The mismatch between the health research and development (R&D) that is needed and the R&D that is undertaken: an overview of the problem, the causes, and solutions

Abstract

One of the most pressing global health problems is that there is a mismatch between the health research and development (R&D) that is needed and that which is undertaken. The dependence of health R&D on market incentives in the for-profit private sector and the lack of coordination by public and philanthropic funders on global R&D priorities have resulted in a global health R&D landscape that neglects certain products and populations and is characterised, more generally, by a distribution that is not ‘needs-driven’. This article provides an overview of the mismatch, its causes, and solutions.

Finding Better Ways to Fill Gaps in Pediatric Health Research

“…Moreover, there is a need to go beyond looking at diseases and identify which interventions are being studied, or neglected, for each disease. 6 In our study of the ICTRP, 63% of all pediatric trials, across all health problems, investigated drugs, biologicals, or vaccines, whereas only 5% studied diagnostics (other large categories of interventions were surgery and other procedures, at 15%, and behavioral interventions, at 11%). Health R&D is often more focused on developing drugs and vaccines than on developing diagnostics.…”

“…However, in determining how much research is needed for an age group, disease burden is just 1 factor. 6 A more nuanced picture can be obtained by also including other factors. In Europe, for example, pediatric investigation plans were required for 70% of all recent medicine applications for adults.…”

“…Health R&D is often more focused on developing drugs and vaccines than on developing diagnostics. 6 Although the need for increased monitoring of pediatric health research can be addressed partly through research studies such as ours, the comprehensive nature of the information that is needed requires a more systematic approach. Additionally, there is a need for periodic monitoring, as opposed to singular studies, allowing a continuous process of identifying the largest gaps, evaluating whether they have been addressed, providing renewed attention for those that have not been, and identifying newly emerging gaps.…”

“…The Global Funding of Innovation for Neglected Diseases (G-FINDER) survey has been collecting information about global funding flows toward neglected disease R&D for years, building a much better knowledge base of what the largest gaps are in that area. 6 In addition to the need for information from a greater variety of sources, there is a need for more accurate information. In our own study, the numbers of trials recruiting in low- Numbers are based on a 5% sample of all interventional and actively recruiting trials on the WHO ICTRP taken on August 10, 2012.…”

“…4 This observatory will provide a sustainable mechanism for regular, global monitoring of health research to improve the prioritization of research, with a special focus on the needs of low-and middle-income countries. 4,6 Because the observatory will increase our understanding of what the largest gaps are in pediatric health research, it is an important first step in redressing the lack of health research for children. However, improving pediatric health research monitoring alone will not be enough.…”