Beyeler Naomi, Fewer Sara, Yotebieng Marcel, Yamey Gavin
Evidence to Policy Initiative, Global Health Group, Institute for Global Health Sciences, University of California, San Francisco, California, USA.
Division of Epidemiology, Ohio State University, Columbus, Ohio, USA.
BMJ Glob Health. 2019 Feb 27;4(1):e001209. doi: 10.1136/bmjgh-2018-001209. eCollection 2019.
Achieving many of the health targets in the Sustainable Development Goals will not be possible without increased financing for global health research and development (R&D). Yet financing for neglected disease product development fell from 2009-2015, with the exception of a one-time injection of Ebola funding. An important cause of the global health R&D funding gap is lack of coordination across R&D initiatives. In particular, existing initiatives lack robust priority-setting processes and transparency about investment decisions. Low-income countries (LICs) and middle-income countries (MICs) are also often excluded from global investment initiatives and priority-setting discussions, leading to limited investment by these countries. An overarching global health R&D coordination platform is one promising response to these challenges. This analysis examines the essential functions such a platform must play, how it should be structured to maximise effectiveness and investment strategies for diversifying potential investors, with an emphasis on building LIC and MIC engagement. Our analysis suggests that a coordination platform should have four key functions: building consensus on R&D priorities; facilitating information sharing about past and future investments; building in accountability mechanisms to track R&D spending against investment targets and curating a portfolio of prioritised projects alongside mechanisms to link funders to these projects. Several design features are likely to increase the platform's success: public ownership and management; separation of coordination and financing functions; inclusion of multiple diseases; coordination across global and national efforts; development of an international R&D 'roadmap' and a strategy for the financial sustainability of the platform's secretariat.
如果不增加对全球卫生研究与开发(R&D)的资金投入,就不可能实现可持续发展目标中的许多卫生目标。然而,除了一次性注入的埃博拉资金外,2009年至2015年期间被忽视疾病产品开发的资金有所下降。全球卫生研发资金缺口的一个重要原因是研发计划之间缺乏协调。特别是,现有计划缺乏强有力的优先事项确定流程和投资决策透明度。低收入国家(LICs)和中等收入国家(MICs)也常常被排除在全球投资计划和优先事项确定讨论之外,导致这些国家的投资有限。一个总体的全球卫生研发协调平台是应对这些挑战的一个有前景的办法。本分析研究了这样一个平台必须发挥的基本功能、应如何构建以实现最大有效性以及使潜在投资者多样化的投资策略,重点是促进低收入国家和中等收入国家的参与。我们的分析表明,一个协调平台应具备四个关键功能:就研发优先事项达成共识;促进关于过去和未来投资的信息共享;建立问责机制以跟踪研发支出与投资目标的对比情况,并策划一系列优先项目以及将资助者与这些项目联系起来的机制。几个设计特点可能会提高该平台的成功率:公有制和管理;协调与融资功能分离;纳入多种疾病;全球和国家努力之间的协调;制定国际研发 “路线图” 以及该平台秘书处财务可持续性的战略。