Global health R&D makes a strong investment case for Team Europe

This report evaluates the health and economic impact of Team Europe’s contribution to the global effort in developing new products for neglected diseases as well as the benefits it brings to the EU’s domestic economies and scientific infrastructure.

 Building on our earlier research on the return on investment in neglected disease R&D, we calculate the lives already saved and project the many more that will be saved thanks to Team Europe’s investments. We also estimate the societal value of these gains in lives saved and disability averted. We also estimated the domestic economic benefits associated with Team Europe’s R&D funding, drawing on the academic literature linking research and development to increases in employment, economic activity, private sector investment and intellectual property measured via increased patents. We also considered the benefits of past R&D funding for researchers in Europe and globally, as today’s investment in basic research paves the way for more efficient and cost-effective projects in the future.

Finally, we provide practical examples through case studies of the EU’s support via the European & Developing Countries Clinical Trials Partnership (EDCTP) for the recently launched R21 malaria vaccine and the role of neglected disease R&D in containing the global rise of antimicrobial resistance.

We hope that highlighting the substantial returns on investment in neglected disease R&D—both globally and within the EU—will inform decision-making on the global health R&D agenda as we approach the final decade to achieve the Sustainable Development Goals (SDGs) and enter a new political and funding cycle in the EU.

_{[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 disease including bacterial pneumonia & meningitis, cryptococcal meningitis, many diarrhoeal disease, hepatitis B & C, Salmonella, rheumatic fever and leptospirosis. See the G-FINDER neglected disease scope.}

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

Estimating Team Europe’s contributions

In May 2024, our report on the Impact of Global Health R&D analysed the estimated long-term health benefits of new products for neglected diseases (launched or anticipated between 2000 and 2040) against the total global investment required for their development from 1994 to 2040.[³]

Our calculations showed that every $1 dollar invested in neglected disease R&D generates a return on investment of $405 dollars, mostly thanks to the societal value of lives saved.

To estimate the share of this global R&D funding provided by Team Europe, we drew on the data from the G-FINDER survey of global health R&D funding for the period 2007 to 2022, including global funding from EU countries. We used this data, combined with the relationship between Team Europe and EU funding and historical trends in EU funding for biomedical R&D, to estimate the funding that occurred between 1994 and 2006, before the creation of the G-FINDER survey. For the funding we project will be required after 2022, we applied the long-term trend in Team Europe’s share of global funding to the total funding we estimate will be required to complete the products currently in the pipeline.  To maintain Team Europe’s share of total global funding, while meeting the levels required to launch the future products captured in our modelling, would require a small ongoing increase in the absolute value of Team Europe’s funding relative to its average over the three years to 2023.

Taken together, these figures suggest that for the period from 1994 to 2040 Team Europe will provide a total of €8.06bn^[4] or 8.5% of the global funding for neglected disease R&D, with the EU itself accounting for a little under half the total (3.6%, €3.5bn). 

Funders' focus: HIV, TB and malaria

From 2007 to 2022, Team Europe invested over €4 billion in neglected disease R&D, based on data from the G-FINDER survey during this period. Around 25% of this funding was allocated to projects targeting multiple diseases, primarily through core funding to product development partnerships. HIV received the largest share of disease-specific funding, accounting for 20%, followed by tuberculosis (19%) and malaria (14%).

 The EU has been the largest funder of neglected disease R&D, contributing nearly half (44%) of all Team Europe funding. Germany follows as the second largest contributor, providing 17%, closely followed by France at 16%. Other notable contributors include the Netherlands, Sweden, Spain, and Ireland, each investing over €100 million since 2007. In total, 17 European countries have funded neglected disease R&D.

 The EU’s funding was thus heavily focused on the ‘big three’ diseases – HIV, TB and malaria – which together accounted for 73% of EU funding. The EU’s disease-specific funding was distributed as follows: 30% for TB, 21% for malaria, and 21% for HIV. Over a third (36%) of EU funding was channelled through the European & Developing Countries Clinical Trials Partnership (EDCTP), aligning with the EU’s priorities by directing approximately a third to TB trials, and around 22% to malaria and 20% to HIV.

 French organisations focused more heavily on HIV (40% of French national spending), with Inserm and the ANRS each investing around €116m. German national funding has prioritised tuberculosis (34% of German funding), with the Bundesministerium für Bildung und Forschung (BMBF, Federal Ministry of Education and Research) providing almost €124m.

 The shares of ‘big three’ funding from France and Germany were lower - both just over 64% of their respective totals. Instead, French and German national funding were a little more evenly distributed across the less prominent neglected diseases, including significant French investment in diarrhoeal diseases (€56m, or 9% of its total spending) and German funding for kinetoplastid and helminth infections (each around €60m, or 10% of German funding).

Top Team Europe public funders of neglected disease R&D 2007-2022

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Just over a quarter of Team Europe’s disease-specific funding was invested in basic research (€735m, 27%) closely followed by vaccines (€639m, 23%) and drugs (€578m, 21%), with diagnostics receiving less than 5% of the total. Funding provided by the EU was relatively more focused on vaccine R&D (34% of its total), while it’s share of investment in drug R&D was the same (21%).

Team Europe’s neglected disease R&D funding, by disease (left) and by product (right)

^{*Multi-disease funding is primarily core funding to the EDCTP}

^{[3] 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.}

^{[4] All amounts in inflation adjusted 2022 Euros and are undiscounted unless otherwise noted.}

Based on Team Europe’s share of global funding and the relationship between R&D funding and health impact established in our earlier research, we estimate that its contributions to product development will ultimately be responsible for 3.45 million lives saved, 240 million disability-adjusted life years (DALYs) averted, and 441 million cases of neglected disease averted. The EU alone will ultimately be responsible for 1.45 million lives saved, 101 million DALYs averted, and 186 million cases of neglected disease averted for the period between 2000-2040.

More than three-quarters of this health impact is yet to come, driven by the wider distribution of the products already approved and, crucially, by the expected development and launch of products currently undergoing late-stage trials. So, these projected figures assume and rely on continued commitments from Team Europe and other global funders.

It is also possible to estimate the monetary value of these health gains, using an estimate for the ‘value of a statistical life’, which is based on the estimated US value (US$12.3m) – derived from US citizens’ observed preferences between health risk and financial reward. We adjust this figure first by comparing average incomes in the US to income levels in the nations where lives will be saved and then using the observed relationship between national income and the value placed on a life year.^[i] Based on this calculation, which values the average year of life saved by neglected disease R&D at a little over €16,000, we estimate that Team Europe’s funding will generate social returns worth €3.86 trillion, of which the EU itself is responsible for €1.63 trillion.

Even this figure understates the true value of Team Europe R&D funding. Once we incorporate a narrow estimate of the direct economic benefit from averting death and morbidity, largely offset by the net costs to the health system associated with implementing new health technologies, the estimated return rises by €10 billion for Team Europe's funding and just over €3.5 billion for the EU itself.

Team Europe R&D funding: timeline of product launches and projected lives saved

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Projected lives saved by R21 vaccination 2022-2040

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To estimate the domestic economic impact of Team Europe and EU funding, we apply the relationships between R&D funding and wider economic indicators estimated as part of a wide-ranging retrospective evaluation of the EU’s research framework programme Horizon 2020.^[ii] This project synthesised the results from a panel of macroeconomic models (NEMESIS, QUEST, and RHOMOLO), finding that every €1 of R&D activity ultimately generates €5.67 in additional output via its flow-on effects in other parts of the economy and that every €1 million euros invested in R&D supports the creation of 2.9 long term jobs.^[iii]

These figures broadly align with the wider literature on R&D and economic activity, including an analysis of the US National Institutes of Health (NIH), which found that each $1 invested in NIH-funded research generates $2.46 dollar in economic activity and 5.27 jobs created per million invested.^[iv] The lower economic multiplier and higher rate of job creation likely reflect the NIH’s greater focus on labour-intensive basic research over clinical development. A separate US study^[v] focused on effects in the immediate vicinity of R&D investments found a positive — though smaller — link between R&D spending and GDP growth.

Applying the Horizon 2020 multipliers to the estimated share of Team Europe funding directed to recipients inside the EU (56% of the total after adjusting for the final destination of EDCTP funding), we calculate that neglected disease R&D will ultimately be responsible for €30.5bn in additional economic activity, of which €12.8bn is specifically attributable to funding from the EU. Team Europe funding will also result in an estimated 15,563 additional long-term jobs in the years immediately following the investment, 6,588 of which are generated by EU funding.  

 In addition to its effects on employment and economic activity, public funding for R&D has been repeatedly linked to subsequent increases in private-sector investment. The resulting long-term increase in private sector activity – sometimes as long as 24 years after the initial public funding – has been shown to peak eight years after the initial government funding,^[vi] Meaning that much of the long-term impact on private R&D will not yet be captured in the multipliers derived from the evaluation of Horizon 2020.

Nonetheless, according to the Horizon 2020 evaluation report, “the programme was especially effective in the private for-profit sector, where for every euro of Horizon 2020 funding, project participants invested an additional €0.57”.^[vii]

Applying this observed relationship to our public funding figures, Team Europe’s funding will ultimately catalyse an additional €3.07bn investment from the private sector, with €1.3bn attributable to the EU. Based on the academic literature, which finds an 8:1 long-term relationship between public and private R&D,^[viii] we predict these figures will likely rise significantly over the next several years.

Alongside the local economic benefits of conducting R&D, funding basic science permanently increases scientific knowledge and research capacity, making subsequent research quicker and less costly to conduct.

One proxy for this kind of knowledge generation is to look at the historical relationship between R&D funding and measures of intellectual property such as patents and research papers. By this standard, using the relationships quoted in the Horizon 2020 evaluation, Team Europe’s neglected disease R&D funding will ultimately lead to around 214 additional patents and 19,550 publications, while the EU funding will result in about 90 patents and 8,223 publications.

Patents and publications, though, are primarily a measure of activity, not of value. Estimates of the value of present-day basic research to future scientific innovation suggest that every €1 spent on basic research today will deliver benefits to future product developers worth €0.43 every year after that – forever.^[ix] This would suggest that the estimated €2.7bn Team Europe will ultimately devote  to basic research in neglected diseases^[5] will ultimately deliver benefits worth several times that amount – as much as €15bn depending on the speed at which present day basic research stops being relevant for future scientists.

^{[5] This figure is the estimated share of Team Europe’s overall €8.06bn in funding devoted to neglected-disease-specific basic research rather than product development.}

The health and economic benefits presented in this report understate the full range of returns from Team Europe’s investments in global health R&D. We have focused on gains to which we can plausibly attach numbers and ignored a range of important but hard-to-quantify, wider benefits.

Most obviously, neglected diseases have always affected high-income nations alongside LMICs. Their impact is projected to increase as global temperatures rise, especially in Southern Europe, which is already experiencing cases of malaria, Dengue and Chagas disease. Our analysis – even without including the effects of climate change on tropical diseases – suggests that, of the millions of lives that will be saved by new products for neglected diseases, thousands of them will be saved in Europe.

Alongside the health gains experienced in LMICs and in Europe itself, Team Europe’s funding through the EDCTP helps to establish scientific, regulatory and clinical trial capacity in nations where it has historically been absent, most needed, and where it will benefit also research in other disease areas than neglected diseases. This, in turn, helps make the research and development of new products an instrument of Team Europe’s geopolitics, fostering research and healthcare capacity and resilience in partner countries through mutually beneficial partnerships.

It is similarly impossible to fully capture the potential value of scientific spillovers (as when the MRNA technology intended to fight HIV became the basis of a COVID vaccine ^xiii) and the capacity building and economies of scale that arise within Europe. We have pointed to the rise in private investment and employment, but these figures dramatically understate the potential gains from developing regional clusters of research excellence and integrating R&D process across the EU, from harmonising clinical trials to strengthening Europe’s medicine’s manufacturing capacities.

All these impacts, though, depend on a continued commitment from funders to finish what they have begun. With more than three-quarters of the gains from R&D projected to arrive over the next two decades, funding is needed to complete the products still in the pipeline and to enable their manufacture and wide-scale distribution. Funding is needed to ensure that recently completed products, like the R21 malaria vaccine, reach the people who need them. And funding is also needed to continue work on the next wave of promising products, like TB vaccines, to meet the many still unmet needs of the people who suffer from neglected diseases.

The next EU Research and Innovation Framework Programme (FP10) represents a historic opportunity to complete the work that began decades ago, reaping the returns on investments in treatments and cures that are close to being delivered while establishing the foundations for the next generation of products.

The assessment of the health, economic and societal impact of investing in global health R&D provides a clear case for an increased funding commitment from Team Europe.

^{i Smith, D.R.M., Turner, J., Fahr, P. et al. Health and economic impacts of Lassa vaccination campaigns in West Africa. Nat Med (2024). https://doi.org/10.1038/s41591-024-03232-y}

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

^{iii Ibid.}

^{iv United for Medical Research, NIH’s Role in Sustaining the U.S. Economy, 2024 update.}

^{v Akcali BY, Sismanoglu E. Innovation and the Effect of Research and Development (R&D) Expenditure on Growth in Some Developing and Developed Countries. Procedia - Soc Behav Sci. juill 2015;195:768-75.}

^{vi Toole A. Does Public Scientific Research Complement Private Investment in Research and Development in the Pharmaceutical Industry? J Law Econ. 2007;50(1):81-104.}

^{vii Above, n iii}

^{viii Toole A. Does Public Scientific Research Complement Private Investment in Research and Development in the Pharmaceutical Industry? J Law Econ. 2007;50(1):81-104.}

^{ix Ibid.}

^{x Center for Global Development (2024), Forecasting the Fallout from AMR: Economic Impacts of Antimicrobial Resistance in Humans.}

^{xi Ibid.}

^{xii Ouakrim, D. A., Oliveira, T. C., and Jendrossek, M. (2018). “Health and economic burden of antimicrobial resistance,” in Stem ming the superbug tide: just a few dollars more. Paris: OECD.}

^{xiii Harris JE. The repeated setbacks of HIV vaccine development laid the groundwork for SARS CoV 2 vaccines. Health Policy Technol. 2022;11(2)}