title: Poverty-related and neglected diseases - an economic and epidemiological analysis of poverty relatedness and neglect in research and development.
abstract: BACKGROUND
  Economic growth in low- and middle-income countries (LMIC) has raised interest in how disease burden patterns are related to economic development. Meanwhile, poverty-related diseases are considered to be neglected in terms of research and development (R&D).
  
  
  OBJECTIVE
  Developing intuitive and meaningful metrics to measure how different diseases are related to poverty and neglected in the current R&D system.
  
  
  METHODS
  We measured how diseases are related to economic development with the income relation factor (IRF), defined by the ratio of disability-adjusted life-years (DALYs) per 100,000 inhabitants in LMIC versus that in high-income countries. We calculated the IRF for 291 diseases and injuries and 67 risk factors included in the Global Burden of Disease Study 2010. We measured neglect in R&D with the neglect factor (NF), defined by the ratio of disease burden in DALYs (as percentage of the total global disease burden) and R&D expenditure (as percentage of total global health-related R&D expenditure) for 26 diseases.
  
  
  RESULTS
  The disease burden varies considerably with the level of economic development, shown by the IRF (median: 1.38; interquartile range (IQR): 0.79-6.3). Comparison of IRFs from 1990 to 2010 highlights general patterns of the global epidemiological transition. The 26 poverty-related diseases included in our analysis of neglect in R&D are responsible for 13.8% of the global disease burden, but receive only 1.34% of global health-related R&D expenditure. Within this group, the NF varies considerably (median: 19; IQR: 6-52).
  
  
  CONCLUSIONS
  The IRF is an intuitive and meaningful metric to highlight shifts in global disease burden patterns. A large shortfall exists in global R&D spending for poverty-related and neglected diseases, with strong variations between diseases.
authors.affiliation: Faculty of Medicine, Technische Universität München, Munich, Germany; Universities Allied for Essential Medicines Europe e.V. (UAEM), Berlin, Germany; peter.philipsborn@alumni.lse.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: von Philipsborn
authors.affiliation: Universities Allied for Essential Medicines Europe e.V. (UAEM), Berlin, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Fridolin
authors.initials: F
authors.lastname: Steinbeis
authors.affiliation: Universities Allied for Essential Medicines Europe e.V. (UAEM), Berlin, Germany; Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Max E
authors.initials: ME
authors.lastname: Bender
authors.affiliation: Universities Allied for Essential Medicines Europe e.V. (UAEM), Berlin, Germany; Institute for Science, Ethics and Innovation, University of Manchester, Manchester, United Kingdom.
authors.forename: Sadie
authors.initials: S
authors.lastname: Regmi
authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Tinnemann
mesh_terms: D035843:Biomedical Research / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data*; D057217:Economic Development / Q000706:statistics & numerical data*; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D058069:Neglected Diseases / Q000453:epidemiology*; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014944:World Health Organization; D014947:Wounds and Injuries / Q000453:epidemiology
keywords: disease burden; double burden; global burden of disease; neglected tropical diseases; poverty-related and neglected diseases; research and development; research and development expenditure