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Will South Africa maintain its role as top funder of health research and development?

South Africa continues to make the list of top funders globally of research and development for neglected diseases, including HIV and TB. But local organisations need more domestic funding to continue cutting-edge research.


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As South Africa advances plans for achieving universal health coverage and the roll-out of the National Health Insurance, there is widespread recognition that the goal will not be met without innovation of all kinds. Particularly, the need for research and development (R&D) to advance new tools (vaccines, drugs and diagnostics) to deliver quality, affordable health care has been elevated as a priority. 

Rapid testing for HIV drug resistance. 

A Doppler device to identify high-risk pregnancies. 

These are just some of the lifesaving tools available now — or soon to be — thanks to South African ingenuity. Investments from the South African government have been pivotal in advancing these innovations, and a new report shows those investments are cementing South Africa as a leader in health innovation across the continent and the world. The announcement of an Innovation Fund, which will be capitalised with R1.2-billion over the next three years, further shows the country’s commitment to supporting research and development.

The annual “G-Finder” report, published by Policy Cures Research, reveals South Africa continues to make the list of top funders globally of R&D for neglected diseases, which include HIV, tuberculosis and malaria. South Africa ranks at number 12 on the list of top funders, behind high-income countries such as the United States, Germany and the United Kingdom. Only one middle-income country, India, ranked higher than South Africa. Furthermore, South Africa rises to number three when investments are considered alongside GDP — a remarkable sign of the South African government’s commitment to developing new health tools to tackle the challenges we face in South Africa and beyond. 

Even as we celebrate these achievements, it is important to note that South Africa’s funding this year is a slight decline from the year before, and South Africa still falls short of the standing target of gross expenditure on research and development at 1.5% of GDP. However, the country is making strides to realise the African Union target to allocate 1% of GDP to R&D, as currently that rate is estimated at  0.8%.

Just imagine what could be possible if we were to meet these goals and unleash even more of South Africa’s innovative power? As representatives of the South African Health Technologies Advocacy Coalition – with a membership of close to 20 civil society organisations focused on advancing health R&D in South Africa, we urge the government to continue making robust investments in health R&D

Health R&D is essential not only for the health of South Africa’s people, but for its economy as well. Despite tremendous progress in recent years, South Africa continues to face numerous complex health challenges, from ongoing epidemics of HIV and tuberculosis to stubborn maternal death rates to the threat of emerging diseases.

To achieve the dramatic health improvements called for by the Sustainable Development Goals and the National Development Plan — and to truly achieve health for all — the South African government must continue to increase funding toward development of new health solutions that will not only bring tangible health benefits for all people in South Africa, but also drive economic growth. By investing resources in health R&D, the South African government supports local researchers and grows the country’s research sector while also ensuring that research priorities are locally generated. 

South Africa’s investments are not only making a difference in advancing new tools, but it also serves as an example for what other rising economies can do. Investments into health R&D globally have risen in the past two years, in part buoyed by increasing investments by middle-income countries including South Africa and India. Within the African continent, South Africa is consistently seen as a leader in innovation. It has grown its investments in R&D across all sectors — not just health — over the past seven years, including an 8.5% increase just last year, according to the Department of Science and Innovation. 

South African institutions continue to be involved in cutting-edge health R&D. One of our organisations, the Aurum Institute, has developed four world-class clinical trial sites and implemented over 70 Phase II and III trials. Aurum is involved in TB vaccine, HIV vaccine, TB drug and HIV drug trials.

Several of these trials, such as the TB treatment shortening trials, provided landmark information for the management of tuberculosis. In addition, the organisation has been leading global research trials such as the WHIP3TB trial – a randomised trial evaluating the use of 3HP TB preventative therapy for people living with HIV – and the PHOENIx trial, one of the first trials to determine if a single drug can successfully prevent MDR-TB in adults and children. The trial is taking place in 27 sites in 12 countries.

With continued public investments, the South African government can boost the research sector and drive economic growth while ensuring we can meet the health needs of all South Africans, today and into the future.

Sibusiso Hlatjwako is the advocacy and partnerships manager at PATH. Follow him on Twitter @tibusis. Kanya Ndaki is the Aurum Institute’s communications director. Follow her on Twitter @KanyaNdaki.

Kanya Ndaki is the Aurum Institute’s communications director. Follow her on Twitter @KanyaNdaki.

Sibusiso Hlatjwako is the advocacy and partnerships manager at PATH. Follow him on Twitter @tibusis.

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