Diseases with almost no funding – leptospirosis, scabies, Buruli ulcer, mycetoma, yaws & trachoma

Leptospirosis funding doubled, but to just $2.4m and Buruli ulcer rebounded slightly, but there was essentially no funding for yaws and none at all for trachoma

Overall funding for leptospirosis diagnostics – the only product area included in our scope – more than doubled to $2.4m (up $1.2m), its highest total since its peak of $3.6m in 2017.

This growth was mostly thanks to $1.0m from the US NIH, it’s first contribution since 2019, and a record high. The only other funding came from the Indian ICMR, which rose by $0.3m to a near-record $1.5m. For the first time in five years, there was no funding from the UK MRC (down from $25k) and once again none from the private sector. There remained almost no leptospirosis funding explicitly devoted to clinical development – just $37k, though up from none at all in 2022. This suggests a continued reliance on public funding, with critical gaps in clinical development and private sector engagement still unaddressed.

The already low level of funding for scabies R&D dropped slightly to $1.6m in 2023 (down $294k, -15%), though nearly half of this fall was due to reduced survey participation. Funding from ongoing respondents was down a slightly less concerning $167k, or 7%.

In 2023, there were just two participating scabies funders: the Australian PDP Medicines Development for Global Health provided $1.3m, or 82% of the total (up $0.7m, 84%) and the Australian National Health and Medical Research Council (NHMRC) with $0.3m (down $0.3m, -44%). This represents a significant decline from the six funders that reported funding in 2022 and five in 2021 partly due to the absence of data from two of those 2022 funders. The concentration of funding in Australia reflects the prevalence of scabies in Australian indigenous communities, but also the departure of the UK’s NHS and DHSC, which together had accounted for 15% of global funding since scabies was added to the survey in 2020.

All funding from Medicines Development for Global Health went towards Phase II clinical trials of the repurposed drug moxidectin. As a result, drug R&D captured over 80% of scabies funding, with its share of funding rising for three years running, up from just 18% in 2020. In contrast, all of the NHMRC’s remaining funding went towards basic research, which fell to a record low of $0.3m, less than one-third of its $1.0m peak in 2020 and 2021.

Funding for Buruli ulcer rebounded again from its record low in 2021 (up $0.6m, 62%), reaching $1.5m after two years languishing below $1m; though it remained less than half of its pre-2021 average.

More than two-thirds of the funding went to basic research, which saw a modest increase to $1.1m (42%), This makes it the only product category to receive consistent funding since the survey began in 2007, totalling $26m.

The slight increase in funding was primarily due to the long-delayed resumption of vaccines funding from the EC for the first time since 2013– though it totalled just $342k. The new EC funding supports the (very) early-stage development of an mRNA-based vaccine and represented essentially all of 2023's vaccine R&D. The only other meaningful increase was from the UK MRC, which contributed a record $328k (up $250k, 319%) for basic research. The US NIH, which had been absent for the last two years after committing an average of more than $1m a year to drug R&D between 2016 and 2022, also resumed its funding, albeit with just $62k. While Buruli ulcer again enjoyed a surprisingly diverse funder base, with ten individual funders, there was no funding from the private sector for the third year in a row.

Global funding for mycetoma R&D increased very slightly in 2023, rising by $80k, a 15% increase which still left it languishing well under a million dollars, as it has in four of the five years since we began including it in the survey.

Industry funders accounted for over half of the limited mycetoma funding, modestly increasing their contributions to $376k – four times the total industry funding received over the previous four years. This reflects private sector investment in the ultimately successful Phase II trial of fosravuconazole, a new oral treatment for mycetoma. Public funding, in contrast, fell by half. This drop was due to the absence of previous UK public funders, the DHSC and the NHS, along with the NIH’s lack of contributions for the first time on record. Only two non-industry funders, the Canton of Geneva and the Japan Society for the Promotion of Science, provided any R&D funding for mycetoma in 2023.

The only funding for yaws basic research that met our inclusion criteria came from the German DFG, supporting a project by the Kumasi Centre for Collaborative Research in Tropical Medicine to investigate the potential of nonhuman primates as reservoirs for human yaws. The six-year project predates the inclusion of yaws in G-FINDER’s data collection and disbursed a total $106k between 2018 and 2024 – an annualised total of less than $20k.

There was once again no direct funding for diagnostic development and the funding from the EDCTP we highlighted last year recorded no new disbursements.

Funding for trachoma vaccine and diagnostic R&D came to a complete halt in 2023, dropping from $173k to nothing, after having averaged $2.6m a year over the decade prior to 2021.

The EC’s TracVac project had propped up funding, averaging $1.7m between 2017 to 2021. The EC’s exit left NIH as the sole funder in 2022, providing just under $0.2m for diagnostic R&D in 2022, which did not continue into 2023.