By Marcus Low, Spotlight
Investment in TB research can be measured in many ways. The most obvious way is simply to look at who gives the most money for TB research. The country that gives the most, by far, is the United States – which gives more money than all other countries combined.
Of the $726 million invested in TB research and development (R&D) in 2016, 66% was invested by governments, 20% by philanthropic organisations, 11% by industry, and 3% by multilateral entities. Together, the United States National Institutes for Health (NIH) and the Gates Foundation contributed half of global investment in TB R&D. Many pharmaceutical companies do not invest in TB at all; and the few that do, invest relatively small amounts.
The top 10 countries in terms of absolute investment in TB R&D were:
- United States $316 471 566
- United Kingdom $27 575 390
- European Union $23 575 253
- Canada $16 898 180
- Germany $14 820 938
- India $14 768 283
- South Korea $12 359 135
- The Netherlands $9 858 859
- Australia $9 489 424
- South Africa $6 465 746
While a new BRICS TB Research Network was announced recently, of the five BRICS countries, only India and South Africa are in the top 10 in terms of absolute investment in TB R&D. Large developing economies such as China, Russia, Indonesia and Brazil make only very modest investments in TB R&D. Among wealthy countries, the very low investment made by France, Japan, Italy and Spain is notable.
SA top on two important measures
In the latest TAG R&D report, South Africa is ranked number one on two important measures of investment in TB R&D: percentage of GDP and percentage of GERD (explained below). In terms of the absolute investment in TB R&D, South Africa ranked 10th, with $6.5 million (around R90 million) invested in 2016. Whichever measure you use, South Africa invests more than most other countries with high TB burdens.
Yet, even with South Africa’s relatively high levels of investment in TB R&D, many of our researchers are still dependent on funding from the United States government to do their research. The United States invests almost 50 times as much as South Africa in TB R&D.
“South Africa ranks first when its spending on TB R&D is judged relative to its GDP and GERD; however, this is largely a function of South Africa’s lower GDP and R&D expenditures, compared to other countries that report data. The absolute amount of money South Africa gives to TB research is still low – only $6.5 million last year – and most goes to a handful of universities and academic medical centres.
“Given the burden of TB in South Africa, its significant clinical trials capacity, and the depth of its scientific talent, there is ample room for South Africa to increase its contributions to TB research. In addition to supporting domestic researchers through grant funding, South Africa should explore innovative ways to finance and incentivise TB research, including co-financing for regional and global initiatives such as The Life Prize or the BRICS TB Research Network.” – Mike Frick, author of the TAG TB R&D Report
Percentage of GDP
Because countries have different-sized economies and different levels of development, simply looking at who gives the most money is not always a fair comparison. One alternative is to see what percentage of a country’s GDP is spent on TB R&D. GDP, or Gross Domestic Product, is the total value of everything produced by all the people and companies in a country.
The top 10 countries in terms of percentage of GDP invested in TB R&D are:
|Country||TB R&D Funding 2016||GDP 2016 (USD Millions)||TB R&D Expenditure as % of GDP Rank Order|
|South Africa||$6 465 746||$294 841||1|
|United States||$316 471 566||$18 569 100||2|
|Norway||$5 503 497||$370 557||3|
|The Netherlands||$9 858 859||$770 845||4|
|Canada||$16 898 180||$1 529 760||5|
|United Kingdom||$27 575 390||$2 618 886||6|
|Switzerland||$5 938 196||$659 827||7|
|South Korea||$12 359 135||$1 411 246||8|
|Australia||$9 489 424||$1 204 616||9|
|India||$14 768 283||$2 263 523||10|
Percentage of GERD
Another option is to look at what percentage of all the money invested in R&D in a country is invested specifically in TB R&D. This total investment in R&D in a country is called GERD, or Gross Domestic Expenditure on R&D.
The top 10 countries in terms of percentage of GERD invested in TB R&D are:
|Country||TB R&D Funding 2016||Average Annual GERD 2010–2015||GERD calculation||TB R&D Expenditure as Percentage of GERD Rank Order|
|South Africa||$6 465 746||$4 718 475 774||0,14%||1|
|Norway||$5 503 497||$5 441 716 100||0,10%||2|
|United States||$316 471 566||$452 804 833 333||0,07%||3|
|United Kingdom||$27 575 390||$41 157 956 465||0,07%||4|
|Canada||$16 898 180||$25 773 702 491||0,07%||5|
|The Netherlands||$9 858 859||$15 342 022 220||0,06%||6|
|Australia||$9 489 424||$21 554 008 715||0,04%||7|
|Switzerland||$5 938 196||$13 669 878 710||0,04%||8|
|The Philippines||$302 178||$762 079 532||0,04%||9|
|New Zealand||$679 649||$1 811 948 569||0,04%||10|
TAG calculated that in order to meet the WHO End TB Plan’s target of $2 billion per year for TB R&D, all high-burden and G20 countries must invest 0.1% of GERD in TB R&D. Currently, the only two countries to meet this target are South Africa and Norway.
- The figures in this article are taken from the Treatment Action Group report ‘The Ascent Begins: Tuberculosis Research Funding Trends, 2005-2016’, published in November 2017. Find the full report at TreatmentActionGroup.org/TB