How a $300M global health partnership will work

Three top global health funders have joined forces in a $300 million research partnership to tackle the linked impacts of climate change, malnutrition, and infectious diseases and antimicrobial resistance in low- and middle-income countries. The Gates Foundation, Wellcome, and the Novo Nordisk Foundation will each provide $100 million over three years to break down barriers between research areas that have typically been siloed, they announced last month. It’s the first time the three funders have all worked together. The aim is to ensure a greater understanding of “the interplay between nutrition, immunity, disease, and developmental outcomes” and “advancing climate data,” according to the announcement last month. This could include looking at how extreme weather events related to climate change cause food insecurity, and subsequently leave undernourished children vulnerable to disease. “There's something really powerful about coming together and finding [solutions] on common areas of concern for all of us and that we can help drive progress, but also mobilize others to join us and to make progress faster,” Wellcome’s Chief Strategy Officer Beth Thompson told Devex. The partnership has a focus on seeking affordable solutions to these challenges and scaling equitable access to existing tools and technologies for people in low- and middle-income countries. It also intends to provide resources to “develop knowledge in a way that is locally relevant” and strengthen research and development capacities in LMICs, Thompson said. The details on just how that will work are still being finalized. “You’re seeing a work in progress rather than a finished product,” said Thompson, speaking the day after the launch of the partnership. “The high-level initiatives that we take forward as part of this will clearly need to be informed by low- and middle-income country priorities and enable that work both to develop knowledge in a way that is locally relevant, but also to enable us to develop those solutions that will have the most impact on the ground.” Doing that will require working with LMIC partners “both in terms of how we're setting the challenges that we're working on but also how we're then taking them forward,” she added. So far they’ve not lined up specific researchers and institutions to work with. The U.K.-based Wellcome, like the other foundations it’s partnering with, has a record of funding companies and nonprofits in the global south, as well as institutions closer to home that also partner with researchers in LMICs. This includes University College London, which used $81.6 million of its $99.8 million grant allocation from Wellcome for a multiyear funding renewal for UCL’s collaboration with the Africa Health Research Institute in South Africa on a wide range of health projects, according to Science Business. Dr. Catherine Kyobutungi, executive director of the African Population and Health Research Center in Kenya, said she hopes that a portion of the funding will go directly to researchers and institutions in lower-income countries, “rather than insisting on partnerships that the funding has to be accessed through in the global north.” The center is not affiliated with the partnership. If scientists have ownership over the grants themselves, she explained, they can define the parameters of the research and who they work with, decide how much time to spend on scientific writing or how much time to spend on outreach, and decide who owns the data. “That's a big thing," she said. She also recommended these grants include both an institutional and individual mix. “There's a tendency for funding bodies to invest in people without thinking about the infrastructure and the institutional base within which these individuals operate,” she said, adding that “there has not been as much investment in the institutions and their structures and systems and processes in the global south.” Kyobutungi also expressed concerns about the potential timeframe for implementation — which has not yet been defined — and recommended the partnership hold multiple calls for grant applications to disburse the $300 million over three years, rather than requiring projects be implemented and finalized within three years. Thompson said that partnerships are the only way to achieve the equitable access that is at the heart of this initiative. A vast network of partnerships from across sectors — from the pharma industry to governments to local communities and academics — will ensure that high-impact R&D, products, and interventions will be affordable, she explained. “Our intent is for this to be a bigger partnership than the three of us. We're the founding members, if you like, but the things that we deliver we will have to bring in others and that is going to be critical to make sure that these solutions are also accessible and affordable,” she said.