Following the latest review of childhood pneumonia research funding, a new letter published in The Lancet Respiratory Medicine today calls on infectious disease research funders to increase the amount of funding they invest in pneumonia, particularly in low- and middle-income countries (LMICs), and to target new funding to research priorities outlined in the 2023 Child Pneumonia Research Investment Scorecard.
Pneumonia is the leading infectious cause of death in children under five, accounting for 14 percent of global child deaths. Despite the role that research can have in reducing childhood pneumonia deaths, less than three percent of infectious disease research funding was spent on pneumonia between 2000 and 2015, compared with 38 percent for HIV and AIDS. In LMICs, which bear 99 percent of child pneumonia deaths, just eight percent of research funding was spent between 2000 and 2015.
In March 2023, Malaria Consortium, supported by the Every Breath Counts (EBC) Research Group, conducted the latest review, assessing publicly available donor databases and research registries to determine whether research funding is currently aligned with the priority topics for paediatric pneumonia research as identified in EBC’s 2021 eDelphi study. This found that funding remains insufficient: 75 percent of the top 20 research priorities, as identified by all surveyed experts, had fewer than 10 registered studies or grants. In LMICs, 60 percent of the top 20 research priorities had fewer than 10 registered studies or grants.
Angharad (Ani) Steele, Malaria Consortium’s Research Coordinator commented, “This exercise to revisit the research priorities for childhood pneumonia is an important step in reinvigorating the momentum for research funding in this disease area. This work has further highlighted the need for funders to prioritise the research needs of LMICs and for the funding to target the full spectrum of research, from discovery and development through to delivery and description”.
The first pneumonia research priority-setting exercise in 2011 positively influenced global funders, researchers and policymakers,the eDelphi review found that eight of the top ten priorities identified in 2011 had been addressed ten years later. However, the funding identified in this review predominantly focused on new clinical tools and technologies, such as vaccines, novel diagnostics and innovative treatments, which alone will not address the specific needs of LMICs to reach Sustainable Development Goal (SDG) 3.2 for child survival.
Today, it is estimated that currently, as many as 54 countries are off-track to achieve SDG 3.2. Few major donors invest in understanding how those tools and technologies can be effectively implemented and how they might be used to sustainably strengthen health systems and address disease burdens in LMICs.
Leith Greenslade, Coordinator of Every Breath Counts added, “Our ask of infectious disease research funders is clear: invest much more in research that matches these 20 priorities; do it in places where a lot of children are dying from pneumonia; and in a way that strengthens local researchers and institutions. This not only has the potential to save many children’s lives but will also build local infectious disease research capacity that will continue to benefit health systems."
The letter urges funders to channel investment into the most neglected topics and ensure clear pathways for integrating discovery, development and delivery funding to improve our understanding of how access to new and existing tools to prevent, diagnose and treat childhood pneumonia and, ultimately, increase the effect of this funding. Funders have a crucial role to play in supporting and connecting LMIC-based researchers and research institutes to lead the pneumonia research investment agenda.