The coronavirus pandemic has seen the government criticised at home, but lauded abroad
The UK government’s response to Covid-19 at home has faced heavy scrutiny and little praise.
From senior government figures breaking their own lockdown rules to complaints that funding for R&D is too little and coming too slowly, criticism of Boris Johnson’s government is now easy to find.
Even those who have seen huge backing for their research are far from fully supportive.
Imperial College’s Robin Shattock received £22.5 million from the government in April for his vaccine-development work. But he has spoken out about the months of lobbying required for this funding and associated grant applications. Time, he says, he could have spent working on potentially life-saving vaccines instead.
But abroad the UK has been pledging generously and quickly, and is widely seen as an international leader and key funder of R&D for Covid-19 tests, drugs and vaccines.
“The UK has a long history of global health leadership and the country is once again stepping up as a global leader,” says Jodie Rogers, communications officer at the Coalition for Epidemic Preparedness Innovations, which is seeking a Covid-19 vaccine.
The UK has backed Cepi to the tune of £250m—the largest contribution to the initiative from any nation.
It has also pledged £40m to support the Global Therapeutics Accelerator and £75m for the World Health Organization’s critical health systems response.
Catharina Boehme is chief executive of the Foundation for Innovative New Diagnostics (Find), which has received £23m from the UK for its work on coronavirus diagnostics. She told Research Fortnight that “the UK has always been a great supporter of Find and diagnostics”, and that its recent contributions are “key”.
In addition, the UK has been front and centre in global fundraising efforts. Last month it co-hosted with the European Commission the Coronavirus Global Response International Pledging Conference, which saw world leaders pledge €8 billion for research on Covid-19 vaccine.
And on 4 June the UK hosted the Global Vaccine Summit, bringing together countries and organisations to follow the UK’s lead in investing in the work of the Global Vaccine Alliance (Gavi). The UK itself has pledged the equivalent of £330m a year over the next five years to the health partnership.
Nick Chapman, chief executive officer of Policy Cures Research, said it was “great” to see “really strong response” from the UK.
Support for international work from the top of the UK government has contrasted sharply with the US approach, which is widely seen as having abdicated international leadership, with president Donald Trump missing some such pledging meetings and pulling funding from the World Health Organization.
Different tallies put the UK somewhere in the second or third spot globally for its levels of R&D funding specifically for coronavirus.
Michael Head, a global health researcher at the University of Southampton, ranks it third after the US and the EU. He is updating the data monthly and by the most recent count the UK is third only to Canada and the EU in terms of coronavirus funding since 2000. He counted 221 awards globally in 2020 that received $416m, most of it focused on vaccine development, followed by therapeutics, and then diagnostics.
“The UK has long been a strong proponent of global health research,” Head says. “Our academic sector has research strengths around global health and infectious diseases.”
But what Head worries about, along with other experts Research Fortnight spoke to, is that a singular and unprecedented focus on one disease, spearheaded by the UK, will divert money from and harm research on other global disease and health priorities.
“Over the last few years, for all infectious disease research, funding has been declining year on year,” says Head. “There are limited resources to cover ‘all health’, and the vast majority of people, money and skills are currently pointed at just one virus…I am not convinced that this focus will translate into increased funding and development across other areas of health and science.”
Chapman adds: “Anecdotally, we know that R&D work in other diseases is already being affected. Some of that is down to the challenges in doing research, especially clinical trials, in the midst of a pandemic, but it’s also significantly due to the reallocation of human resources and funding to focus on Covid-19.
“There is a real risk in the immediate term that R&D programmes for other global health priorities, such as neglected infectious diseases, are going to have their funding redirected or put on hold.”
Some of this is already coming to pass, with groups such as Gavi and the Global Polio Eradication Initiative announcing recently that vaccination campaigns around the world are being delayed due to Covid-19.
The focus on Covid-19 is also raising issues for the Drugs for Neglected Diseases initiative (DNDi), a non-profit organisation that is working on cures and treatments for diseases such as Chagas disease and sleeping sickness, according to Joelle Tanguy, director of DNDi’s external affairs.
In the short term, travel restrictions mean health personnel cannot reach sites. In the medium term, the focus on coronavirus is affecting planning and fundraising for future research and trials.
“There is an operational disruption and that we think will reduce probably the scope of our work between 10 and 15 per cent this year, and we also expect even further disruption.” says Tanguy.
“There is not a single government that is able to have a discussion about what to do for next year with us unless it’s already been decided before [the pandemic]. The new conversations on neglected tropical diseases or other neglected diseases research, are not taking place because everybody’s focused on Covid.”
Furthermore, she says, it could be disrupting progress on research on elimination of neglected tropical diseases as outlined in the London Declaration of 2012, which was “very significant effort…backed by UK partners”.
This year was supposed to see key international meetings and initiatives to “rally and secure pledges from governments to this effort”, she says, “this is not happening because of Covid-19.”
A global endeavour
What will happen when the Covid-19 crisis ends is an open question. Will the governments go back to business as usual, but perhaps with more closed, national agendas that we already see rising? Or, asks Tanguy, will “people realise that health matters and that global health is actually a global endeavour that requires convergence?”
Some in the area of traditionally neglected diseases hope that a new, more widely spread appreciation of the importance of R&D and preparedness will result in a more proactive approach to funding.
“One thing that has been made abundantly clear is that we could have been in a much better position to combat Covid-19 if there had been more R&D investment in this area in advance,” says Chapman, “and that the cost of this proactive R&D investment pales into insignificance compared to the cost of a disease pandemic that we lack the tools to prevent or control.”
“The question is whether this attention also extends to other diseases with an even greater health burden but which can’t rely on commercially driven R&D investment, like neglected diseases.”
For the UK—and other nations emerging from the coronavirus—this is going to be a billion-dollar question.
Large investments in Covid-19 drug and vaccine development “won’t change anything regarding the course of the epidemic in the next few months” due to the time lag between R&D in these areas and deployment, says Joelle Tanguy, director of external affairs at the Drugs for Neglected Diseases initiative.
That leaves an “urgent research question” which needs funding so it can be addressed immediately: how to better respond to the pandemic in resource-constrained settings in low- and middle-income countries using the tools available now.
But, Tanguy says, most funded trials on Covid-19 solutions are not looking at situations in such countries.
One challenge is that despite a huge mobilisation of research funding for Covid-19 from high-income countries, there is competition for the same funds between teams looking at the national Covid-19 crisis and those looking at low-income settings.
Meanwhile, overseas aid—which has done “a tremendous job in the last 15 years in advancing the science on neglected tropical diseases”—has not yet been mobilised to support research rather than just the immediate response.
This article also appeared in Research Fortnight