Opinion: G20 leadership on tackling disease would save lives and money

Flags of G-20 members. Photo: Crown copyright / CC BY-NC-ND

The world’s most deadly poverty related neglected diseases, or PRNDs, afflict millions of people living in G-20 countries — the “Group of 20” largest economies brought together to advance international economic and financial cooperation.

That may come as a surprise, but it is the reality.

A majority of tuberculosis cases, and around 50 percent of HIV/AIDS and malaria cases, are found in G-20 countries, according to research by Prof. Peter Hotez, United States science envoy under President Obama. Around 12 million U.S. citizens are infected with at least one of these deadly diseases.

In light of this, we can no longer think of these as diseases of the developing world. It is critical that the G-20 countries recognize this fact, and do more to address the health needs of vulnerable groups within their borders.

Drug resistance, threats of pandemics and neglected diseases of poverty pose long-term threats to global development. Perhaps the fact that these diseases are afflicting people at home, as well as abroad, will convince governments to act.

Pandemic response a cycle of 'panic and neglect,' says World Bank president

The international community is ill-prepared for another pandemic, World Bank President Jim Kim has said at the Skoll World Forum, adding that financial support for the bank's new pandemic response mechanism has dropped to just two countries.

Inaction today will only serve to make future emergencies costlier, a lesson we should have learned from the recent Ebola epidemic.

In 2014 and 2015, Ebola claimed 11,325 lives in West Africa, and cost the three affected countries — Guinea, Liberia and Sierra Leone — more than $1.6 billion of their economic output for 2015; around 12 percent of their combined gross domestic product. The World Bank estimated that the final economic cost of the epidemic for the African continent would be in the region of $6.25 billion, far higher than if health systems had been prepared to cope with the threat of a pandemic.

The international community was rightly criticised by nongovernmental organizations providing services on the ground and the United Nations for failing to do enough and acting too slowly in response to the Ebola epidemic. Of an estimated $5 billion pledged by wealthy countries, only a small portion was actually made available to the affected countries.

“The world was ill-prepared,” said Margaret Chan, director-general of the World Health Organization in March 2015. “It shows. We must reduce this vulnerability as a matter of urgency.”

The scourge of antimicrobial resistance, or AMR, has produced similarly dire pathogens: A person being treated for extensively drug-resistant tuberculosis with today’s prevailing treatments has a lower likelihood of survival than the average case fatality rate for Ebola.

Plan ahead, and work across sectors

Agreement on the need for urgent action among G-20 leaders in July would help to ensure that we are better prepared to deal with future health crises.

However, the medicines, diagnostics, and vaccines needed will never exist if governments expect the private sector to do the job alone.

Product development is a long and uncertain process. Even when adequately funded, the discovery, development, manufacturing and distribution of drugs and vaccines to combat tropical and poverty related diseases often takes a decade or more.

Pharmaceutical companies have had little financial incentive to create anti-malarial drugs, for example, leaving the pipeline for new drugs empty for years.

Behind the scenes on new malaria vaccine pilot roll-out

Three African countries will be the first to participate in a widespread malaria vaccine pilot program that advocates hope could dramatically boost efforts to end the disease as well as kickstart research on an even more effective vaccine.

Product Development Partnerships, or PDPs, are working to fill this gap. Since emerging in the late 1990s, PDPs have developed and brought dozens of new health technologies targeting diseases of poverty to the market.  

The PDP model, which acknowledges that the pharmaceutical sector will not sufficiently fund the high costs of research and clinical development, leverages the public and philanthropic sectors to share the risk of investing in urgently-needed medicines, vaccines and diagnostics.

This model has seen promising results. To take one example, international funding for malaria control and elimination was $2.7 billion in 2013, a threefold increase since 2005.

A version of this model should be supported by leaders in July. First and foremost, G-20 members should pool their national public health and scientific expertise to support global efforts to combat AMR.

We also need a commitment from G-20 members to steadily increase investments in health R&D, and pool their public health and scientific resources.

Build on previous experience

3 calls to action for G-20:

1. G-20 members should pool their national public health and scientific expertise to support global efforts to combat AMR.

2. A commitment from G-20 members is needed to steadily increase investments in health research and development, and offer innovative financing options.

3. The G-20 must provide political leadership to address the inter-related issues of AMR, pandemic preparedness/response and PRNDs.

One of the successes of the Millennium Development Goals was in focusing the minds of policymakers on dramatically reducing the leading causes of infant mortality — diarrhoeal disease, pneumonia and malaria, HIV incidences and the death toll from tuberculosis. That is a start, but it is not enough.

There is no excuse for tolerating a world in which millions of people — many of them in wealthy countries — die from treatable diseases because of market failure and political neglect.

Getting our own house in order would also be a giant step towards ending the epidemics of HIV/AIDS, tuberculosis and malaria, itself one of the U.N.’s recently agreed Sustainable Development Goals. A coordinated effort by the G-20 countries would help eliminate two-thirds of the global disease burden.

The World Bank has estimated that, without additional resources, these diseases will push an additional 28.3 million people into poverty, increase global health care costs by $1.2 trillion and cost low income countries more than 5 percent of GDP by 2050.

Saving lives while saving money should be something that all politicians can agree on.

Stay tuned for a special 10-week series featuring the latest news, views and expert analysis on how to finance the health-related Sustainable Development Goals, launching May 16 on Devex.

The views in this opinion piece do not necessarily reflect Devex's editorial views.

About the authors

  • Alan Donnelly

    Alan Donnelly is the executive chairman of Sovereign Strategy, having founded the company in 2000. He was a Labour MEP from 1989-1999.
  • Willo Brock

    Willo Brock is the senior vice president of external affairs for the Global Alliance for TB Drug Development. He leads TB Alliance's fundraising, advocacy and policy, and community and stakeholder engagement work.
  • Claire Wingfield

    Claire Wingfield is a senior policy officer with the advocacy and public policy program at PATH.