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To estimate how much additional funding is needed for poverty-related and neglected disease (PRND) product development and to target new resources effectively, policymakers need updated information on the development pipeline and estimated costs to fill pipeline gaps. In this study, we analyze the product pipeline for PRNDs up to August 31, 2019 for 45 diseases and 6 multiple diseases and also conduct a comparison analysis with the product pipeline analysis we conducted for PRNDs in 2017 that included 35 diseases and 5 multiple disease categories. The data files in this project include: Data file 1: Full list of diseases included in 2017 and 2019 pipelines Data file 2: Expected launches: unrounded, rounded to nearest integer, and rounded down, Data file 3: Candidates in the pipeline for neglected diseases, as of August 31, 2019 Data file 4*: P2I.v2 tool showing anticipated launches and costs by disease and archetype for the 2019 direct comparison pipeline Data files 5 and 6*: P2I.v2 tool showing anticipated launches and costs by disease and archetype for the 2019 complete pipeline *Data files 4,5 and 6 which includes the P2I modelling tool are provided in Microsoft Excel format as the files cannot be uploaded in any other format. To use these data files please download the file and use Microsoft Excel software to open the files.

During the covid-19 pandemic, we have seen the best of international collective action and its limits. Global scientific cooperation drove the development of safe, highly effective covid-19 vaccines in under one year.1 Yet we have also witnessed global vaccine inequity,2 in which low and middle income countries have “limited supply and limited vaccine brand options.

Additional file 1.

There have been many important innovations in the landscape of vaccine development for neglected and emerging infectious diseases, such as the launch of public-private product development partnerships (PDPs). However, there is still a gap in funding the development of such vaccines, especially when it comes to financing late-stage trials. There is a financial risk in investing in late-stage trials, and there is no guarantee of a commercial market, particularly for the most neglected diseases of poverty. One result of the funding gap is that there are many infectious diseases with a high burden in the Asia-Pacific region for which there are no licensed, highly effective vaccines, including HIV/AIDS, tuberculosis, soil-transmitted helminths and schistosomiasis. There are also neglected infectious diseases that affect populations in the region where the existing vaccines have limitations, such as malaria, dengue, and Japanese encephalitis. Understanding how much additional financing is needed for vaccine research and development (R&D) for neglected and emerging infections is a crucial first step in closing the financing gap. Annual spending on vaccine R&D for neglected diseases was approximately $ 1 billion in 2020. Our previous modelling research, using a financial tool called the Portfolio to Impact model, estimated that $ 3 billion is needed annually, suggesting there is an annual financing gap of $ 2 billion. For vaccine R&D for emerging diseases, annual spending on the Blueprint diseases was $ 350 million in 2018, but the annual financing need is approximately $ 400 million to $ 520 million, suggesting an annual funding gap of $ 50 million to $ 170 million. How much is the Asia-Pacific region investing in vaccine R&D through the public, private, and philanthropic sectors and via PDPs? Using data from the G-FINDER database, we estimate that from 2018-2020, there was only $ 35 million annually being invested in the region in neglected disease vaccine R&D and $ 3.8 million annually being invested in emerging infectious disease vaccine R&D. These are very low levels of financing compared with the need. Despite such low levels of financing, our report finds that there is significant vaccine trials and manufacturing capacity in many developing countries of the region. Closing the vaccine R&D funding gap in the Asia-Pacific region would have enormous health and economic returns. The various policy approaches to closing this gap can be organized into (1) resource mobilization (e.g. government contributions, airline ticket levies), (2) pooling of resources (e.g. a regional pooled R&D fund), and (3) strategic purchasing (see figure).

Per capita GDP has limited use as a well-being indicator because it does not capture many dimensions that imply a "good life," such as health and equality of opportunity. However, per capita GDP has the virtues of easy interpretation and can be calculated with manageable data requirements. Against this backdrop, a need exists for a measure of well-being that preserves the advantages of per capita GDP, but also includes health and equality. We propose a new parsimonious indicator to fill this gap and calculate it for 149 countries.

Since the global economic crisis, a harsher economic climate and global commitments to address the problems of global health and poverty have led to increased donor interest to fund effective health innovations that offer value for money. Simultaneously, further aid effectiveness is being sought through encouraging governments in low- and middle-income countries (LMICs) to strengthen their capacity to be self-supporting, rather than donor reliant. In practice, this often means donors fund pilot innovations for three to five years to demonstrate effectiveness and then advocate to the national government to adopt them for scale-up within country-wide health systems. We aim to connect the literature on scaling-up health innovations in LMICs with six key principles of aid effectiveness: country ownership; alignment; harmonisation; transparency and accountability; predictability; and civil society engagement and participation, based on our analysis of interviewees' accounts of scale-up in such settings.We analysed 150 semi-structured qualitative interviews, to explore the factors catalysing and inhibiting the scale-up of maternal and newborn health (MNH) innovations in Ethiopia, northeast Nigeria and the State of Uttar Pradesh, India and identified links with the aid effectiveness principles. Our interviewees were purposively selected for their knowledge of scale-up in these settings, and represented a range of constituencies. We conducted a systematic analysis of the expanded field notes, using a framework approach to code a priori themes and identify emerging themes in NVivo 10.Our analysis revealed that actions by donors, implementers and recipient governments to promote the scale-up of innovations strongly reflected many of the aid effectiveness principles embraced by well-known international agreements - including the Paris Declaration of Aid Effectiveness. Our findings show variations in the extent to which these six principles have been adopted in what are three diverse geographical settings, raising important implications for scaling health innovations in low- and middle-income countries.Our findings suggest that if donors, implementers and recipient governments were better able to put these principles into practice, the prospects for scaling externally funded health innovations as part of country health policies and programmes would be enhanced.

Background Preterm birth (PTB) is the leading cause of death in children under age five. Healthcare policy and other decision-making relevant to PTB may rely on obsolete, incomplete or inapplicable research evidence, leading to worsened outcomes. Appropriate knowledge transfer and exchange (KTE) strategies are an important component of efforts to reduce the global PTB burden. We sought to develop a ‘landscape’ analysis of KTE strategies currently used in PTB and related contexts, and to make recommendations for optimising programmatic implementation and for future research. Methods In the University of California, San Francisco’s Preterm Birth Initiative, we convened a multidisciplinary working group and examined KTE frameworks. After selecting a widely-used, adaptable, theoretically-strong framework we reviewed the literature to identify evidence-based KTE strategies. We analysed KTE approaches focusing on key PTB stakeholders (individuals, families and communities, healthcare providers and policymakers). Guided by the framework, we articulated KTE approaches that would likely improve PTB outcomes. We further applied the KTE framework in developing recommendations. Results We selected the Linking Research to Action framework. Searches identified 19 systematic reviews, including two ‘reviews of reviews’. Twelve reviews provided evidence for KTE strategies in the context of maternal, neonatal and child health, though not PTB specifically; seven reviews provided ‘cross-cutting’ evidence that could likely be generalised to PTB contexts. For individuals, families and communities, potentially effective KTE strategies include community-based approaches, ‘decision aids’, regular discussions with providers and other strategies. For providers, KTE outcomes may be improved through local opinion leaders, electronic reminders, multifaceted strategies and other approaches. Policy decisions relevant to PTB may best be informed through the use of evidence briefs, deliberative dialogues, the SUPPORT tools for evidence-informed policymaking and other strategies. Our recommendations for research addressed knowledge gaps in regard to partner engagement, applicability and context, implementation strategy research, monitoring and evaluation, and infrastructure for sustainable KTE efforts. Conclusions Evidence-based KTE, using strategies appropriate to each stakeholder group, is essential to any effort to improve health at the population level. PTB stakeholders should be fully engaged in KTE and programme planning from its earliest stages, and ideally before planning begins.

A new BMJ series will examine the latest evidence

The Commission on Investing in Health (CIH), an international group of 25 economists and global health experts, published its Global Health 2035 report in The Lancet in December 2013. The report laid out an ambitious investment framework for achieving a “grand convergence” in health—a universal reduction in deaths from infectious diseases and maternal and child health conditions—within a generation. This article captures ten key elements that the CIH found important to its process and successful outcomes. The elements are presented in chronological order, from inception to post-publication activities. The starting point is to identify the gap that a new commission could help to narrow. A critical early step is to choose a chair who can help to set the agenda, motivate the commissioners, frame the commission’s analytic work, and run the commission meetings in an effective way. In selecting commissioners, important considerations are their technical expertise, ensuring diversity of people and viewpoints, and the connections that commissioners have with the intended policy audience. Financial and human resources need to be secured, typically from universities, foundations, and development agencies. It is important to set a clear end date, so that the commission’s work program, the timing of its meetings and its interim deadlines can be established. In-person meetings are usually a more effective mechanism than conference calls for gaining commissioners’ inputs, surfacing important debates, and ‘reality testing’ the commission’s key findings and messages. To have policy impact, the commission report should ideally say something new and unexpected and should have simple messages. Generating new empirical data and including forward-looking recommendations can also help galvanize policy action. Finally, the lifespan of a commission can be extended if it lays the foundation for a research agenda that is then taken up after the commission report is published.

Concerted action is required to reverse downward trends in research and development

Background Preterm birth (PTB) is the leading cause of death in children under age five. Healthcare policy and other decision-making relevant to PTB may rely on obsolete, incomplete or inapplicable research evidence, leading to worsened outcomes. Appropriate knowledge transfer and exchange (KTE) strategies are an important component of efforts to reduce the global PTB burden. We sought to develop a ‘landscape’ analysis of KTE strategies currently used in PTB and related contexts, and to make recommendations for optimising programmatic implementation and for future research. Methods In the University of California, San Francisco’s Preterm Birth Initiative, we convened a multidisciplinary working group and examined KTE frameworks. After selecting a widely-used, adaptable, theoretically-strong framework we reviewed the literature to identify evidence-based KTE strategies. We analysed KTE approaches focusing on key PTB stakeholders (individuals, families and communities, healthcare providers and policymakers). Guided by the framework, we articulated KTE approaches that would likely improve PTB outcomes. We further applied the KTE framework in developing recommendations. Results We selected the Linking Research to Action framework. Searches identified 19 systematic reviews, including two ‘reviews of reviews’. Twelve reviews provided evidence for KTE strategies in the context of maternal, neonatal and child health, though not PTB specifically; seven reviews provided ‘cross-cutting’ evidence that could likely be generalised to PTB contexts. For individuals, families and communities, potentially effective KTE strategies include community-based approaches, ‘decision aids’, regular discussions with providers and other strategies. For providers, KTE outcomes may be improved through local opinion leaders, electronic reminders, multifaceted strategies and other approaches. Policy decisions relevant to PTB may best be informed through the use of evidence briefs, deliberative dialogues, the SUPPORT tools for evidence-informed policymaking and other strategies. Our recommendations for research addressed knowledge gaps in regard to partner engagement, applicability and context, implementation strategy research, monitoring and evaluation, and infrastructure for sustainable KTE efforts. Conclusions Evidence-based KTE, using strategies appropriate to each stakeholder group, is essential to any effort to improve health at the population level. PTB stakeholders should be fully engaged in KTE and programme planning from its earliest stages, and ideally before planning begins. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0238-0) contains supplementary material, which is available to authorized users.

Methods for searching the knowledge transfer and exchange research literature. (DOCX 15Â kb)

BackgroundThe United Nations Sustainable Development Goal for health (SDG3) poses complex challenges for signatory countries that will require clear roadmaps to set priorities over the next 15 years. Building upon the work of the Commission on Investing in Health and published estimates of feasible global mortality SDG3 targets, we analysed Mexico's mortality to assess the feasibility of reducing premature (0-69 years) mortality and propose a path to meet SDG3.MethodsWe developed a baseline scenario applying 2010 age-specific and cause-specific mortality rates from the Mexican National Institute of Statistics and Geography (INEGI) to the 2030 UN Population Division (UNPD) population projections. In a second scenario, INEGI age-specific and cause-specific trends in death rates from 2000 to 2014 were projected to 2030 and adjusted to match the UNPD 2030 mortality projections. A third scenario assumed a 40% reduction in premature deaths across all ages and causes. By comparing these scenarios we quantified shortfalls in mortality reductions by age group and cause, and forecasted life expectancy pathways for Mexico to converge to better performing countries.FindingsUNPD-projected death rates yield a 25·9% reduction of premature mortality for Mexico. Accelerated reductions in adult mortality are necessary to reach a 40% reduction by 2030. Mortality declines aggregated across all age groups mask uneven gains across health disorders. Injuries, particularly road traffic accidents and homicides, are the main health challenge for young adults (aged 20-49 years) whereas unabated diabetes mortality is the single most important health concern for older adults (aged 50-69 years).InterpretationUrgent action is now required to control non-communicable diseases and reduce fatal injuries in Mexico, making a 40% reduction in premature mortality by 2030 feasible and putting Mexico back on a track of substantial life expectancy convergence with better performing countries. Our study provides a roadmap for setting national health priorities. Further analysis of the equity implications of following the suggested pathway remains a subject of future research.FundingMexico's Ministry of Health, University of California, San Francisco, and Bill & Melinda Gates Foundation.

Methods for synthesizing the literature on KTE and summary of the evidence. (DOCX 17Â kb)

En noviembre de 2014, la Secretaría de Salud de México fue sede de una mesa redonda con miembros de la Comisión de The Lancet para la Inversión en Salud (CIS) para analizar el informe de esta misma comisión titulado Salud global 2035 y sus posibles implicaciones para el mejoramiento de la salud pública...

The Global Health 2035 report shows that there is tremendous potential to achieve dramatic gains in global health over the next 20 years, particularly with regards to the G7's priorities of eliminating NTDs, preparing effectively for pandemics, and tackling AMR. These challenges require urgent international collective action and demand the leadership and focused investment of the G7. To maximize its impact and help mobilize action for the post-2015 health agenda, the G7 should target its efforts towards four critical policy options: investing in new tools, supporting policy and implementation research, strengthening national health systems, and fostering global coordination. By working in partnership with donor, low- and middle-income countries on these policy options, the G7 can set the course to achieve a grand convergence in global health.

The Global Health 2035 report shows that there is tremendous potential to achieve dramatic gains in global health over the next 20 years, particularly with regards to the G7's priorities of eliminating NTDs, preparing effectively for pandemics, and tackling AMR. These challenges require urgent international collective action and demand the leadership and focused investment of the G7. To maximize its impact and help mobilize action for the post-2015 health agenda, the G7 should target its efforts towards four critical policy options: investing in new tools, supporting policy and implementation research, strengthening national health systems, and fostering global coordination. By working in partnership with donor, low- and middle-income countries on these policy options, the G7 can set the course to achieve a grand convergence in global health.

Only 23 countries are on course to reach Millennium Development Goal (MDG) 5: to reduce the maternal mortality ratio by 75% by 2015 [1]. One reason for this slow progress is that, in many low-income and middle-income countries, most poor women deliver at home without skilled attendance, and thus face a high rate of obstetric complications. Our recent analysis, for example, found that in sub-Saharan Africa, from 2003 to the present, 78% of births among the poorest women occurred at home, of which 56% were unattended [2]. Reasons for this high rate of unattended home births include poor availability of health facilities, and social and cultural preferences for home delivery [2,3]. Increasing the proportion of poor women receiving skilled obstetric care is a complex public health challenge that defies easy solutions. Innovative approaches are desperately needed. References 1. Hogan MC, Foreman KJ, Naghavi M, et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010; 375: 1609–23. 2. Montagu D, Yamey G, Visconti A, Harding A, Yoong J. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data. PLoS One 2011; 6: e17155. 3. Koblinsky M, Matthews Z, Hussein J, et al, on behalf of The Lancet Maternal Survival Series steering group. Going to scale with professional skilled care. Lancet 2006; 368: 1377–86.