The concept of global public goods represents a framework for organizing and financing international cooperation in global health research and development (R&D). Advances in scientific and clinical knowledge produced by biomedical R&D can be considered public goods insofar as they can be used repeatedly (non-rival consumption) and it is difficult or costly to exclude non-payers from gaining access (non-excludable). This paper considers the public good characteristics of biomedical R&D in global health and describes the theoretical and observed factors in the allocation R&D funding by public, private, and philanthropic sources.
We first conducted a literature review on factors theoretically associated with funding for early-stage biomedical research, including the expected correlates of funding levels for basic research, pre-clinical studies, and Phase I – IV clinical trials. To explore possible relationships between theorized drivers of R&D funding and actual funding flows, we analyzed evidence on how public, private, and philanthropic investments are affected by the public good characteristics of four high-burden diseases that disproportionately affect low- and middle-income countries: malaria, tuberculosis, hepatitis C, and soil-transmitted helminthiases.
Multiple factors influence R&D investment by public, private and philanthropic funders, including disease pathology and epidemiology, the current intervention landscape, policy and regulatory environment, and current and projected market conditions. Private sector investments are theorized to be primarily determined by opportunities for positive financial returns, while public and philanthropic investments may be motivated by a variety of social returns. We examine the specific funding decision factors identified in the literature for each of the four selected diseases.
Factors influencing the allocation of funds for biomedical R&D vary by disease, resulting in uneven funding across diseases. Due to issues of transparency and a lack of systematically collected data regarding R&D investments for diseases in low- and middle-income countries, especially from the private sector, these factors can be difficult to observe and measure. Furthermore, persistent data gaps can affect both aggregate investment and cooperative agreements.
Findings from this project were presented at the 8th Annual Consortium of Universities for Global Health conference in Washington, DC, and at the Evans School Research Symposium in May 2017. This research contributed to further research on funding for agricultural and health R&D public goods by sector (EPAR Technical Report #329).