United Kingdom - Global health R&D

This section focuses on donor countries’ support for global health research and development (R&D) that addresses the global health challenges disproportionately affecting the world’s most disadvantaged people. Following the methodological approach used by Policy Cures Research (read G-Finder’s scope document), it focuses on donor funding and policy in three main areas: 1) emerging infectious diseases (EIDs); 2) poverty-related and neglected diseases (PRNDs); and 3) sexual and reproductive health (SRH). As part of the EID R&D funding, this section also takes a closer look at donor contributions for COVID-19 R&D within the framework of the Access to COVID-19 Tools Accelerator (ACT-A). This section excludes domestic funding for health R&D that does not benefit low- and middle-income countries. Not all funding mentioned qualifies as official development assistance, or ODA.)

The UK was the second-largest donor to global health R&D in 2019  

According to data from the G-FINDER survey conducted by Policy Cures Research, the UK contributed US$281 million in total to research and development (R&D) for emerging infectious diseases (EIDs), poverty-related and neglected diseases (PRNDs), and sexual and reproductive health (SRH) in 2019, making it second-largest public donor to R&D for these areas. The majority (59% or US$ 166 million) of this funding was spent on R&D for PRNDs only. 19% (US$53 million) was spent on R&D exclusively for EIDs, and 6% (US$18 million) on SRH. 8% (US$24 million) was spent on R&D initiatives targeting NDs and EIDs together and 7% (US$19 million) NDs and SRHs. The remainder was spent on R&D initiatives targeting multiple disease areas.  

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The UK spent US$78 million on R&D for EIDs in 2019 

In 2019, UK spent US$78 million on R&D for EIDs, including funding exclusively for EID R&D (US$53 million), funding for R&D relevant to both EIDs and PRNDs (US$24 million), and funding relevant to EIDs, PRNDs, and SRHs (US$2 million). This makes the UK the third-largest donor to R&D for EIDs in 2019.   

UK’s funding for EIDs increased by US$21 million in 2019 compared to 2018. This does not necessarily indicate a significant re/de-prioritization of the sector since it is quite normal for EID R&D funding to fluctuate considerably as donors respond to outbreaks; however, consistent funding for EID R&D (for example, funding for the Coalition for Epidemic Preparedness Innovations; CEPI) is essential to ensuring preparedness in advance of EID outbreaks and ensuring a rapid response in terms of both research and containment to emerging disease threats. 

Most of the UK’s EID R&D funding in 2019 went to ‘R&D of more than one disease’ (US$64 million or 82% of EID R&D funding), mainly in the form of core funding of multi-disease R&D organizations (US$44 million or 57%). CEPI was the largest recipient of this funding (US$26 million or 33% of EID R&D funding) followed by the Foundation for Innovative New Diagnostics (FIND; US$15 million or 19%), and the European & Developing Countries Clinical Trials Partnership (EDCTP; US$3 million or 4%). FIND is a global non-profit that accelerates the development and delivery of diagnostic tests. Vaccines (US$9 million or 12% EID R&D funding) and ‘vaccine delivery technologies and devices’ (US$4 million or 5%) were the main products financed by the EID R&D funds. (For more information on policy priorities related to EIDs, see ‘Policy Priorities’ and ‘Global Health’)

The 2021 Integrated Review of UK Security, Defence, Foreign Policy and Development identifies the need to address global health risks and pandemic preparedness of infectious disease outbreaks as critical to achieving resilience at a global level. The UK plays a leading role in CEPI, Gavi COVAX Advance Market Commitment (AMC), and the World Health Organization (WHO; see ‘Policy Priorities’ and ‘Global Health’).

The UK has stepped up R&D funding to EID through its international COVID-19 response, committing US$661 million from February till September 2020

According to Policy Cures Research’s COVID-19 R&D tracker, between the start of the pandemic and September 2020 (latest data available), UK announced funding commitments totaling US$661 million for COVID-19 R&D. US$473 million of this will go towards vaccines, US$95 million towards basic research, US$56 million towards therapeutics, and US$37 million towards diagnostics. The remaining US$250,000 has been committed for unspecified purposes.   

Among its commitments, UK pledged US$308 million to CEPI for vaccine development for COVID-19 and other infectious diseases, and US$104 million to the University of Oxford for the development of the AstraZeneca vaccine. These funds will be provided by the UK government (agency not specified). CEPI (along with Gavi, the Vaccine Alliance) is convening the vaccine pillar of Access to COVID-19 Tools Accelerator (ACT-A). ACT-A is a framework for collaboration through which donor countries have committed funds toward R&D for COVID-19; however not all ACT-A funding is for R&D, since it also has strong health system strengthening and vaccine distribution components. (For additional information on the broader ACT-A global health response to COVID-19, see sector ‘Global Health’)

The UK’s funding for PRNDs decreased slightly in 2019 after a period of progress growth from 2015 to 2018

In 2019, the UK invested US$210 million in R&D for PRNDs, including funding exclusively relevant to PRNDS (US$166 million), areas of overlap with EIDs (US$24 million), areas of overlap with SRH (US$19 million), and areas of overlap with EIDs and SRH (US$2 million). This makes the UK the second-largest public supporter of PRND R&D in 2019. In 2019, funding levels saw a slight decrease of 3% compared to 2018. Funding for PRND R&D increased from US$94 million in 2015 to US$216 million in 2018; an increase of 129%.

Most of the UK’s funding for PRNDs in 2019 was used toward drugs R&D (34%), followed by diagnostics (9%), and basic research (7%). 24% of PRND funding in 2019 was spent on R&D for malaria, 15% on tuberculosis, and 14% on R&D for more than one disease. 

The primary recipients of the UK’s PRND R&D funding in 2019 were the Product Development Partnerships (PDPs; US$114 million or 54% of PRND R&D funding) followed by academic and other research institutions (US$63 million or 30% of PRND R&D funding) primarily based in the UK. PDPs are a non-profit organization that develops vaccines, drugs, and diagnostics. The government states that it will “continue its collaboration with development partners including the EU and the multilateral development banks on issues such as antimicrobial resistance, AIDS, tuberculosis, and malaria”. (For more information on PRNDs, see  ‘Global Health’)

UK’s funding for SRH R&D has increased by more than 500% from 2015 to 2019, but future funding is uncertain

In 2019, UK spent just over US$38 million on R&D for SRH, including US$18 million on HIV/AIDS. This makes the UK the second-largest donor to this sector in 2019. UK’s funding for SRH R&D increased by 529% from US$6 million in 2015 to US$38 million in 2019.

In addition to HIV/AIDS (47% of SRH R&D funding), UK made disbursements for R&D for sexually transmitted infections (STIs; 21%) and R&D for more than one SRH issue (16%). 30% of SRH R&D funding went toward microbicides, 22% went towards diagnostics, and 14% to drugs. Microbicides are experimental products that prevent the transmission of HIV and STIs.

UK’s R&D investments address global health challenges, partly financed by ODA

Global health R&D will be in part be financed by the Foreign, Commonwealth and Development Office (FCDO) from its ODA budget. In addition, the UK Government committed nearly £15 billion in funding for UK economy-wide R&D in FY2021/22. This will partly support the delivery of new drugs, treatments, and vaccines that may also benefit global health challenges. The UK Prime Minister’s five-point global pandemic preparedness plan set out at the 75th United Nations General Assembly (UNGA) in September 2020 proposed a “worldwide network of zoonotic research hubs to spot a new pandemic before it starts”. The plan also targeted the need to increase manufacturing capacity for treatments and vaccines, which may affect funding flows to health R&D in the future. The 2020 Research and Development Roadmap and the 2021 Integrated Review of UK Security, Defence, Foreign Policy identified ODA as a vehicle to support R&D partnerships internationally. UK’s public investments in global health R&D remain unclear due to ODA funding cuts in 2021 and possibly 2022 (see ‘ODA trends’).

The FCDO is responsible for global health policy development

Before its merger with the former FCO, DFID disbursed US$121 million in ODA funding for global health R&D (43% of UK’s overall R&D disbursements for EIDs, PRNDs, and SRH).  It is not yet clear how the UK’s health spending will be organized in the new FCDO.