1. Tracking the Shortfall in TB Research Funding Javid Syed Treatment Action Group (TAG)

2. What is Needed? Global Plan estimates that $9 billion needed from 2006 to 2015 to meet goals –rolling back TB levels by 2015 –elimination of TB by 2050 Estimate includes drugs, diagnostics, and vaccine research, but not basic and operational research

3. How Are We Doing? Who is funding TB research? How much is being spent? What are the trends in TB research spending? How much research is currently being funded in each category? How much more money is needed? Are we reaching the Global Plan targets?

4. Tuberculosis R&D: A Critical Analysis of Funding Trends, 2005–2006 TAG tracked TB research investment in 2005 and 2006 –Goal: Help policymakers, funders, researchers, and advocates understand the current state of research on TB, and provide a baseline for understanding how much TB research funding will need to increase in order to bring TB under control over the next decade. Method: –Inquiry sent to 100 known and potential funders –Reasonable follow up (persistent with known funders) Criteria for inclusion: –Original source of funding (not pass through) –Money actually disbursed in fiscal year (not granted or announced; not multi-year)

5. Tuberculosis R&D: A Critical Analysis of Funding Trends, 2005–2006 Strengths: –TB research space is not huge (unfortunately) –Many public donors have duty to report –Few industry investors; smaller companies willing to disclose Limits: –Self reported; categorized by donor or by TAG no standard definitions of research categories, phase, or focus –Large proportion for “unspecified” research (infrastructure?) –Industry unwilling to disclose (offered anonymity) –Confusion about criteria (disbursement vs. granting) –Non-response TAG’s results in general agreement with TB investment estimation by bibliometric methods (Lewison 2004)

6. 2006 TB Research Investment Results Who Donates? How Much? $429,166,680 reported spent by 42 funders Top 10 donors: –US NIH (NIAID)$119,717,818 –Bill & Melinda Gates Foundation 96,466,861 –Otsuka Pharmaceutical Co. 22,900,000 –Wellcome Trust 18,380,741 –US NIH (other institutes) 17,579,000 –US CDC 17,057,774 –US NIH (NHLBI) 13,139,532 –European Commission 12,804,807 –UK Dept for Intl Development (DFID) 12,576,359 –Institut Pasteur 8,785,490

8. Slow Growth in TB Investment 2005 Total: $392.7 million 2006 Total: $429.2 million* Increased by $36.5 million (9%) –Largest increase by philanthropy sector * (~ $5M low due to Inserm not reporting in 2006)

13. 2006 TB R&D Investment What is Being Funded? Drug research 33.6%$144,264,486 Basic science 23.4%$100,218,236 Vaccines 18.2% $78,092,104 Diagnostics 7.3% $31,424,479 Operational rsch 7.5% $32,097,698 Unspecified 10.0% $43,069,677 Total $429,166,680

21. How Are We Doing? Global Plan estimated needed investment for TB drugs, vaccine, and diagnostics as ~$1 billion per year from 2006 to 2015 TAG estimated needed investment is ~$2 billion per year when basic science and operational research is included By either measure we are falling short –gap is growing

23. Conclusions TB R&D funding is falling far short of the need estimated by the Global Plan to Stop TB: 2006-2015 TB R&D funding increased only slightly from 2005 to 2006 –greatest increase in drug research Philanthropic giving increasing faster than public sector investment

24. Recommendations Increase TB research investment five-fold to meet goals set in Global Plan Develop a global TB R&D agenda that includes basic and operational research Better coordination required for TB R&D, globally and nationally Donors should track and transparently report on TB R&D investments