The Astonishing Returns of Investing in Global Health R&D


By Lawrence H. Summers and Gavin Yamey

How to reach a “grand convergence” by 2035

We have a once-in-human-history opportunity to achieve a “grand convergence” in global health—a reduction in infectious, maternal, and child deaths down to universally low levels everywhere on the planet.

The Global Health 2035 report that we coauthored with 23 other economists and health experts came to a startling conclusion: with the right investments, we could reach grand convergence in just one generation, averting 10 million deaths every year by 2035.

But today’s health tools alone won’t get us there. We’ll need tomorrow’s tools as well, including new medicines, vaccines, diagnostics, and other innovations.

Investing in global health R&D won’t just save millions of lives. It will also reap astonishing economic returns.

Take the polio vaccine. In the 1950s, the March of Dimes invested about US$26 million in developing the vaccine. Since routine vaccination was introduced in the United States, more than 160,000 polio deaths and about 1.1 million cases of paralytic polio have been prevented. Treatment cost savings have generated a net benefit of around $180 billion. It’s hard to think of a better $26 million investment in human history.

Today’s scientists are focusing on equally game-changing innovations, like an HIV vaccine. Our colleagues Dean Jamison and Rob Hecht have shown that every $1 invested in this vaccine would return between $2 and $67, assuming a vaccine of 50 percent efficacy becomes available by 2030 and R&D costs of about $900 million annually. Other game-changers—like a single-dose malaria cure or inhaled oxytocin to treat life-threatening maternal bleeding—are likely to bring similar economic returns.

Discussions about global health R&D often lead to concerns about whether countries have the institutional capacity to deliver new tools. One of the striking features of health innovations is that they can be “capacity-conserving.” Our main tool for preventing malaria is arranging regular mass distributions of bednets and teaching households how to use them properly, a hugely resource-intensive intervention. When we develop a highly effective malaria vaccine, we will be conserving such resources. Bednets will come to be seen as a cumbersome relic, akin to the iron lung in the era before polio vaccines.

In Global Health 2035, we called on donors to step up their R&D investments. Public, private, and philanthropic investors are now on the lookout for high-impact R&D opportunities to catalyze global change. Today, 129 billionaires have pledged to give at least half of their wealth to charity through The Giving Pledge. Health is their number one interest.

But investors want more guidance on how to achieve maximum impact. We believe a new “health investors’ platform” could provide this kind of strategic knowledge about the greatest health challenges facing poor populations, the most promising candidates in the R&D pipeline, and the likely health and economic impacts of developing these into health tools that will reach the poor.

Global Health 2035 challenged all of us to reach higher and faster. But we will fail unless we find creative ways to bring new health tools to those with the greatest health needs.

July 12, 2015

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