A stronger and safer United Kingdom through global health R&D investment

Funding decisions in today’s global political context are tougher than ever. But this new research makes the investment case crystal clear.

• By 2040, the £2.2 billion that has been invested by the United Kingdom in neglected disease R&D since 1994 – along with an additional £800 million required to complete products already in the pipeline – will have saved 1.43 million lives, averted 99.1 million disability-adjusted life year (DALYs) and prevented 183 million cases of neglected disease. ¹
• If sustained, the UK’s investment in neglected disease R&D has the potential to generate a global societal return of £1.39 trillion, with nearly £7.7 billion of additional economic activity in the UK alone, catalysing more than £4.8 billion of private sector investment in R&D and creating nearly 4,000 UK jobs.
• While this represents an outstanding success story for the UK, these economic, scientific and health benefits depend on continued funding commitments from the UK government.
• Cuts in funding since 2020, and those recently announced, put these gains at risk - particularly the health gains accruing from products still in the pipeline. If products in late-stage trials do not reach the market because of funding cuts, it could result in over 113,000 lives lost, 3.8 million DALYs and 132,000 more cases than would otherwise have occurred. If ODA cuts also affect the rollout of products already launched, the impact will be much higher – as many as a million additional lives lost, over 67 million DALYs and 157 million more cases occurring than would otherwise have happened.

^{1. While the data used for this analysis, and therefore the benefits we have identified, focus exclusively on neglected disease R&D, the arguments we make apply to global health R&D more broadly.}

The United Kingdom has been a leader in funding and conducting research and development targeted at neglected diseases (‘neglected disease R&D’^[1]) over the last two decades. As some public funders around the world begin to question the value of foreign aid, this report articulates not only the scale of the benefits these programmes deliver to people in low- and middle-income countries (LMICs) but also the economic and scientific benefits R&D delivers to the funding nations themselves. Beyond these direct returns, such investments also foster long-term scientific and economic partnerships, strengthen global influence through knowledge-sharing and collaboration, and help secure the UK’s role as a world leader in health research and innovation.

While the data we use in this report focus exclusively on neglected disease R&D, the arguments apply to R&D for global health more broadly.

Recent decisions by the UK Government to further reduce its official development assistance (ODA) budget to as low as 0.3% of its gross national income—on top of previous cuts—have sparked renewed concern about the fate of global health R&D funding. The impacts are not limited to the UK: the US has also made reductions in its foreign aid with global health budgets one of the hardest hit areas. Other high-income countries such as France, Germany, Belgium and the Netherlands have also signalled plans to scale back support ^[i]. Such moves come at a precarious time, when high-burden diseases in LMICs continue to pose a threat to global health and geopolitical security.

This report clearly outlines that investments in global health R&D have a proven record of delivering lifesaving interventions and stopping the international spread of infectious threats. Strong R&D pipelines help generate new scientific discoveries, support jobs and industries, and foster goodwill and leadership on the global stage. Allowing global health R&D budgets to contract undermines these returns, threatening not only the health of vulnerable communities but also the broader scientific and economic progress that stems from robust international collaboration.

This report presents both the ethical imperative of sustaining investments that improve health outcomes for the most vulnerable and the strategic benefits of supporting research that delivers tangible gains for the people of the UK. The investment case is clear:^[2] new pharmaceutical products developed because of UK funding are projected to save millions of lives over the next two decades, generating a societal return that is hundreds of times greater than their cost of development and supporting a stronger and safer United Kingdom.  

^{[1] We define ‘neglected diseases’ in line with the G-FINDER survey, which includes TB, HIV, malaria, the majority of the WHO neglected tropical diseases and several other diseases including bacterial pneumonia & meningitis, cryptococcal meningitis, many diarrhoeal diseases, hepatitis B & C, Salmonella, rheumatic fever and leptospirosis. See https://gfinderdata.impactglobalhealth.org/pages/static/neglected-disease-rd-scope.}

^{[2] See https://www.impactglobalhealth.org/insights/report-library/the-impact-of-global-health-rd}

^{[i] Donor Tracker. The Budget Cuts Tracker. SEEK Development.}

Drawing on our earlier research on the return on investing in neglected disease R&D, we calculate the likely long-term impact of the UK’s contribution to global health. We estimate the lives that have already been saved as well as the many more that will be saved in the future, provided UK investment in neglected disease R&D is sustained at past levels. We project the value to society of these gains in lives saved and disability averted.  We also estimate potential gains that may not be achieved if further anticipated funding cuts derail the expected completion of products in the late-stage pipeline.

Looking beyond the direct benefits to individuals and communities affected, we estimate the extent to which the UK’s R&D funding has delivered domestic economic benefits far greater than its original investment. We draw on the academic literature linking R&D to increases in employment, economic activity, private sector investment and intellectual property measured via increased patents. We also consider the benefits of past R&D funding for researchers in the UK and globally, as today’s investment in basic research paves the way for future products. 

Finally, we provide tangible examples through case studies of the UK’s support via the Innovative Vector Control Consortium (IVCC) for the development of a novel bed net that kills mosquitoes resistant to traditional insecticides, as well as the role of neglected disease R&D in laying the groundwork for the rapid development of the Oxford/AstraZeneca COVID-19 vaccine – demonstrating that research intended for use elsewhere can also deliver direct benefits to UK citizens.

By highlighting the substantial returns on investment in neglected disease R&D—both globally and within the UK—we offer policymakers clear evidence of the impact of their decisions. Our data underscore the economic, scientific, and health benefits of sustained funding, showing how continued investment accelerates innovation, bolsters health security, and improves outcomes for the world’s most vulnerable people. This report offers critical insights to policy makers responsible for securing a resilient future for the UK’s global health R&D.

Estimating the UK’s contributions to global neglected disease funding

To determine the global and domestic impact of the money the UK spends on neglected disease R&D, we first need an estimate of how much it contributed, and the share of overall global R&D that was provided by the UK Government.

Estimating past UK R&D funding based on survey data

To estimate the funding provided by the UK, we drew on data from the G-FINDER survey of global health R&D funding from 2007 to 2022. We used the trend of the UK share of global funding from that dataset to predict funding from 1994 to 2006, before the survey was started. This long timeline enables us to be comprehensive and to compare the full costs and eventual benefits of new products launched between 2000 and 2040.

Estimating future UK funding needed to complete the products in the pipeline

To estimate the future UK funding needed to complete the products in the pipeline, we applied the same UK trend to the post-2022 total global funding. This assumes an annual total slightly below its recent average level, because we measured only what is needed to finish the existing products and not the funding necessary to replenish the pipeline with the next generation of candidates.

Altogether, past and future funding figures suggest that for the period 1994 to 2040, the UK will provide a total of £3.05 billion^[1] for neglected disease R&D, with the vast majority (78%) of this money already having been spent, and the remainder assuming that funding does not fall below its recent averages.  

The health impact of UK funding

To estimate the global health impact of this funding, we drew on our May 2024 report on the Impact of Global Health R&D, in which we compared the estimated long-term health impact of new products for neglected diseases (launched since 2000 or projected to be launched before 2040) against the total global investment required for their development from 1994 to 2040.^[2]

Based on those calculations we estimated that every £1 invested in neglected disease R&D generates a return on investment of £405, mostly thanks to the societal value of lives saved.^[3]

Our total funding estimate of £3.05 billion suggests that the UK Government has provided 3.5% of the global funding for neglected disease R&D. By extension, this means the UK can be credited with generating 3.5% of both the past and future global health benefits these products deliver.

Estimating the UK’s impact in a shifting funding landscape

The recent flurry of US Executive Orders halting or sharply reducing support for global health programmes, including neglected disease R&D, add urgent pressure to an already fragile funding environment. Historically, the US has been the single largest public investor in these initiatives. This sudden cutback will create a massive shortfall in the global R&D pipeline, endangering projects that are already in advanced clinical trials.

This looming crisis amplifies the significance of the UK’s role. Although the UK has provided 3.5% of global funding thus far, even this contribution—which has recently been in question due to proposed budget cuts – cannot plug the enormous gap that a US withdrawal would create. With all major UK public funders reducing their contributions and no clear replacement in sight, this downward trajectory raises the question of whether the UK is retreating from its leadership in neglected disease R&D. Given the UK's historical impact and the continued global need, sustained funding is essential to ensure both domestic and global health and economic benefits.

Vital research in malaria, HIV, and tuberculosis, among other diseases, could stall, jeopardizing new vaccines like R21 that are poised to save millions of lives. If the US continues stepping away from its traditional role in supporting R&D, the UK’s contribution will become even more critical and the value of sustained funding needed even higher— multiplying the likely impact on global health if it, too, retreats from its funding commitments. If both the US and the UK reduce their support simultaneously, breakthroughs in neglected diseases could rapidly unravel, leaving progress on life-saving interventions and their far-reaching returns in grave jeopardy.

Where have UK funders focused their efforts?

UK Government funding for neglected disease R&D between 2007 and 2023 (the period for which actual G-FINDER survey data are available) totalled £2 billion.^[4] Yearly funding peaked in 2018 at £207 million and has declined each year since, to just over a third of this peak (£71m) in 2023.

The UK pools its funding with other countries by supporting product development partnerships

Much of this funding – a little over half of the total – was directed to various ‘product development partnerships’ (PDPs), such as the Medicines for Malaria Venture and TB Alliance. These are nonprofit organisations which combine funding from different backers who then direct that funding to industry or academic research organisations to develop a portfolio of different products. Just under a quarter of UK funding went directly to academic or other nonprofit research organisations, and around 10% each to other parts of the Government or the European and Developing Countries Clinical Trials Partnership (EDCTP). The EDCTP funds late-stage clinical trials for potential vaccines and medicines in LMICs, including the Kenya-based PanACEA drug development programme to shorten and simplify the treatment of tuberculosis, run in collaboration with University College of London.

Key funders of UK global health R&D

The Foreign and Commonwealth Development Office (FCDO), Medical Research Council (MRC) and Department for Health and Social Care (DHSC) are key funders of UK global health R&D. During the period 2007-2023, 54% (£1bn) of total UK neglected disease funding has come from the FCDO. This has left overall funding highly vulnerable to shifts in FCDO contributions to neglected disease, including the 2018 peak and the subsequent overall decline. MRC funding comprised 32% (£644m) of the total and was relatively stable at around £40 million annually, until 2021 when it began falling to reach just £22 million in 2023. The DHSC, the third-largest UK funder, only began investing significantly in neglected disease R&D in 2017, peaking the following year at £51 million before plummeting to just £6 million by 2023, which reflects its broader focus on non-communicable diseases (NCDs).

^{[1] All amounts in inflation adjusted 2022 GBP and are undiscounted unless otherwise noted.}

^{[2] These figures included global funding across the full range of neglected diseases included in the G-FINDER report. Health gain modelling was restricted to tractable and/or high impact scenarios: new vaccines for bacterial pneumonia and meningitis, cholera, rotavirus, malaria, typhoid and TB, improved diagnostics for HIV and TB, improved drugs for HIV, TB and malaria and malaria vector control.}

^{[3] https://www.impactglobalhealth.org/insights/hubs/the-impact-of-global-health-rd-hub.}

^{[4] Figures in this section, only, have been updated to reflect the latest G-FINDER survey and inflation data and differ slightly from the figures used to conduct our earlier global health impact modelling elsewhere in the report, mostly as a result of 22/23 inflation.}

Figure 1: Top UK public funders of neglected disease R&D 2007-2023

Open to enlargeDownload

Like the rest of the world, UK funding prioritises the ‘big three’ neglected diseases – HIV, TB & malaria

Just three diseases – HIV, TB and malaria – have received 60% of all UK funding since 2007, with malaria funding alone accounting for over a quarter (£527m, 27%) of the total, followed by TB (£384m, 19%) and HIV (£284m, 14%). Non-disease-specific investment accounted for another 18% (£360m) of total funding, over 80% of which was core funding to multi-disease R&D organisations, in this case mostly EDCTP and FIND. Among other diseases, kinetoplastid diseases were the only area to receive significant UK Government investment (£226m, 11%), primarily through FCDO’s support of the Drugs for Neglected Diseases Initiative (DNDi).

In terms of research priorities, drug R&D has received the largest funding share (£690m, 42%), followed by basic research (£374m, 23%), while vaccine R&D has seen comparatively lower investment at just £241 million (15%).

Figure 2: UK’s neglected disease R&D funding, by disease (left) and by product (right)

Open to enlargeDownload

Estimated health gains

Based on the UK’s share of global funding between 1994 and 2022 and the relationship between R&D funding and health impact established in our earlier research, we estimate that its contribution to product development will ultimately be responsible for

More than 75% of this health impact is still to come, driven by wider distribution of the products already approved and, crucially, by the expected development and launch of products currently undergoing late-stage trials.

While it is difficult to tie individual funding decisions to specific product development outcomes, a 40% reduction in UK R&D funding would threaten the delivery of key products still in the pipeline and does not allow for any new products to be developed which are not already in the pipeline.

^{[1] This figure is based on the UK’s actual share of all global funding 2007-2022; its estimated (“backcast”) share of global funding 1994-2006; and an assumed maintenance of that 1994-2022 share across only the 2023-2040 funding necessary to complete those products in the pipeline as of 2022 – but not the full forecast value of UK funding 2023-2040. Please see our earlier report for details.}

Figure 3: Timeline of product launches and projected lives saved by UK R&D funding

Open to enlargeDownload

Estimated economic gains

We can also estimate the monetary value of these health gains using the ‘value of a statistical life,’ based on the estimated US figure of $12.3 million, which reflects US citizens’ observed trade-offs between health risks and financial rewards. To make this relevant to the nations where lives will be saved, we adjust the US value by accounting for differences in average income and the observed relationship between national income and the value placed on a life year.^[i]

However, this figure still underrepresents the full value of UK R&D funding. By incorporating even a very narrow estimate of the additional direct economic benefits of preventing deaths and illness—while factoring in the net costs to health systems for adopting new technologies—the total estimated return increases by an additional £3 billion.

^{[i] Smith, D.R.M., Turner, J., Fahr, P. et al. (2024) Health and economic impacts of Lassa vaccination campaigns in West Africa. Nature Medicine.}

Investing in R&D for neglected diseases not only directly benefits global health but also delivers substantial benefits to the UK. Such funding boosts local economic activity in related sectors, stimulates private sector investment, and contributes valuable knowledge for future research advancements.^[i]

Economic activity and job creation

To assess the domestic economic impact of UK public funding, we draw on insights from the relationships between R&D investment and broader economic outcomes, as estimated in the international academic and grey literature, particularly the comprehensive retrospective evaluation of the biomedical R&D funded under the EU’s Horizon 2020 research framework programme.^[ii] This evaluation synthesized findings from a suite of macroeconomic models (NEMESIS, QUEST, and RHOMOLO), estimating that every €1 the EU invested in R&D generated €5.67 in additional economic output and that every €1 million invested supported the creation of 2.9 long-term jobs.^[iii]

This 5.67 to 1 ratio between R&D investment and the wider economic activity it generates is at the higher end of estimates found in the wider literature on the multiplier effects of R&D on economic activity. A recent study of UK charitable R&D investment in medical research found that every £1 million spent generates £3.15 million in economic output, while a study of (basic research focused) R&D by the US National Institutes of Health arrived at 1:2.46 ratio. ^[iv] These lower estimates of the multiplier may reflect differences between philanthropic and public funding, between basic research and product development, or between the UK, the US and the EU; or may simply reflect random variation in the investments they observed. While acknowledging this uncertainty, we favour the estimate from the larger EU Horizon 2020 study due to its larger sample size and incorporation of estimates from multiple macroeconomic models.

Catalysing private sector investment

Public funding for R&D not only impacts employment and economic activity but has also consistently been linked to increased private-sector investment.

A recent report by the National Centre for Universities and Business found that every £1 of public R&D spending stimulates between £0.60 and £1.10 of private investment in the short term, and between £3.09 and £4.02 in the long term. ^[v]

These findings broadly align with a separate study showing that a 1% increase in UK public expenditure is associated with a 0.81% rise in private sector investment and help to explain the figure of over US$9 billion that pharmaceutical companies reported investing in neglected disease R&D alone between 2007 and 2023 – almost a fifth of which came from companies based in the UK. ^[vi] The UK’s short-term private investment multiplier of £0.85 is only slightly higher than the £0.57 derived from the evaluation of Horizon 2020 (£0.60-£1.10 vs. £0.57), with the different estimates potentially reflecting cross-national differences or random variation between the studies themselves.

^{[i] Clancy, M. Government Funding for R&D and Productivity Growth. Estimating the returns to public R&D, using data. Retrieved from: Government Funding for R&D and Productivity Growth}

^{[ii] European Commission. (2024). Ex-post evaluation of Horizon 2020, the EU Framework Programme for Research and Innovation.}

^{[iii] Ibid.}

^{[iv] Fraser of Allander Institute. (2021). The contribution of medical research funding by charities to the UK economy.}

^{[v] National Centre for Universities and Business (NCUB). (2024). Unlocking growth: The impact of public R&D spending on private sector investment in the UK. Retrieved from: https://www.ncub.co.uk/insight/unlocking-growth-the-impact-of-public-rd-spending-on-private-sector-investment-in-the-uk/}

^{[vi] Saini, V., Green, J. (2016). Economic evaluation of interventions to prevent the spread of infection in healthcare settings: A systematic review. BMC Medicine, 14, 137. https://doi.org/10.1186/s12916-016-0564-z}

In addition to the local economic benefits of R&D, funding basic science has a lasting impact on scientific knowledge and research capacity, making future research faster and more cost-effective.^[i] One way to gauge this type of knowledge generation is by examining the historical link between R&D funding and indicators of intellectual property, such as patents and research publications. Based on the relationships outlined in the Horizon 2020 evaluation, the UK’s investment in neglected disease R&D is projected to result in approximately 54 additional patents and 5,000 publications.

Patents and publications, however, primarily reflect research activity rather than its underlying value to society. Academic estimates of the value of basic research for future scientific innovation indicate that every £1 spent today on basic research will generate £0.43 in annual benefits for future product developers, indefinitely. ^[ii] Quantifying these benefits until 2040 suggests that the £424 million which the UK will ultimately invest in basic research for neglected diseases^[1] could  potentially yield a return of up to £2.7 billion, depending on how quickly today’s basic research loses relevance for future scientists.^[2]

A separate study examining the value of medical research more broadly than basic research alone estimated slightly lower perpetual annual gains of £0.25 for every £1 invested^[iii], which would suggest gains worth £11 billion by 2040 from the UK’s £3.05 billion overall investment in neglected diseases R&D. While estimates of the future value of scientific research are sensitive to the research methodology applied and the rate at which perpetual future gains are discounted, even conservative figures suggest that scientific research ultimately pays for itself simply via the knowledge spillovers it provides to future researchers.

^{[1] This figure is the estimated share of UK’s overall €3.05bn in funding devoted to neglected-disease-specific basic research rather than product development.}

^{[2] We have applied an annual discount rate of 5%}

^{[i] Clancy, M. Knowledge Spillovers are a Big Deal. They are usually more than half the point of R&D. Retrieved from: Knowledge Spillovers are a Big Deal · New Things Under the Sun.}

^{[ii] Toole, A. (2012). The impact of public basic research on industrial innovation: Evidence from the pharmaceutical industry. Research Policy, 41(1), 1–12.}

^{[iii] Wellcome Trust, National Institute for Health Research, Academy of Medical Sciences, Medical Research Council, Arthritis UK. (2017). Medical research: What’s it worth?}

The misguided focus on overseas aid cuts

When governments are faced with tight budgets and seeking to save money, it is always easy for them to look first at the tiny share of funding that benefits people overseas. Easy, but misguided. This funding is not only justified by the significant benefits it delivers relative to its share of rich nations’ spending, but also by the direct advantages it offers to funding nations themselves. This report clearly demonstrates measurable financial and scientific benefits, alongside the significant wider benefits that R&D can generate for the citizens of the UK and for its soft power and geopolitical partnerships.

The dual benefits of public funding: global health and national gains

Beyond immediate health benefits in both LMICs and the UK, public funding also plays a pivotal role in strengthening scientific, regulatory, and clinical trial capacities in regions where they have historically been underdeveloped. This investment is crucial for countries facing the greatest health burdens and creates pathways for research spanning multiple disease areas, not just neglected diseases.

By building this critical infrastructure and working within equitable partnerships, the UK not only advances global health but also helps strengthen healthcare systems, develop LMIC scientific research capacity and leadership to accelerate innovation, and foster greater resilience worldwide. The UK also protects its own global health security and helps to create capacity in LMICs that can be pivoted to emerging health threats that may also, ultimately, affect the UK.

Nevertheless, measuring the full scope of scientific benefits within the UK—such as how the ChAdOx platform, originally focused on malaria and other emerging pathogens, served as the foundation for the COVID-19 vaccine—remains a challenge. The same applies to quantifying the effects of capacity-building efforts and economies of scale. Although we have noted increases in private investment and job creation, these figures only hint at the wider benefits of fostering regional R&D hubs and streamlining processes nationwide, from coordinating clinical trials to expanding medicine manufacturing capabilities.

The need for continued investment and support

These impacts, however, hinge on continued support and investment to finish current projects and a focus on the future pipeline of next generation products. With over three-quarters of anticipated R&D gains set to emerge in the next two decades, sustained funding is essential to bring pipeline products to completion and scale up their manufacturing and distribution.

The R21 malaria vaccine stands as a key example of the UK’s leading role in neglected disease R&D^[i] . Ensuring that newly completed vaccines like R21 reach those who need them most is vital, as is maintaining the momentum to advance the next generation of products—such as TB vaccines—to address critical gaps in neglected disease care.

The UK has a long history of prioritising neglected disease R&D, and this report underscores the necessity of maintaining that commitment. Doing so not only secures returns from treatments and vaccines on the cusp of completion but also lays the groundwork for the next generation of products.

^{[i] Impact Global Health. Global health R&D makes a strong investment case for Team Europe. Impact Global Health. Retrieved from: https://www.impactglobalhealth.org/insights/report-library/the-impact-of-global-health-rd-european-union-}