A guest post by David Cook
Executive Vice President and Chief Operating Officer of the International AIDS Vaccine Initiative (IAVI)
As a new Congress and the Obama Administration look for high value in government investments as they convene for the State of the Union address Tuesday, they should consider the proven value of investments in biomedical research and development to address the major diseases and health issues facing the world.
Today, in a speech at the Center for Global Development, Dr. Rajiv Shah, Administrator of the United States Agency for International Development (USAID), outlined the agency’s plans to modernize aid, including harnessing the potential of science and technology for game-changing innovations that would save lives, reduce costs, and foster growth both in the U.S. and in the developing world. USAID is working with other government agencies to “build on recent advances in science and technology, especially in high return areas such as vaccinating children, preventing HIV, malaria and TB and focusing on childhood nutrition during pregnancy and the first two years of life,” Shah said.
The U.S. has long held an advantage in science and technology, and its biotechnology industry is driving innovation to make lifesaving products – including cheaper and more widely available flu vaccines and novel vaccines for dengue virus – to protect hundreds of millions of people around the world. Health innovations that emerge from R&D also yield cost savings and economic improvements. The Centers for Disease Control and Prevention estimates the U.S. has saved more than $3 billion since investing $32 million in the global campaign to eradicate smallpox because expenditures for smallpox treatment and vaccination are no longer needed.
Global health R&D also is putting people to work across the U.S. at research centers, academic institutions and biotech companies. For every $1 million the National Institutes of Health (NIH) spent on R&D in fiscal 2007, $2.21 million was generated in business activity in the U.S., according to Families USA. In Washington state alone, global health endeavors generate $4.1 billion of business activity, and nearly 3,700 residents work in global health research or service delivery, according to Research!America.
In addition, global health R&D can strengthen scientific and technological skills and infrastructure in developing countries, which can contribute to creating more vibrant economies. Economists examining trends from 1960 to 2000 found that, on average, $1 of science and technology investment resulted in a $0.78 increase in GDP, with developing countries reaping higher returns than industrialized countries. Some countries, such as China, India, and South Korea, earned returns on scientific investment of more than 100 percent. By making people healthier, the innovations produced by global health R&D also make economies stronger. Health economists have attributed up to 15 percent of the economic growth in developing countries from 1960 to 1990 to reductions in mortality.
Today, diseases that significantly impact the developing world require reforms that spur innovative new solutions. HIV/AIDS, which has been shown to decrease life expectancy and slow economic growth in highly impacted countries, is one significant example. While access to antiretroviral drugs has rapidly expanded in low- and middle-income countries enabling millions of people to lead productive lives, for every person who goes on treatment, two more are newly infected with HIV. Plainly, new methods of HIV prevention are needed if we are to sustain the progress made in stabilizing the most affected countries.
Thankfully, tremendous progress made over the last 18 months offers hope that R&D investments will produce those new methods and yield ways to eventually end the AIDS pandemic. In the fall of 2009, a trial in Thailand, a joint project of the U.S. and Thai governments, demonstrated that a vaccine can prevent transmission of HIV. The vaccine candidate showed a moderate efficacy of 31 percent. The quest for an AIDS vaccine has been further buoyed by discoveries by researchers at and affiliated with the International AIDS Vaccine Initiative and the Vaccine Research Center of the NIH of several new antibodies that neutralize a broad swath of HIV variants, giving scientists targets that are valuable in designing a potentially highly effective vaccine. In mid-2010, South African researchers announced that in a trial funded by USAID a vaginal microbicide gel containing the antiretroviral drug tenofovir had reduced HIV infections in women by 39 percent. Finally, recent results from a global study funded in part by the NIH found that taking as a prophylactic a combination pill currently used to treat HIV reduced the risk of HIV infection by 44 percent among men who have sex with men.
These results provide evidence that science and technology, if properly funded and focused, hold the potential to deliver the type of innovations Dr. Shah alluded to in his speech today. As researchers in the U.S. and around the world are poised to build on this recent momentum, lawmakers looking to find common ground on how to spur the economy both in the U.S. and in the developing world have a great place to start in global health R&D. As Dr. Shah noted today, U.S. foreign assistance is not just USAID’s tag line of “from the American people” but also “for the American people” in part because U.S. assistance helps develop the “markets of the future.”
NOTE: Dr. Shah also recently spoke about HIV vaccine R&D and IAVI’s efforts to find an AIDS Vaccine. Excerpts of his comments can be seen on IAVI’s YouTube channel: http://www.youtube.com/user/IAVIVideos