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This report, published by the Global Forum for Health Research, tracks global investments in health research and development (R&D).

The authors review global targets and commitments for R&D in health and evaluate how well these are being met. They highlight the differences in funding by region, including analyses from Argentina, China and the United States; and provide a breakdown of investments in R&D for cancer and 20 widespread infectious diseases.

They also describe the different sources of R&D funding, providing data on private, public and not-for-profit investments.

The authors discuss the implications of the current funding climate for future health research and make recommendations for improving research agendas, suggesting that R&D investments must match the health needs of developing countries now and in the future.

This report is the WHO's official record of data produced by its technical programmes and regional offices in close consultation with countries and in collaboration with researchers and development agencies. The WHO produces the statistics to provide an evidence base for strategies to improve global public health.

The report clearly shows that the global burden of disease is shifting from infectious diseases to non-communicable diseases, with chronic conditions such as heart disease and stroke now being the chief causes of death globally. The shifting trends indicate that leading infectious diseases — diarrhoea, HIV, tuberculosis, neonatal infections and malaria — will become less important causes of death globally over the next 20 years.

The report documents in detail "the levels of mortality in children and adults, patterns of morbidity and burden of disease, prevalence of risk factors such as smoking and alcohol consumption, use of health care, availability of health care workers, and health care financing."

This joint publication between the World Health Organization and the Global Forum for Health Research reveals mental health research capacity in 114 low-income and middle-income countries in Africa, Asia, and Latin America and the Caribbean. The extensive review identified over 10,000 articles, 4,633 mental health researchers and 3,829 other stakeholders. The authors argue that this is "the first systematic attempt to confirm the pressing needs of improving research capacity in mental health".

The publication provides useful details in table and charts, analysed by group of stakeholders and by region, on topics such as: researchers' profiles; priority-setting process; amount and type of research production; services and technical support available to them; courses and trainings offered; funding patterns; and dissemination of research findings. The appendix provides two extensive lists — by country — of policy and practice that resulted from research evidence, as well as research evidence that was never translated into policy and practice.

Nine recommendations indicate how the management of mental health research can be strengthened so that it meets the national needs of the countries as well as contributes to the global fund of knowledge. The authors say their report thus enables evidence-based decision-making in funding and priority setting in the area of mental health research in low-income and middle-income countries.

These consist of two reports: SuRF1(Surveillance of risk factors related to non-communicable diseases: current status of global data) and SuRF2 (Surveillance of chronic disease risk factors: country-level data and comparable estimates).

These reports are the result of a large WHO project to set up for the first time a global database of the prevalence of risk factors for non-communicable diseases collected from WHO member states. The first report is largely a collection of the country profiles; the second analyses the data to produce comparable estimates for risk factor prevalence in the countries. The WHO designed this as an advocacy tool to highlight where primary prevention and health promotion need to be directed.

The eight risk factors were chosen because they are easily measurable and theoretically can be changed through prevention efforts. They are: tobacco and alcohol use, patterns of physical inactivity, low fruit/vegetable intake, obesity (as measured by BMI), blood pressure, cholesterol and diabetes (measured by blood glucose).

The second report presents country-level estimates for overweight/obesity and systolic blood pressure. It also shows the attributable mortality and disease burden from all causes of death due to these overweight and high blood pressure for the 11 most populated countries. 

(See WHO Global InfoBase Online for electronically searchable data contained in the reports http://www.who.int/infobase/surf2/online.html.)

Chronic diseases — heart and lung disease, cancer and diabetes — are having a negative economic impact on both the developed and developing world, says this report, which is why they should be properly addressed by domestic and international policy makers. Compared to the epidemiological evidence on the rise of non-communicable diseases in developing nations, there is little information on how this increase will affect their economies.

This report investigates the demographics of the problem and finds that contrary to popular belief, the disproportionate burden of disease on the elderly does have economic implications. The reason is that though the elderly may not be part of the workforce, they are still consumers and therefore a part of the economic equation.

Whether approaches to tackling chronic diseases are cost-effective or not is a vital issue for countries whose health budgets are already overstretched — the report outlines some of the interventions that offer most bang for buck. The authors point out that strategies that work well in developed countries are not so effective in developing countries, and call for more research to assess what will be appropriate.

This extensive report was one of the first to document the scale of the problem of chronic diseases in developing countries, and crucially, to offer guidance on feasible and practical methods of tackling them.

The document starts by laying out in detail the profiles of chronic diseases in different countries, projections for the future, and how chronic diseases are linked with poverty. It also examines in depth the economic costs of such diseases and the macroeconomic consequences of not tackling them quickly enough. The authors outline interventions — whether community, workplace, or school — that have robust evidence supporting them.

The report ends with a call for a unifying framework of global health experts and stakeholders, in which the government has a key role. It also specifies what policymakers need to do to ensure that measures to tackle chronic diseases are put into action.

The report focuses on the lack of antibiotics in the pharmaceutical pipeline. Until now, it says, problems of resistance have been overcome by the development of new drugs. The older ones, to which bacteria or parasites have become resistant get phased out, and the new effective ones are brought in. But what happens when the cupboard is bare?

After a year's investigation of the problem, the authors say that while all stakeholders have a part to play in reducing the effect of resistance, pharmaceutical and biotechnology companies are best placed to take the lead in developing new drugs. The reason for the slump in production has been the high risk involved in investing large sums of money in drugs that might not yield a high return (especially if the drugs are most needed in poor countries).

Legislative and policy changes are needed to spur the pharmaceutical industry into action, says the report. Changes might include allowing companies to extend the exclusivity period on drug patents if they develop a priority antibiotic, tax incentives for R&D of priority antibiotics, or a guaranteed market (for example, by a government or donor agreeing to buy large quantities of drugs).

This annual update gives an overview of the latest developments in the global HIV/AIDS epidemic and provides regional statistics on the diseases's spread. It shows that numbers of people living with HIV and the number of deaths from AIDS are growing.

The report presents trends in HIV prevalence, including estimates of the number of young people and women infected in different countries. It discusses how high-risk behaviour such as unprotected sex and intravenous drug use contributes to the epidemic and how external factors such as malaria, tuberculosis, migration or political conflict affect HIV prevalence.

This paper maps African countries' knowledge base through patent applications and publications. It shows South Africa as academically, and technically, the strongest country of the continent. The number of publications is growing in other African countries, but patenting remains limited all-round.

The paper ends on a positive note, arguing that African countries already possess the basis for knowledge-driven development.

This draft document contains general guidelines on the creation and governance of health research ethics committees (HRECs) in Nigeria.

It also lists the principal characteristics research projects need to demonstrate in order to gain HREC approval. Research in Nigeria must have social or scientific value, be scientifically valid, ensure fair selection of participants, minimise health risks and undergo independent review. In addition, all participants of research projects must give their informed consent and be respected at all times. All projects must adhere to good clinical and laboratory practices. Researchers must do all they can to ensure their work has a lasting impact — transferring technology where appropriate and contributing to capacity building efforts.

A vaccine that stops people passing on the malaria parasite to others would benefit communities rather than individuals — since individuals could still become infected with the malaria parasite. This report summarises this and other conclusions of a 1999 meeting between international scientists and representatives of industry, funding agencies and the World Health Organization to discuss the feasibility of developing and using such a vaccine to control and prevent malaria in different types of epidemics.

A vaccine that stops people passing on the malaria parasite to others would benefit communities rather than individuals — since individuals could still become infected with the malaria parasite. This report summarises this and other conclusions of a 1999 meeting between international scientists and representatives of industry, funding agencies and the World Health Organization to discuss the feasibility of developing and using such a vaccine to control and prevent malaria in different types of epidemics.

Researchers led by Bob Snow of the Kenyan Medical Research Institute-Wellcome Trust Laboratories used new and existing data to map the incidence of the most severe form of malaria, caused by the parasite Plasmodium falciparum. Their results indicated that there were more than 500 million cases in 2002 — double the World Health Organization's estimate.

The malaria parasite's genetic code — published in 2002 — has created a whole new foundation for basic research into malaria. This article, part of a special supplement published in the 19 August 2004 issue of Nature, describes the different technologies being used to study interactions between the malaria parasite and its human and mosquito hosts. These include using 'gene chips' to analyse which parasite genes are switched on at any particular stage in its life cycle, and the science of 'proteomics', which searches malaria proteins for new drugs and vaccine targets. The article is aimed at readers with some scientific background.

This policy paper says government policies on the development of drugs for neglected tropical diseases, including malaria, are based on misconceptions and need revising. Widely held but outdated beliefs include the notion that neglected diseases offer little commercial incentive for large pharmaceutical companies. In addition, it says, there is the perception that public-private partnerships (PPP) — which bring researchers from industry and academia together in non-profit drug development ventures — are too inexperienced to inspire confidence. The reality in 2005, however, is quite different, says the paper. About ten new drugs for neglected diseases are expected within the next five years, mostly because of PPPs. These have included collaborations that aim to provide drugs to poor countries at not-for-profit prices. A full report by the paper's authors is on the Wellcome Trust's website.

This article highlights ways of improving advanced research and development (R&D) of malaria drugs to speed up their eventual licensing and use. Public-private partnerships are boosting funding for such R&D and increasing the number of drugs being developed. But better administration and funding are also needed to ensure new drugs are tested adequately in the field, including their use in combination with other drugs. The authors also stress the need for more involvement by scientists and organisations in developing countries. The article is part of a special supplement published in the 19 August 2004 issue of Nature.

This review describes how new antimalarial drugs act on the malaria parasite. It also describes factors affecting whether or not drugs are finally licensed, and how private-public partnerships are boosting research and development.

This overview of malaria vaccine research focuses on potential vaccines that are in, or expected to enter, clinical trials by the end of 2005. Reviewing both published and unpublished findings, the article categorises different types of vaccines currently in development according to the stage of the malaria parasite life cycle they target. The article assumes knowledge of vaccine terminology, but presents a useful overview, including a summary table, of the status of different vaccine candidates. It also describes growing optimism in the field owing to new funding from private-public partnerships, including new North-South collaborations.

Part of a special supplement published in Nature in 2004, this article describes possible solutions for the control of mosquitoes as malaria vectors. The difficulties of scaling up and sustaining access to insecticide-treated nets, and the presence of insecticide-resistant mosquitoes, means that many people remain at risk of being bitten by mosquitoes. Solutions that could become reality within ten years include new insecticides that attack the mosquito in different ways or prevent resistance from developing, and releasing genetically modified mosquitoes that cannot breed or carry the malaria parasite.

This feature article, written for non-specialist readers, looks at the prospects of controlling malaria by releasing genetically modified mosquitoes into the environment. The rationale is to render mosquitoes incapable of transmitting the malaria parasite, but it will be many years before such technology is developed and shown to be environmentally safe. Issues to be resolved before such mosquitoes are released include the possibility that the genetic modification could disappear in subsequent mosquito generations.