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US government proposals to spend less on global health research will be bad for many countries – but perhaps worst of all for the US. An analysis of US research into diseases of poor nations has found that it massively benefits the US.

Between 2007 and 2015, the US spent $14 billion on global health research, according to the (GHTC), a group of organisations that promote such research, including the Gates Foundation and the International AIDS Vaccine Initiative.

But according to the GHTC’s analysis, for each of those dollars spent, 89 cents remained in the US, paying for US researchers and their needs. This investment is calculated to have created 200,000 new jobs and added $53 billion to the US’s economic output.

This is because government investment in research for diseases of the poor helps stimulate work on treatments that would otherwise be unprofitable for pharmaceutical and biotech firms to develop.

“What really struck me was that every taxpayer’s dollar spent on basic research generates an additional $8.38 of industry investment over eight years,” says Jamie Bay Nishi, of the GHTC.

America first

The analysis calculated that by 2023, US government spending on basic global health research back in 2015 will have generated nearly $4 billion in private investment that will support US jobs and businesses.

But President Donald Trump’s proposed , published in May, revealed plans to cut federal funding for programmes described as providing “little return to the American people”. The was titled “Putting America’s Health First”. The GHTC estimates that the cuts associated with these plans add up to around $5 billion.

But global health spending also protects the health of people in the US, says Nishi, where 300,000 people have the so-called “tropical” Chagas disease, for example. If Ebola vaccine research had not been mothballed in 2012 for lack of funds, she says, the 2014 Ebola outbreak may not have cost the US the $3 billion it spent in defensive measures.

As the US threatens to cut spending on global health, at least poorer countries may start spending more. A World Health Organization showed that most of the world’s countries can afford to improve their own healthcare enough to meet the UN’s set for 2030.

Less aid

These targets call for a cut in infant and maternal deaths and an end to AIDS, TB, malaria and other epidemics. Fewer deaths from pollution, car accidents and non-infectious diseases are also among the goals.

To achieve these, poor countries will need to boost their spending on health from an average of 5.6 per cent of GDP up to 7.5 per cent by 2030. The WHO calculates that countries will be able to afford to pay 85 per cent of that, though the poorest will still need $54 billion a year in aid.

The figures suggest that poorer nations, many of which have neglected healthcare, will be able to rely less on aid to achieve health, and greater prosperity with it.

The key, says the WHO, is for poor countries to build better healthcare systems and provide universal health insurance. If they can manage this, the rewards should be 97 million fewer premature deaths by 2045 and increases of life expectancy by up to 8 years in poorer nations.

The WHO’s new director general Tedros Adhanom Ghebreyesus says improving healthcare is a political choice. That statement also applies to the US, as it decides whether to keep developing the treatments poor nations will need as they try to improve health.