- Jo Mulligan — Research and Evidence Division, Department for International Development
- Cari Tuna — Co-Founder, Good Ventures
- Elie Hassenfeld— Co-Executive Director, GiveWell
Note: This set of notes gives an overview of the major points made by Jo Mulligan.
DFID's Research and Evidence Division
The Research and Evidence Division of the UK's Department for International Development (DFID) has about 30 program types and spends roughly $70 million a year. DFID funds a lot of research on malaria but also funds health research in many other areas. Some of these other areas are:
- Tuberculosis, HIV, and neglected tropical diseases
- Maternal and newborn health
- Family planning
- Health systems
- Mental health
- Evidence synthesis and systematic reviews
- Tobacco control
DFID funds Global Alliance for Improved Nutrition (GAIN), which does work that cuts across a number of these areas.
The Human Development Team within DFID’s Research and Evidence Division is very small compared to other health research funders and so does not have the capacity to fund a large number of small proposals. For this reason, DFID often works with other funders such as the UK Medical Research Council and the Wellcome Trust.
In addition to putting out calls for proposals on identified priority areas, DFID also has a responsive funding scheme through its Joint Global Health Trials scheme (with the Wellcome Trust and Medical Research Council) because researchers sometimes have the best ideas about what research would be useful.
DFID Research and Evidence Division’s work on malaria
DFID’s Research and Evidence Division has always funded malaria research, but since 2010 has adopted a more intense focus on malaria research.
The division funds research on antimalarial drugs and malaria diagnostics. Some of the organizations that it funds in this area are:
- The World Health Organization’s Tropical Disease Research (TDR)
- Other World Health Organization (WHO) components
- Medicines for Malaria Venture (MMV)
- Drugs for Neglected Diseases Initiative (DNDi)
- Institute for OneWorld Health
- Foundation for Innovative New Diagnostics (FIND)
In addition, DFID has a number of joint working relationships with other research funders such as the United Kingdom’s Medical Research Council (MRC) and the Wellcome Trust.
MMV, DNDi, Institute for OneWorld Health and FIND are examples of Product Development Partnerships. These are public-private partnerships that aim to develop drugs and diagnostics for underserved populations.
The division funds research on artemisinin resistance.
The division does not fund the development of malaria vaccines because it feels as though there are funders who are already covering that area of research.
The division is looking into the possibility of funding more research in vector control and malaria operational research but final decisions have not yet been taken.
Joint Global Health Trials
DFID has a joint initiative with MRC and the Wellcome Trust called Joint Global Health Trials. This initiative is designed to fund outstanding research on health interventions that is likely to produce implementable results addressing the major causes of mortality or morbidity in low and middle-income countries. It is not exclusively focused on malaria, but it does fund a lot of malaria research. The organization is investigator driven. There is a lot of competition for funding and only the highest quality proposals are selected.
Insecticide resistance research
The Global Plan for Insecticide Resistance Management (GPIRM) has found that the area of insecticide resistance has both a funding gap and an expertise gap. The malERA Consultative Group on Vector Control has proposed a research and development agenda. Some examples of research in insecticide resistance are:
- Research on developing a new class of insecticides to use against mosquitoes that are resistant to the insecticides currently in use. The Innovative Vector Control Consortium (IVCC) is working on this.
- The study of how the insecticides used can be optimally rotated so as to keep them as effective as possible in the face of the potential for the development of resistance.
- The study of how insecticides can be applied in combination with one another so as to kill mosquitoes that are resistant to one insecticide but not the other.
- The study of and development of methods of counteracting changes in the habits of mosquitoes in response to the use of insecticide treated nets. Mosquitoes are evolving to bite more frequently in the outdoors than they were previously. People in Tanzania are developing fences made out of insecticide treated nets to prevent mosquitoes from biting during the day.
There is also a need for training more entomologists within National Malaria Programs because:
- Surveillance is important for insecticide resistance research
- Many of the existing entomologists are close to retirement age.
DFID put out a call for proposals for product development research in April 2012. It hopes to make final funding decisions by the end of the year. Because DFID is still in the middle of competitive tendering process it is not able to share any details on the process. However, DFID will be able to share what it decides funding and what the remaining gaps are after making final decisions in December. DFID would like to keep in touch with GiveWell about this if GiveWell decides to focus on vector control.
Operational research on malaria control
DFID put together an evidence paper on operational research on malaria control. DFID is interested in funding operational research in the field of managing insecticide resistance, as well as operational research in other areas of malaria control. Often national malaria control program within countries have the people most in touch with what the key operational research questions are, so it seems important that operational research be linked with national malaria control programs.
Noncommunicable diseases in developing countries
Noncommunicable diseases such as hypertension, diabetes and mental illness are often thought to be problems that afflict people in wealthy countries specifically. However, these diseases are increasingly affecting people in developing countries as well. Noncommunicable diseases are already a large portion of the disease burden in India and South Africa. There is very little research funding in the area of treating these diseases in developing countries.
DFID funds Programme for Improving Mental health care (PRIME) at University of Cape Town in South Africa. DFID’s reason for choosing to fund mental health research is that a large part of the disease burden is mental illness. DFID has also funded tobacco control efforts in the developing world in partnership with International Development Research Centre (IDRC) in Canada.
PRIME, IDRC and WHO are good organizations for GiveWell to contact to learn more about funding opportunities in the area of noncommunicable disease.
Health systems research
Health systems research is the field of learning how to strengthen and improve health systems so they can deliver evidence-based interventions or structural changes to improve health. DFID is one of the few major funders of health systems research. It funds:
- Alliance for Health Policy and Systems Research
- “Research for the building of pro-poor health systems during recovery from conflict” (ReBUILD)
- Future Health Systems: Innovations for Equity
- Resilient and Responsive Health Systems (RESYST)
GiveWell can contact these organizations to learn more about funding gaps in health systems research. There is an upcoming major conference called the Global Symposium on Health Systems Research in Beijing (31st October — 3 November 2012), which will help to identify research priorities in the area of health systems. The website is a good resource for learning more about health systems research. DFID is also working with other UK research funders at a possible new responsive funding scheme in this area.