More money, more actors, more capacity

More than ten years after the Global Forum's creation, the world has more resources than ever to realize the potential of research and innovation to address the health problems of poor and marginalized populations. There is more money to innovate, more actors committed to shaping health agendas and more capacity to provide incentives for research in neglected areas. In fact, global investments in health R&D have increased more than five-fold since the first estimate was made for 1986, reaching over US$ 160 billion by 2005. New funding mechanisms, philanthropy, a myriad of public-private and product development partnerships and innovative developing countries have emerged, and powerful groups are increasingly negotiating and making decisions about global health.

Persistent problems and inequities

But sadly, most research resources are still devoted to the health of the better-off, while basic tools are lacking for many health problems that are concentrated in the poorer regions of the world. Stark health disparities within and between populations persist:

• Seven out of 10 deaths in under-5 children occur in low- and middle-income countries ― most of them in Africa.
• What countries spend on health per citizen varies dramatically, from US$10 in low-income countries to more than US$2000 in high-income countries.

New challenges

Alongside persisting threats in low- and middle-income countries, new ones are continuing to emerge such as climate change, the double burden of infectious and noncommunicable diseases and injuries, urbanization, new patterns of work, changing lifestyles and population ageing to name but a few.

Little research has been conducted on how these many challenges are affecting the poorest people and how known tools and strategies can be adapted, or new ones created, to meet local conditions and make best use of available resources.