasm that outputs from these proposed projects would provide clear benefits in informing health policy and R&D strategy. Outputs from the ongoing study covering infection-related R&D investments in the G20 nations will be available in 2017.

Background

The Research Investments in Global Health study (ResIn, www.researchinvestments.org) has systematically mapped the UK landscape for infectious disease research by describing funding trends for awards to UK institutions between 1997 and 2013 inclusive [1, 2]. Awards related to infection from all the major funders of health and biomedical research were categorised by disease area, pathogen, clinical specialty and the type of science along the R&D pipeline. Investments were also compared to the global burden of disease, using data sourced from the Global Burden of Disease (GBD) study [3, 4], to gain an idea of UK areas of likely research strength and diseases that appear relatively poorly-funded.

Since October 2015, ResIn has been funded by the Bill & Melinda Gates Foundation to consider R&D investments for infection across all the G20 nations. In 2016, Public Policy @ Southampton (http://www.southampton.ac.uk/publicpolicy) awarded ResIn a small grant (£3900) to organise three workshops that engage funders, policymakers and other stakeholders in global health. With a combined attendance of 45 individuals (Tables 1, 2, and 3), the aim of the workshops was to highlight the activity of the ResIn project, to prepare the R&D community for the publication of the global dataset in 2017, to present ideas for expansion into other disciplines, and to seek critique and feedback on study methodology.
Table 1

Invited attendees of London workshop, 25 May 2016

Alex

Blum

Public Policy @ Southampton

Gavin

Costigan

Public Policy @ Southampton

Catherine

Cotton

Federation of European Microbiological Societies

Kevin

Dolby

Wellcome Trust

Emily

Gale

Medical Research Council

Pat

Goodwin

Microbiology Society

Felix

Greaves

Public Health England

Chris

Lowry

British Society of Immunology

Anthony

Scott

London School of Hygiene & Tropical Medicine

Andrew

Smith

Foreign and Commonwealth Office

Vinny

Smith

Meningitis Research Foundation

Neil

Squires

Faculty of Public Health

Sophie

Taysom

Department of Health

Charlotte

Watts

UK Department for International Development

Philip

Price

Wellcome Trust

Graham

Tynan

Wellcome Trust

Marco

De Ambrogi

The Lancet Infectious Diseases

John

Broughall

Antibiotic Research UK

Mark

Zuckerman

Clinical Virology Network

Table 2

Invited attendees of Brussels workshop, 2 June 2016

Jozef

Anne

Federation of European Microbiological Societies

Brendan

Barnes

European Federation of Pharmaceutical Industries and Associations

Roberto

Bertollini

WHO Brussels office

Julie

Cantalou

Public Policy@Southampton

Laurence

Colin

European Research Council

Alain

Deleener

Research Foundation - Flanders (FWO)

Evelyn

Depoortere

European Commission

Maribel

Glogowoski

UK Research Office

Oliver

Karsten

Friends of the Global Fund Europe

Barbara

Kerstiens

European Commission

Hugh

Laverty

Innovative Medicines Initiative

Kevin

McCarthy

European Commission

Martine

Sabbe

Scientific Institute of Public Health

Table 3

Invited attendees of Geneva workshop, 8 June 2016

Taghreed

Adam

WHO Global Observatory on Health R&D

Lauranne

Botti

COHRED

Vania

de la Fuente Nunez

WHO Global Observatory on Health R&D

Nebiat

Gebreselassie

WHO Global TB Programme

Abdul

Ghaffar

WHO Alliance for Health Policy and Systems Research

Hope

Johnson

GAVI

Christian

Leindhart

WHO Global TB Programme

Manuel

Martin

UAEM

Maya

Matthews

European Commission

Deepak

Mattur

UNAIDS

Amit

Prasad

WHO Global Observatory on Health R&D

Alistair

Robb

WHO Information, Evidence and Research

Robert

Terry

Special Programme for Research and Training in Tropical Diseases (TDR)

Discussions centred around two themes – methodology, and wider engagement with the research, funding and policy communities. The material presented at the workshops is provided here (supplementary information).

Methodologies

A theme that emerged across all three meetings concerned the use of a standardised categorisation system– comment included that ResIn should adopt an existing system (such as that used by the NIH, Health Research Classification System or MESH terms) and work towards a unified categorisation methodology. The ResIn project created its own system which would cover many of the keyword and disease areas used by the other classifications; however, there was general agreement that it would be useful if a standardised system could be introduced that remained comprehensive but with flexibility to adapt as research investment analyses evolve. This could be an activity developed in collaboration with the WHO R&D Observatory.

Further category development would be useful to draw out further granular detail for highlighting specific sub-sections of data, for example further breakdown of the public health category to illustrate investments directed towards social science, epidemiology, economics etc; one further example was to differentiate between primary data collection and secondary data analysis. A possible weighting system to allocate proportional amounts of funding across pathogens was suggested e.g. £1 m study relating to co-infection of HIV and tuberculosis would see £500 k towards HIV and £500 k towards tuberculosis. This would be more difficult to achieve across cross-cutting themes (such as global health and antimicrobial resistance). The distribution of funds from lead institutions to collaborators (particularly those in low- and middle-income countries (LMICs)) is currently difficult to systematically track but is an important factor to consider. Additional useful analyses would include comparison of levels of investment with i) risk factors for disease (alongside the existing burden of disease comparisons), ii) implementation and aid funding; iii) projected future health burdens; iv) differences between datasets of disease burden e.g. that produced by the Institute for Health Metrics and Evaluation and the WHO; v) awards directed straight to LMICs, including infrastructure and other capacity-building initiatives.

The data gap of private sector data was noted, with limited options for systematic provision of such information. Pragmatic approaches may help (for example methods developed by Prof Jonathan Grant, King’s College London). Partnerships between the private sector and public or charitable organisations (such as the International Medicines Initiative or GAVI) tend to provide some public information about industry investment. Policy Cures have also carried out surveys with the for-profit sector to obtain such information anonymously.

Differing levels of overheads across different sectors will mean that the amount of money for the visible costs of research (staff, consumables) varies between funders. A sensitivity analysis to assess these differences would be helpful. Another area of difficulty highlighted was the funding flow between lead institution receiving the award and project partners – at any large systematic scale, this would be very complex to describe. Accessibility of data across countries is anticipated to be broadly satisfactory, though there may be language difficulties with some nations (Russia and China were noted examples where open data, in English, may be limited). Investments directed specifically towards infrastructure to house research activity is not directly captured as part of the ResIn analysis, and is often difficult to attribute to disease areas.

Project engagement with global and national stakeholders

The ResIn analysis can drive forward the movement towards open access investment data, in an accessible format. Funders and other stakeholders could be invited to suggest further aspects of categorisation and data visualisations that would be most useful. The granularity of the data is important, and the ability to provide detailed cross- and sub-national analyses is extremely useful. The format in which ResIn data was made available was discussed, with reports and papers, policy briefs and online customisable visualisations all considered useful, depending on the audience. The online visualisations, in particular, allow users to draw data and infer conclusions in precise areas.

The presentation included possibilities for further work packages that could enhance the data collection, including integration with geospatial, policy and scientometric methodologies. There was broad enthusiasm that outputs from these proposed projects would provide clear benefits in informing health policy and R&D strategy. Expert input from colleagues and organisations in resource-poor settings could identify priority projects and areas of focus to be addressed by the ResIn study.

There was a mixed view on whether expansion of the ResIn project should concentrate on a broad focus of large-scale data collection and top-level analyses, or a more defined focus on specific topic areas (e.g. infectious disease) where the project can provide significant expertise. A networking function that proactively links stakeholders across national borders and disease areas was also suggested as a potential benefit.

The presentation noted that funding was very reactive in nature, and there followed suggestions that ResIn could help to inform proactive thinking about future R&D priorities and work alongside existing groups that have a ‘horizon-scanning’ remit (such as the EU network for emergency preparedness). Broader engagement with the WHO would be particularly important, and engagement with some member nations will typically be most effective if in conjunction with the WHO.

Declarations

Acknowledgements

We acknowledge and thank all attendees of each workshop. We acknowledge the Bill & Melinda Gates Foundation (project funder), Public Policy@Southampton (meetings funder), and colleagues at the Wellcome Trust, UK Research Office in Brussels, and the WHO R&D Observatory for agreeing to host the meetings. Thank you to all attendees for giving us their time and input into project strategy. MGH and RJB are funded by the Bill & Melinda Gates Foundation (grant ref OPP1127615). We also acknowledge the input of Dr Stuart Clarke.

Funding

Publication of this article was funded by the Bill & Melinda Gates Foundation. Public Policy@Southampton provided funding for the three meetings to take place.

Availability of data and materials

The presentation from the meeting can be obtained by emailing the corresponding author.

Authors’ contributions

MGH and RJB co-organised and co-presented at the workshops. MGH wrote the first draft of this article, RJB provided revisions. Both authors approved the final draft.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

Not applicable.

Ethics approval and consent to participate

Not applicable.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Global Health Research Institute and Faculty of Medicine, University of Southampton
(2)
Farr Institute for Health Informatics, University College London

References

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Copyright

© The Author(s). 2016