Time for EU to take charge of global health research agenda

And yet, we cannot afford to be complacent - on malaria, or other global health challenges.

Malaria still kills 445,000 people around the world, not to mention the burden of HIV & AIDS, tuberculosis, and other emerging threats. All of these problems will require new tools and research to solve them.

Today the EU is at a crossroads for the future of its global health research agenda.

Brexit uncertainty is fuelling concern about the future of EU research funding in general. In particular, there are fears that health research – particularly for diseases of poverty like malaria, AIDS and TB – may be relegated to the second tier of policy priorities when the European Commission publishes its vision for EU research policy for the next decade.

Critical decisions in 2018

The EU has a critical decision to make.

It could continue with business as usual, adapting Europe's ambitions to reflect a new and uncertain political reality.

Or, European leaders could seize upon a once-in-a-decade opportunity in 2018, building on what it has achieved so far to forge ahead with a new, radical research agenda that leverages the EU budget to tackle global societal challenges.

This is the only way that Europe can truly tackle the challenges of defeating malaria, HIV & AIDS, tuberculosis, and other diseases of poverty.

It already has a good foundation on which to build.

The EU is a significant donor to global health research, contributing $77m (€62.8m) last year (however, it still lags behind the US and the UK).

In addition, there has been much progress under the EU's Horizon 2020 research agenda, both abroad and at home. Instruments like the European and Developing Countries Clinical Trials Partnership (EDCTP) have advanced lifesaving health innovations, supported research excellence in Europe and Africa, and encouraged investment and high-quality jobs in Europe.

Brexit concerns

And yet, the unknown and unpredictable consequences of Brexit could unravel the EU's R&D ambitions. Already, the global health community is alarmed.

Dr Michael Makanga, the EDCTP's executive director, has questioned how the UK will be involved in EU research after 2019, given that it is responsible for 40 percent of the partnership's funding and hosts some of the world's most renowned research institutions.

Whatever happens, there is bound to be disruption to EU research for some years to come, and the EU needs to take measures now to make sure that this is minimised as much as possible.

A refresh of the EU's research agenda is welcome, but scrapping the EDCTP would be hugely damaging, orphaning global health research and leaving it without a dedicated budget.

Furthermore, a recently leaked impact assessment of the commission's research framework has suggested merging the policy sections that cover "industrial leadership" and "societal challenges" into one overarching objective, which could further endanger funding for global health research.

While this change of direction could spell trouble for poverty-related diseases, it does not have to.

A renewed and refreshed EU research agenda with global health as a core component would be a game changer.

The EU and its member states have said that they are willing to commit to an increased EU budget, and one that focuses on supporting cutting edge research – global health research could be a natural part of this.

It is has already been high on the agenda in recent years, as governments have recognised the value in pre-emptively investing in responses to the likes of anti-microbial resistance and pandemic preparedness.

EU decision makers have a unique opportunity to build on this momentum in 2018, using the EU budget to overcome global uncertainty and turbocharge investment in global health research.

Commissioner Carlos Moedas has already started down this road, embracing a "mission-driven" research agenda, focusing policy behind a select number of research targets.

To be effective, these "missions" have to address societal challenges, be needs-driven, and address challenges that are not being dealt with by traditional market forces.

Imagaine €1bn

Imagine the impact an EU mission focused on diseases of poverty with substantial funding of at least €1bn could have, creating the next generation of life-saving medical interventions.

There are also practical reforms the EU can implement.

Maintaining a dedicated instrument for disease research, building on the accomplishments of the EDCTP into the next decade, is vital.

So too is increasing funding, making it more accessible and transparent. Funding needs to support "translational" research, basic research, and later-stage clinical trials.

Geographic restrictions should be relaxed, so that EU researchers and institutions can develop new tools with partners based in countries where they are needed most. Investment should be backed by a comprehensive vision for global health research that is driven by the wants of people most in need.

If, in May 2018, the commission were to announce its intention to undertake these radical reforms, the EU would be well-placed to confirm its place as a world leader in using research and innovation in the fight against diseases of poverty.

It would be some legacy for commissioner Moedas and his colleagues to leave behind them: a tooled-up EU research agenda capable of launching a new era of health research, reinvigorating a global push to end malaria, HIV & AIDS, tuberculosis and other diseases of poverty.