Disease outbreaks have shaped human history. The infamous plague, caused by Yersinia pestis, has caused multiple pandemics. Influenza, HIV, SARS-CoV, and now SARS-CoV-2 have also left devastation in their wake. The ability of a microorganism to decimate our security, health and economy will continue to shape our future. It is critically important that we, as a global community, continue to work toward minimizing the impact something so small can have on all of us.
The Ebola epidemic in West Africa made it apparent how poorly prepared we are to combat infectious disease outbreaks. In 2016, the U.S. National Academy of Medicine, along with eight other countries, formed a commission on a Global Health Risk Framework for the Future (GHRF). The GHRF covers the “challenges of mobilizing additional funds for research and development (R&D) in the infectious disease arena, or of achieving greater harmonization and efficiency in development and approval processes.” In the report, it is estimated that an injection of $1 billion per year, on top of current countries spending, will accelerate research, development and production of medical equipment, diagnostics, vaccines, and drugs. That one billion dollar amount is intended o support R&D across the planet. The GHRF also relies on the funding gap to be filled by philanthropy dollars and the lucrative appeal of biomedicine to private companies.
The GHRF states that $1 billion is representative of mid-level Pharma company spending on vaccine and drugs for infectious disease. In 2018, the smallest budget of the top ten in Big Pharma in the United States, has a 40 billion dollar global revenue and spends five times what GHRFs recommended global increase. Four of those Big Pharma companies dominate the vaccine market, yet still rely on governmental funding to support their efforts, as only $57 million is invested by private funders. Looking at vaccine development alone, it only makes up 11 percent of their global revenue.
Meaning it is not a very lucrative endeavour for Big Pharma to pursue vaccine development. The industry will continue to require an injection of funds to pursue the long and expensive task of infectious disease prevention and care. It is not enough for a global summit to rely on private funding and Big Pharma to foot the bill for what is ultimately philanthropic reasons.
The United States is recognized as one of the wealthiest global super powers, with the resources to lead the fight against infectious diseases. The amount the U.S. contributes is a tricky number to tack down due to the dispersement of funds across multiple government branches. The United States spent $686 billion dollars on defense in 2019 with only two percent budgeted for basic research.
There are multiple branches of the military that have additional spending on infectious disease research, such as, Military Infectious Diseases Research Program (MIDRP) with a small $70 million annual budget, and Infectious Diseases Directorate (IDD) with an even smaller budget of $10 million per year. On the grand scale of defence spending, these numbers are low. The National Institute of Health (NIH) spends $38 billion dollars annually to support health research in the United States. Branches of the NIH have very different spending profiles. The National Cancer Institute’s budget for 2020 is $6.4 billion about a $300 million increase from 2019. The National Institute of Allergy and Infectious Diseases $4.7 billion, a decrease of about $770 million from 2019.
Decreases in disease research and preparedness have been reduced across the board with the current administration. According to a report from Fortune, the CDC was forced to cut 80 percent of its efforts toward global disease prevention and the disbanding of the global health response team. Had these cuts not been made the current administration would not needed to request the additional $2.5 billion in emergency funds to combat the spread of SARS-CoV-2.
As of April 2020, COVID-19, an upper and lower respiratory tract infection caused by the SARS-Cov-2 virus, has infected an estimated 1.3 million people and the death of 75,000. Respiratory disease is something that is not going to go away, and is not a ‘once-in-a-century problem’. According to the World Health Organization, globally the fourth leading cause of death is lower respiratory infections with three million humans perishing annually. Lung cancers only caused 1.7 million deaths. Lower respiratory infection was even more disastrous for low-income countries with a total of seven million victims.
It is clear the impact an infectious disease can have on human society and the global economy. With the low amount of spending on infectious disease research, the current administration in the United States is not participating as much as they could be, nor are they taking the threat seriously. A shame for the scientist, doctors and support staff that are.
GHRF (GHRF on a Global Health Risk Framework for the Future). The neglected dimension of global security: A framework to counter infectious disease crises.
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About The Author
This article was written by Desirée Denman, a graduate student in the M.S. in Infection and Immunology program at UT Health San Antonio. The “Beyond The Bench” series features articles written by students and postdoctoral fellows at the Graduate School of Biomedical Sciences at The University of Texas Health Science Center San Antonio.