Analysis of funding and assessment of research impacts on neglected tropical diseases, with an emphasis on dengue fever in Brazil
Neglected Diseases; Dengue; Health Research Evaluation; Research Financing; Brazil
Neglected tropical diseases (NTD) are a public health problem, but scientific development in the area is insufficient to meet the needs of the affected population. The aims of this study were to analyze research funding for NTD and dengue fever by the Ministry of Health’s Department of Science and Technology (Decit/MS) and partners from 2004 to 2020, and assess the impacts of studies on dengue fever funded by public calls for tender by Decit/MS and the National Council for Scientific and Technological Development in 2006, 2008 and 2012. The first stage involved a descriptive study, with secondary data from the Health Research repository in order to analyze the research funding of NTD and dengue fever. In the second stage, the impact of 24 dengue fever studies was assessed, using advances in knowledge, research capacity, informed decision making and health impacts of the Canadian Academy of Health Science. A total of 1,158 NTD and 252 dengue fever studies were funded (R$ 584.2 and R$ 164.0 million, respectively). The funding trend was stationary for NTD and dengue fever, with an influence of federal government management changes. Resource distribution was unequal in the regions of the country (concentrated in institutions from the Southeast – 62.6% NTD and 72.8% dengue fever), and the hiring modalities (concentrated in national calls for tender – 55.9% NTD and 41.5% dengue fever). These results indicate the demand for a sustainable and equitable funding policy. More than 60% of the NTD studies involved dengue fever, leishmaniasis and tuberculosis. For chikungunya, Chagas disease, schistosomiasis, malaria and taeniasis/cysticercosis, diseases with a high prevalence/mortality/load in Brazil, there was a disconnect between research funding and the epidemiological situation in the country, highlighting the need to reassess the priority of the topics funded. A total of 1,108 impacts were identified, most of which were advances in knowledge and research capacity (712 and 314 impacts, respectively) and a minority involving informed decision making and health impacts (75 and 7 impacts respectively). Highlighted were study results presented at congresses (390); articles (134); human resource training (186) and establishment of partnerships to conduct the studies (123 researchers and 74 institutions), demonstrating the importance of scientific research in promoting scientific progress in dengue fever. In the interviews, the researchers identified the impacts on knowledge generation, human resource training and the structure of teams/research laboratories. The challenges of scientific dissemination were discussed and the need for study results to be applicable in the National Health System (SUS in Portuguese). It was concluded that funding for NTD and dengue fever research had stagnated, since it was concentrated in one region of the country (Southeast) and one hiring modality (national calls for tender). There was a diversity in the impacts achieved by the dengue fever studies, confirming the returns/benefits of research in strengthening science and helping the health system cope with dengue fever.