Science and Global Health R&D
The Cures That Never Get Funded
Diseases that kill the world's poorest get a sliver of global research funding, while diseases of the rich get the rest.
People needing treatment for a neglected tropical disease
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Estimated so far this year.
The evidence
A Billion People, Twenty Diseases, Almost No Attention
Roughly 1.6 billion people require intervention against at least one of the twenty conditions the WHO classifies as neglected tropical diseases (WHO, 2025). In 2023 alone an estimated 119,000 to 139,000 people died from NTDs.
The Market Failure Behind the Suffering
Of 1,556 new drugs approved between 1975 and 2004, only 21, about 1.3%, were developed specifically for tropical diseases and tuberculosis (DNDi). Pharmaceutical R&D follows purchasing power, not disease burden.
Funding Has Stalled for a Decade
Global funding for neglected disease R&D reached just $4.17 billion in 2023, essentially flat versus 2022 and roughly $650 million below its 2018 peak once inflation is accounted for (Policy Cures Research G-FINDER, 2024).
Malaria Still Kills Hundreds of Thousands a Year
Malaria caused an estimated 610,000 deaths in 2024, with the WHO African Region bearing 95% of both cases and deaths (WHO World Malaria Report, 2024-2025).
Even Successful R&D Gets Starved of Follow-Through
Within the modest pool of neglected disease funding, HIV/AIDS, tuberculosis, and malaria together absorb more than 65% of all investment, leaving a shrinking remainder split across seventeen or more other neglected tropical diseases (G-FINDER, 2024).
When We Do Fund It, It Works
Global immunization efforts have saved at least 154 million lives over the past fifty years (Gates Foundation, 2024). Every $1 spent on vaccination programs returns roughly $21 in medical savings and recovered productivity.
What we can do
Phase 1: protect and grow public R&D funders like the NIH, Wellcome Trust, and Gates Foundation so basic science on NTDs, malaria, and neglected vaccines does not depend on unreliable industry interest. Phase 2: scale pull mechanisms, advance market commitments, prizes, and guaranteed procurement that make it commercially rational to finish and manufacture treatments. Phase 3: redirect a meaningful share of global health philanthropy toward the most neglected, highest-burden diseases.
Sources: World Health Organization, Policy Cures Research G-FINDER, Drugs for Neglected Diseases Initiative, Gates Foundation, Gavi, Open Philanthropy
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