The US is the largest funder of global health R&D, with a focus on HIV/AIDS
The US’ funding for research and development (R&D) on poverty-related and neglected diseases (PRNDs), referred to in this profile as ‘global health R&D’, stood at US$1.6 billion in 2017, according to G-FINDER. The US is by far the largest public funder to global health R&D, contributing 69% of all public funding in 2017 (the second-largest funder, the UK, contributed US$186 million). Funding was largely stable between 2016 and 2017, increasing by just US$23 million.
In 2017, US global health R&D funding focused primarily on HIV/AIDS (US$837 million), representing 52% of total US global health R&D spending. Other focus areas included tuberculosis (TB; US$266 million, 17%) and malaria (US$215 million, 13%), followed by diarrhoeal diseases (US$49 million, 3%), kinetoplastids (US$48 million, 3%), and dengue fever (US$47 million, 3%). These figures may differ from the trend numbers presented in the chart due to changes in the scope of the G-FINDER survey from year to year.
In terms of product development, the US allocated its funding in 2017 to preventative vaccines (US$625 million, 39% of total funding), basic research (US$464 million, 29%), drugs (US$254 million, 16%), and microbicides (US$122 million, 8%).
Funding for US global health R&D efforts is likely to remain steady going forward. The FY2019 appropriations bill rejected cuts to global health R&D proposed in President Trump’s FY2019 budget request.
Multiple agencies lead on global health R&D, chiefly the NIH
Currently, the US does not have an overarching strategy for global health R&D. Funding comes from and is implemented through, a variety of programs across several agencies. These are listed below, in order of the amount of funding provided in 2017.
National Institutes of Health (NIH) comprises 27 institutes under the Department of Health and Human Services (HHS; see question three: ‘Who are the main actors in the US’ development cooperation?’). NIH is the biggest funder of global health R&D in the world. It is also the leading US agency for medical research and provided US$1.4 billion for investment in global R&D, 87% of the total US funding in 2017. Within NIH, the National Institute for Allergy and Infectious Diseases (NIAID) leads on research for infectious diseases such as HIV/AIDS, Ebola, and Zika.
Department of Defense (DOD) is also a central actor in US global health R&D efforts, mostly addressing infectious diseases and other neglected health conditions that US service members may encounter while stationed overseas. The department provided US$93 million, or 6%, of US global health R&D funding in 2017.
US Agency for International Development (USAID), the US’ lead development agency, provided US$85 million, or 0.1%, of the US’ global health R&D funding, led by its Bureau for Global Health. USAID focuses funding on TB, malaria, and neglected tropical diseases; global health security; nutrition; maternal, newborn, and child health; HIV/AIDS; family planning and reproductive health; and water, sanitation, and hygiene, including air pollution. The agency houses the Malaria Vaccine Development Program.
Centers for Disease Control and Prevention (CDC) make up the largest government agency worldwide working in disease surveillance, control, and prevention. CDC operates under HHS. In 2017, CDC spent US$23 million in global health R&D funding. In 2010, the CDC established the Center for Global Health, which oversees all of CDC’s global health operations, and focuses on topics such as women’s health, HIV/AIDS, malaria, refugee health, and health systems strengthening. CDC leads the TB Trials Consortium and is an implementing partner of the PMI, the USAID’s Neglected Tropical Diseases program, and PEPFAR.
- US Congress, FY2019 consolidated appropriations (2019)
- US Congress, FY2019 consolidated report (2019)
- Congressional Research Service, Appropriations Status Table, FY2020 (2019)
- Congressional Research Service, CRS report, SFOPs, FY2019 (2019)
Civil society sources
- Global Health Technologies Coalition and Policy Cures Research; Return on Innovation, Why global health R&D is a smart investment for the United States; 2017
- Global Health Technologies Coalition; Breakthroughs Blog, Medical research, global health programs face steep cuts in Trump budget; 2017
- Research America; US Investments in Medical and Health Research and Development; 2016