title: Relative and absolute addressability of global disease burden in maternal and perinatal health by investment in R&D.
abstract: Maternal and perinatal disease accounts for nearly 10% of the global burden of disease, with only modest progress towards achievement of the Millennium Development Goals. Despite a favourable new global health landscape in research and development (R&D) to produce new drugs for neglected diseases, R&D investment in maternal/perinatal health remains small and non-strategic. Investment in obstetric R&D by industry or the not-for-profit sector has lagged behind other specialties, with the number of registered pipeline drugs only 1-5% that for other major disease areas. Using a Delphi exercise with maternal/perinatal experts in global and translational research, we estimate that equitable pharmaceutical R&D and public sector research funding over the next 10-20 years could avert 1.1% and 1.9% of the global disease burden, respectively. In contrast, optimal uptake of existing research would prevent 3.0%, justifying the current focus on health service provision. Although R&D predominantly occurs in high-income countries, more than 98% of the estimated reduction in disease burden in this field would be in developing countries. We conclude that better pharmaceutical and public sector R&D would prevent around 1/3 and 2/3, respectively, of the disease burden addressable by optimal uptake of existing research. Strengthening R&D may be an important complementary strategy to health service provision to address global maternal and perinatal disease burden.
authors.affiliation: UQ Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia. n.fisk@uq.edu.au
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Fisk
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.forename: Rifat
authors.initials: R
authors.lastname: Atun
mesh_terms: D035843:Biomedical Research / Q000191:economics*; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare; D018743:Perinatal Care / Q000592:standards; D054238:Perinatal Mortality; D011247:Pregnancy; D012109:Research Support as Topic