Vaccines and AMR: An analysis of the funding landscape for human bacterial vaccines in low-and middle-income countries.

Background: Vaccines are critical tools to prevent the emergence and spread of antimicrobial resistance (AMR) through prevention of infection and reduction of subsequent antibiotic use. Since AMR is a critical issue disproportionately affecting Low- and Middle- Income Countries (LMICs), we examined investments in research and development for bacterial vaccines with a focus on LMIC-driven research.

Methods: Publicly available funding data on projects active from January 2007 to 15 January 2024 from the G-FINDER and Global AMR R&D Hub databases were analysed. The investment into human bacterial vaccine R&D was analysed to identify the recipients and geographic distribution of funding provided directly from funders and through intermediary organisations.

Findings: Global funding of vaccine R&D for bacterial pathogens in this dataset totals 4.50 billion USD, with the majority of funding directed towards M. tuberculosis and S. pneumoniae. Most funding was received by organisations in North America and Europe, with Asia, Africa, and Central/South America collectively receiving less than 20 % of the total funding. Philanthropic and intermediary organisations, particularly Product Development Partnerships (PDPs), emerge as critical players in mobilising and coordinating resources for bacterial vaccine R&D in LMICs.

Conclusion: Comprehensive and transparent reporting is needed to accurately assess funding to LMICs. Nevertheless, the current analysis shows that PDPs and intermediary funders are pivotal in ensuring investments reach LMIC product developers. Data gaps remain for critical bacterial pathogens on WHO's AMR priority pathogen list.