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The US is to cut funding for vital research into contraception, tropical
diseases and other health problems confronting developing countries. Faced
with a $1 billion cut in its budget, to $6 billion, the US Agency for International
Development (USAID), was this week deciding how to pare back its health
and population programme.

Cuts by the agency could leave big gaps in research into the health
problems of the developing world. Tore Godal, head of TDR, the programme
of research on tropical diseases at the WHO, says he has had confirmation
of only $500 000 of the $2.5 million he was expecting from USAID for 1994.
Last year, the agency funded $3 million of TDR’s $30 million budget.

Last week in Washington DC, officials at USAID stressed that no final
decisions had been taken about where the axe would fall, and that their
aim was to reduce overlap between agencies rather than remove whole research
programmes. ‘We do expect cuts in all of our programmes,’ says Jay Byrne,
a spokesman for the agency. ‘Every single programme is under scrutiny. We
are taking a look at the tropical diseases research programmes to see where
we can find any cost savings.’

One likely casualty of the cuts is malaria research. The disease kills
3 million people a year and blights the economies of many developing countries.
Its effects are worsening as drug-resistant strains of the malaria parasite
spread. But USAID says other agencies, such as the Department of Defense,
are working on malaria. This is true, but the DoD has also steadily reduced
its funds for research on the disease. For example, it has reduced spending
on malaria drugs alone from $2.4 million in 1986 to $1.7 million in 1990.

Louis Miller, who is head of the malaria laboratory at the US National
Institutes of Health in Bethesda, Maryland, argues that some overlap is
essential to allow different approaches to a complex problem. ‘In many areas
of the world people are essentially living without drugs,’ says Miller.
‘The only hope for new technologies is to have new research.’

Godal fears that TDR will also have to reduce its work in areas where
research is beginning to have a big impact on controlling disease. One obvious
example, he says, is leprosy, where multidrug therapy, tested widely in
recent years, has proved highly effective and is now used worldwide. But
many scientists fear that if the leprosy problem is seen as solved, funding
bodies will lose interest and complacency will allow the disease to spread
once again, as has been the case with TB.

USAID is adopting short-term goals. ‘If we have to make decisions between
funding research projects and treatments, such as oral rehydration therapy,
we are going to go with the programmes that are saving children’s lives
today,’ says Byrne.

He also warns that there is little hope that the WHO will receive the
$3 million in new money that it has requested from the agency for its research
programme on TB.

Byrne claims that the WHO’s overheads and stationery costs are too high
and that USAID’s directly funded programmes are run more cheaply. Godal
retorts that TDR’s costs are lower ‘than any other programme in the UN system’.
‘We would be very happy to provide USAID with information about our cost-effectiveness,’
he says.

The reduction in USAID’s budget was passed by Congress earlier this
month.