Call for Europe to stay the course on neglected diseases Global health groups make the case for continued European leadership

Speaking at a Science|Business debate on research and innovation (R&I) funding in the EU’s new mandate, global health leaders underlined the enormous return on investment (ROI) of such global health spending not just for developing countries, but also for Europe. “The investment will pay off to the world, and it will pay off for your own countries and constituents,” said Vanessa Candeias, strategy and external affairs lead for Impact Global Health, which advocates for R&I in historically neglected and underfunded diseases and co-sponsored the debate together with DSW. 

The diseases are considered neglected because the people they most affect live in low- and middle-income countries (LMICs), undermining the business case for the development of purely commercial vaccines.

In this context, the combination of European science and long-term EU funding is now delivering potentially transformative results: two malaria vaccines have recently been licensed, while three tuberculosis vaccines have reached stage three testing – the last development step before they are approved for general use.

Candeias cited data from a new Impact Global Health study that calculated that the EU receives a whopping 567% return on every euro spent addressing neglected diseases. The Global health R&D makes a strong investment case for Team Europe report said €8.06 billion in EU investments (including funding both by the EU and member states) in global health will ultimately be responsible for €30.5 billion euros in additional economic activity and 15,563 additional long-term jobs — in addition to saving 3.5 million lives. Of those figures, €12.58 billion of economic activity, and 6,588 new jobs are specifically attributable to €3.5 billion in EU funding (as opposed to member-state funding).  The figures take into account the long-term expected returns on investments that have already been made. 

Multiple factors fuel huge ROI 

Several factors help explain the huge return on investment. For one, although the funding may initially appear to benefit LMICs, international travel and climate change have already brought diseases, such as dengue and malaria, to Europe’s doorstep and will continue to do so. 

 “We talk about the tropics, but we may soon be talking about the Mediterranean or Southern Europe,” said Kasia Jurczak, head of the DG Research unit within the European Commission that is focused on combatting diseases. Climate change has already led some mosquitoes carrying dengue fever and malaria to shift their habitats northward into southern Europe, she noted. 

Investing in new vaccines for neglected diseases also benefits Europe’s fight against the global scourge of antimicrobial resistance, which public health experts have described as a silent pandemic. Because neglected diseases are often treated with antibiotics, preventing those diseases with vaccines directly reduces demand for antibiotics, which directly reduces the growth of antimicrobial resistance that threatens people world-wide. Lack of investment in global health R&I leads to medicines with low effectiveness, exacerbating pathogen resistance. One strain of tuberculosis, which is resistant to the most effective antibiotics, is a stark example.

Ole Olesen, executive director of the European Vaccine Initiative and Tuberculosis Vaccine Initiative, noted that Europe was the birthplace of the first two malaria vaccines and the three most advanced tuberculosis vaccines in development. However, due to limited funding and incentives, the final development of such vaccines is often outsourced, leading to a loss of European ownership once they enter production and are procured by global health multilateral bodies, he added.

Eradicating malaria alone could add €16 billion annually to Africa’s economy, creating significant positive spillover effects for Europe—economically and politically, Olesen suggested. As a result, the return on investment for Europe could be even higher than that calculated by Impact Global Health in its new report. 

Prevention is more cost-effective than cure

Several speakers at the event underlined the strong economic and social benefits of a strategy based on preventing infectious diseases as opposed to treating people after-the-fact. 

“It’s more cost-effective to invest in prevention than in responding to outbreaks in cases of emergency,” said Michael Makanga, executive director of Global Health EDCTP3, an EU Joint Undertaking set up to fund and support R&I projects on poverty-related and neglected infectious diseases. “What starts as a small outbreak in one small country, when it expands into an epidemic and pandemic, has very serious health and economic consequences, and Europe is not spared.”

The debate took place against the backdrop of last year’s European and US elections, which have resulted in a shift in priorities – towards security in Europe, and towards isolationism and self-sufficiency in the US. With the US having announced its intention to withdraw from the World Health Organisation and already implementing unprecedented cuts to its Agency for International Development (USAID) – one of the world’s leading global health funders – several speakers said it was more important than ever for Europe to guarantee a sustainable source of financing for vaccine development and other global health priorities. 

The timeline for the development of vaccines is measured in decades, much longer than election cycles, and public money helps de-risk investments by the private sector, several speakers noted. With a nod to political priorities in Brussels and other national capitals, Jurczak stressed that securing supply chains for public health emergencies should be considered an essential element of the EU’s security strategy.  “The costs of preparedness are significant, but the return on those investments is even more significant,” she said.