U.S. investments in global health research have saved millions of lives and prevented immeasurable suffering. And by working to detect, treat and eventually eliminate infectious diseases worldwide, we’re protecting our own country too. That cliché about diseases knowing no borders is unfortunately very true. All that alone should be enough to remain committed to the cause.
But a couple weeks ago, a new report from the Global Health Technologies Coalition (GHTC) offered another persuasive reason: U.S. funding for global health research and development (R&D) is good for the American economy. The report, “Return on Innovation,” found that in 2015, 89 cents of every U.S. public dollar directed to global health R&D was invested right here at home. Between 2007 and 2015, that investment injected $12 billion into the U.S. economy, creating an estimated 200,000 new jobs and generating an additional $33 billion in economic output. Every $1 that the National Institutes of Health spends on basic research is estimated to generate more than $8 of industry investments over the next eight years.
“We want policymakers to know that (global health funding) affects their constituents,” Jamie Bay Nishi, director of GHTC, told me. “Part of the interesting story here is the catalytic power of U.S. government investment in terms of incentivizing private investment.”
Nishi said work on the new report began last fall — before the presidential election — and wasn’t initially intended as a response to global health cuts now being proposed by the Trump administration. With U.S. funding for global health R&D either stagnant or declining since 2009 (with the exception of emergency funds for Ebola and Zika), Nishi said the report was written to help “change that trend line regardless of administration.” According to the report, the U.S. invested $1.7 billion in global health R&D in 2015, which represented less than one-tenth of 1 percent of U.S. gross domestic product. The 2015 budget for global health R&D was already a quarter-billion dollars less than 2012 funding levels.
President Trump’s fiscal year 2018 proposal doesn’t look much better. Among its many recommended cuts to global health: A 50 percent cut to USAID global health programs, including a zeroing out of its HIV programs; a $25 million cut to neglected tropical diseases; a $65 million cut to maternal and child health; a $1.1 billion cut to the National Institute of Allergy and Infectious Diseases, which leads critical infectious disease research; and a $70 million cut to the CDC’s National Center for Emerging and Zoonotic Infectious Diseases. There’s more than that, but fortunately no one — including Nishi — thinks Trump’s budget will make it out of Congress in one piece. Like many other advocates working in Washington, D.C., she called it “dead on arrival.”
The budget proposal from House looks better for global health — it increases the NIH budget and saves its global health center, though it still recommends sizeable cuts to USAID and CDC. The House proposal may be an improvement over Trump’s, but Nishi said “there’s still too many variables out there for us to feel that global health funding for R&D is safe.”
Enter the new GHTC report, which provides a trove of information on the benefits and returns we yield with investments in global health R&D. Its authors write:
Not only does U.S. government investment play an essential and catalytic role in developing new drugs, vaccines, diagnostics, and other urgently-needed tools for neglected diseases and health conditions, but it also delivers tangible economic and security returns for Americans. This is a win-win from a humanitarian and strategic perspective – these investments save and improve lives in vulnerable populations around the world, while at the same time advancing American leadership in science and innovation, creating jobs and economic growth at home, supporting public-private partnerships, and protecting American and health security.
First, the lives saved. According to the GHTC report, all 42 new drugs, diagnostics, vaccines and reproductive health technologies created since 2000 with U.S. investment have made a positive difference. For instance, a 50-cent meningitis A vaccine, developed with U.S. global health R&D funding support, prevented 673,000 cases of disease, 378,000 deaths and 63,000 cases of lifelong disability. By the end of this decade, this one vaccine will have saved $9 billion in health care spending. Other examples include a new pediatric malaria treatment estimated to have saved 750,000 children, and a late-stage HIV vaccine candidate now being tested that could cut the number of new HIV infections in half in just 10 years.
Global health R&D is good for America’s health and economy too. Since 2007, global health R&D investment has created about 200,000 U.S. jobs and generated more than $30 billion in economic output as it cycles its way through the American economy. For example, the U.S. invested $192 million in global health R&D monies into U.S.-based pharmaceutical companies in 2015. That investment, according to the report, encouraged those companies to invest another $294 million, with the majority of that money spent domestically. In other words, “US government investment in global health R&D has a stimulative effect” that not only encourages additional private investment in the U.S. economy, but investment in disease research that benefits the world’s poorest people.
Plus, upfront investments now could help avert much higher spending in the future. For example, the growing problem of antimicrobial resistance — a problem often described as a looming public health crisis — is expected to cause 10 million deaths by 2050 and cost the global economy upwards of $100 trillion. However, according to the GHTC report, investing $2 billion annually in anti-microbial R&D could lead to the kinds of tools needed to combat the problem. Global R&D investments also prepare us for the next novel disease outbreak. The report notes:
The US government spent nearly $600 million to improve domestic preparedness for Ebola within the United States during the recent outbreak, and an additional $2.4 billion on efforts to combat and contain the Ebola outbreak at its source. If a point-of-care diagnostic and vaccine against Ebola had been available at the start, the 2014 West African Ebola outbreak would never have grown into the global health emergency it became. Not only would thousands of deaths have been prevented, but the US government would also have saved billions of dollars.
Nishi said the coalition hopes to follow its new report with one that breaks down the impact of global health R&D at the state level — “we really want to connect those dots for policymakers so they understand why they should care about this,” she said.
“First and foremost, it’s about saving millions of lives,” Nishi said. “The U.S. has an incredible history of being a leader in technology and innovation and that should hold true when it comes to (global health R&D) as well.”
She added: “Sometimes it does seem like these are distant problems and it’s hard to see the connections. …But it can’t be U.S. health versus global health — U.S. health is global health.”
For a copy of the “Return on Innovation” report, visit GHTC.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.