The 10/90 gap in sub-Saharan Africa: resolving inequities in health research

Sub-Saharan Africa (SSA) is worse off in terms of health indicators than any other region of the world, and suffers badly from the 10/90 gap, whereby 90% of the world's investment in health research addresses only 10% of the global health problems. This anomaly in health research investment in SSA is mainly attributed to rampant poverty, weak educational institutions, deficient health research capacity, feeble communications systems and isolation. Translating research results into action, manufacturing and access are also weak. Furthermore, many diseases of poverty are neglected diseases, they receive scanty research attention; there are no new drugs or vaccines for their treatment or prevention. The situation in SSA is made worse by the surge in noncommunicable diseases and injuries. The paper reviews actions taken over the last two decades to resolve the 10/90 gap through: (i) policies prioritizing funding for health research, (ii) developing capacities of credible public and private SSA health research institutions, (iii) activities of international NGOs undertaking research aimed at resolving the gap, and (iv) the setting up of research based mechanisms to ensure access to new effective products for the treatment and prevention of poverty-related diseases. The paper highlights examples for each of the above, and discusses the overall situation. We conclude that despite the many capacity strengthening actions, and achievements made towards resolving the 10/90 gap, the disequilibrium still persists; there is need for greater investments aimed at closing it.