What drives research and development in the health sector? Or determines which new drugs and treatments are prioritized for development? ‘Need’ would seem to be the most obvious answer. Surely, whether it’s government funding for basic research or transnational pharmaceutical companies developing new drugs, ‘demand’ must drive research towards the diseases and ailments that affect the largest numbers of people, or for which the greatest gaps exist in available treatments.
Sadly, there is often very little correlation between levels of investment in health R&D and actual need. The Lancet reported in 2013 that just one per cent of global health research and development funding was being spent on what are known as ‘neglected diseases’ – a group of over 30 diseases, ranging from HIV/AIDS, malaria, and diarrhoeal disease to leprosy, trachoma and rheumatic fever, that disproportionately affect people in the Global South.1 This phenomenon is part of a wider problem that also includes insufficient research into finding replacements for failing antibiotics, or into so-called ‘orphan diseases’ which have significant impacts but on only a relatively small number of people.
