| Popis: |
Aim Childhood cancers have long been missing from the global health agenda despite being a leading cause of childhood mortality, accounting for an estimated 75 000 deaths in children under 15 years old in 2018. Understanding the current research landscape is essential to ascertain how research resources are allocated to address clinical and operational knowledge gaps in childhood cancer epidemiology, clinical care and the effectiveness of interventions. We analyse trends in global public and philanthropic research funding for childhood cancers, a useful proxy for global research activity. Methods We systematically searched for and analysed the inflation-adjusted amounts (in US Dollars) awarded by, and topics of, 3414 grants from 115 funders across 35 countries between 2008–16; using data from the Dimensions database. Research funding was mapped according to funding source, recipient, tumour type, research focus and pipeline categories; describing trends over time. Results In 2008–16, total global funding for paediatric oncology research was $2 billion; with a mean of only $227 million per year. Despite a small increase in research infrastructure grants in 2013–14, direct funding for paediatric oncology research has declined since 2011. Most funding supported general childhood cancer research including infrastructure grants ($772 million; 37.9%), followed by research into leukaemia ($449 million; 22·0%), central nervous system tumours ($330 million;16·2%), and neuroblastoma ($181 million;8·9%). The majority of funding was awarded from, and to, United States based institutions ($1.6 billion; 77·7%); with pre-clinical research receiving $1·2 billion (59·3%) and only $116 million (5·7%) and $113 million (5·5%) directly supporting clinical trials and healthcare delivery research, respectively. Only $18 million (0·9%) was awarded for prevention research. Conclusion Funding for paediatric oncology research is indaequate for a leading cause of child mortality and suffering. There is a bottleneck in funding between pre-clinical biology/aetiology research and clinical trials; with an urgent need for developing new models of care through health systems and healthcare delivery research. New momentum towards achieving universal health coverage for children must be met with major new public and philanthropic commitments to support future research to better understand the distribution, burden and causes of paediatric malignancies, and to develop innovative prevention and treatment strategies. |
