The allocation of USdollar;105 billion in global funding from G20 countries for infectious disease research between 2000 and 2017: a content analysis of investments.
The allocation of USdollar;105 billion in global funding from G20 countries for infectious disease research between 2000 and 2017: a content analysis of investments.
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DOI：
10.1016/s2214-109x(20)30357-0
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Atun R
中科院分区：
文献类型：
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作者：
Head MG;Brown RJ;Newell ML;Scott JAG;Batchelor J;Atun R
每年，全球在传染病研究和开发上花费数十亿美元。然而，对全球研发的系统跟踪很少。我们介绍了20国集团(G20)国家资助者在跨越2000-17年的18年时间段内对传染病研究的投资研究，比较了不同情况下的投资额，并考虑了全球疾病负担，以确定相对资金不足的潜在领域。这项研究审查了2000至2017年间G20公共和慈善资助者为传染病研究颁发的研究奖项。我们使用一系列关键词搜索研究数据库，并从资助者网站提取开放获取的数据。奖项按科学、专业和疾病或病原体的类型进行分类。收集的数据包括研究标题、摘要、获奖金额、资助者和年份。我们使用描述性统计和Spearman相关系数来调查研究投资和疾病负担之间的关系，使用2017年全球疾病负担研究数据。2000年至2017年的最终数据集包括94个 074个传染病研究奖项，总投资为1049亿美元(年度范围为41亿至84亿)，奖项规模中值为257IQR176( 62 562-770 661)。临床前研究从70个 337(74.8%)奖项获得61.1亿美元(58.2%)，公共卫生研究从19个 197(20.4%)奖项获得295亿美元(28.1%)。艾滋病毒/艾滋病获得421亿美元(40.1%)，结核病获得70亿美元(6.7%)，疟疾获得56亿美元(5.3%)，肺炎获得35亿美元(3.3%)。埃博拉病毒(12亿美元)、寨卡病毒(3亿美元)、流感(44亿美元)和冠状病毒(5亿美元)的资金通常在高调爆发后不久达到最高水平。2000年至2006年，传染病研究投入同比普遍增加，2007年至2017年呈下降趋势。美国的资助者提供了816亿美元(77.8%)。根据2017年残疾调整生命年(DALY)的资金，艾滋病毒/艾滋病获得的相对投资最多(每DALY为772美元)，而结核病(DALY每DALY为156美元)、疟疾(DALY每DALY 125美元)和肺炎(DALY每DALY 33美元)。梅毒和麻疹的相对投资最少(每DALY均为9美元)。我们观察到投资与2017年疾病负担之间存在微弱的正相关(r=0.30)。相对于Daly Burden，HIV研究获得了最高金额的投资。麻疹和梅毒获得的相对资助最低。对高威胁病原体(如埃博拉病毒和冠状病毒)的投资往往是被动的，并伴随着疫情的爆发。我们发现，几乎没有证据表明资金是由全球负担或大流行风险主动引导的。我们的发现显示了研究投资是如何分配的，以及这与疾病负担和具有大流行潜力的疾病之间的关系。比尔和梅琳达·盖茨基金会。
Each year, billions of US$ are spent globally on infectious disease research and development. However, there is little systematic tracking of global research and development. We present research on investments into infectious diseases research from funders in the G20 countries across an 18-year time period spanning 2000–17, comparing amounts invested for different conditions and considering the global burden of disease to identify potential areas of relative underfunding. The study examined research awards made between 2000 and 2017 for infectious disease research from G20-based public and philanthropic funders. We searched research databases using a range of keywords, and open access data were extracted from funder websites. Awards were categorised by type of science, specialty, and disease or pathogen. Data collected included study title, abstract, award amount, funder, and year. We used descriptive statistics and Spearman's correlation coefficient to investigate the association between research investment and disease burden, using Global Burden of Disease 2017 study data. The final 2000–17 dataset included 94 074 awards for infectious disease research, with a sum investment of $104·9 billion (annual range 4·1 billion to 8·4 billion) and a median award size of $257 176 (IQR 62 562–770 661). Pre-clinical research received $61·1 billion (58·2%) across 70 337 (74·8%) awards and public health research received $29·5 billion (28·1%) from 19 197 (20·4%) awards. HIV/AIDS received $42·1 billion (40·1%), tuberculosis received $7·0 billion (6·7%), malaria received $5·6 billion (5·3%), and pneumonia received $3·5 billion (3·3%). Funding for Ebola virus ($1·2 billion), Zika virus ($0·3 billion), influenza ($4·4 billion), and coronavirus ($0·5 billion) was typically highest soon after a high-profile outbreak. There was a general increase in year-on-year investment in infectious disease research between 2000 and 2006, with a decline between 2007 and 2017. Funders based in the USA provided $81·6 billion (77·8%). Based on funding per 2017 disability-adjusted life years (DALYs), HIV/AIDS received the greatest relative investment ($772 per DALY), compared with tuberculosis ($156 per DALY), malaria ($125 per DALY), and pneumonia ($33 per DALY). Syphilis and scabies received the least relative investment (both $9 per DALY). We observed weak positive correlation (r=0·30) between investment and 2017 disease burden. HIV research received the highest amount of investment relative to DALY burden. Scabies and syphilis received the lowest relative funding. Investments for high-threat pathogens (eg, Ebola virus and coronavirus) were often reactive and followed outbreaks. We found little evidence that funding is proactively guided by global burden or pandemic risk. Our findings show how research investments are allocated and how this relates to disease burden and diseases with pandemic potential. Bill & Melinda Gates Foundation.