Calling for increased investment in health research and development
Context and Landscape of Health R&D in SA
We, the South African Health Technologies Advocacy Coalition (SAHTAC), a civil- society coalition which advocates for an enabling environment for health research and development, recognises that, the South African government has demonstrated its commitment to the Health Research and Development (R&D) agenda by adopting a number of policies, strategies and programs aimed at implementing the country’s innovation agenda.
With the adoption of the Mexico (2004), Bamako (2008) and Algiers (2008) Declarations, the South African has committed to allocating 2% of the national health budget to health research, while the National Health Research Policy (2001) proposed that the country budget for health research should be 2% of total public sector health expenditure.1 However more recent data indicate that public sector health research funding has remained below 2% of the national health budget, supporting the perception that funding of public sector health research funding is in decline.
According to the G-finder report (2022), South Africa ranked 12th among top public funders for R&D in the 2018 and 2019 G-finder reports, with funding amounts of US$13 million and US$12 million, respectively. However, in subsequent years (2020 and 2021), South Africa has dropped out of the top 12 list of top public funders, indicating a further decline in public funding, with funding which amounts to less than US$11 million in 2020 and below US$10 million in 2021. However, South Africa’s public spending per US$100k of GDP on neglected diseases R&D fell to US$2.5 in 2020 and a further US$1.6 in 2021, ranking the country 4th and relegating catastrophically four places down to 8th, respectively. It is important to note that the decline in public funding is compounded by a shrinking South African economy that has experienced successive decreases in GDP in all reported years, resulting in lower spending from a smaller GDP.3
Lessons from COVID-19
The most recent COVID-19 global health crisis demonstrated how a complex array of health agencies were able to respond to the challenge, first in researching appropriate strategies to deal with the pandemic, and then rolling out evidence-based strategies to fight the virus and mitigate its disastrous impact. However, the pandemic has also shown that more collaborations and investments are needed to ensure that we are prepared and ready to deal with any future pandemic.
Rationale for investing in Health R&D
We need to be willing to expand and deepen our investment in a health R&D if we want to secure a healthy nation. Health R&D can provide us with the tools to find creative ways to tackle our emerging health problems, to develop or adapt health technologies that are affordable and have the potential to transform health and societies. But with limited resources and competing priorities, is it worth investing in research and development?
Investing in health R&D saves lives: Since the global roll-out of HIV antiretroviral treatment, an estimated 16.6 million [11.7 million–24.2 million] AIDS-related deaths have been averted just over the last two decades, which includes a 47% decline in AIDS-related mortality since 2010 (Update, UNAIDS Global AIDS, 2021).
Investing in health R&D saves money: Research conducted in Mozambique (Steel et al., 2023) shows that the implementation of a rotavirus vaccine in 2015, resulted in the prevention of approximately 4 600 deaths, over a four-year period, resulting in a saving of an estimated 3.1 million dollars in health costs.
Research and Development: Driver of economic growth, job creation: Investment in Health research and development has a catalytic effect, creating an estimated 10 additional vacancies in areas of support and service. We also know that for devices and tools to improve the lives of those who need them the most, they must be affordable, accessible, and appropriate for the communities and settings in which they’ll be used.
Call to Action!
1) We call on the South African Government to increase its Health R&D budget allocation to meet the 2% commitment National Health Budget to Health R&D.
2) We are calling for harnessing and strengthening of Public Private Partnerships for health R&D.
3) Invest in developing new TB tests, TB vaccines, and better treatment regimens for TB.
4) We urge the government to provide leadership to make South Africa the leader in of local medicines manufacturing and creating the health technologies to achieve this.
There is an urgent need to prioritise Health research and development!