10/90 gap

“Health research applied to the needs of low- and middle-income countries remains grossly underresourced in many areas”

Context

In 1990, the Commission on Health Research for Development estimated that only about 5% of the world’s resources for health research (which totaled US$ 30 billion in 1986) were being applied to the health problems of low- and middle-income countries, where 93% of the world’s preventable deaths occurred.

What the Global Forum does

Some years later, the Global Forum coined the term “10/90 gap” to capture this major imbalance between the magnitude of the problem and the resources devoted to addressing it. Since its foundation in 1998, the Global Forum advocated effectively around the “10/90 gap” and gave a voice to people who would otherwise not have had one.

In the meantime, the landscape of health research for development has changed in important ways:

  • global expenditure on health research has more than quadrupled to over US$ 125 billion in 2003 (US$ 160.3 billion in 2005);
  • there are many more actors engaged in funding or conducting health research relevant to the needs of low- and middle-income country populations;
  • but the epidemiology of diseases has shifted substantially, so that many low- and middle-income countries are now experiencing high burdens of injuries and noncommunicable diseases such as cancer, diabetes, heart disease and stroke, as well as continuing high burdens of infectious diseases.

Investment studies by the Global Forum for Health Research continue to demonstrate that health research applied to the needs of low- and middle-income countries remains grossly underresourced in many areas and the term “10/90 gap”, while not representing a current quantitative measure, has become a symbol of the continuing mismatch between needs and investments.