It was reported in 1990 that only 5% of global expenditures on health research are directed at the health problems unique to developing countries, and less than 10% of donor assistance for health is devoted to research, both biomedical and in the social sciences. Several thousand serious deficiencies in the international health research and development system were identified. For example, the expertise of the global pharmaceutical industry is not being adequately applied to the development of drugs and vaccines that could reduce the toll of early childhood disease. Technology assessment is weak, as is the health policy research needed to determine more equitable and efficient ways to finance and deliver health services. Most important, local research capacity in developing countries is woefully inadequate. A number of promising research efforts, including the Children's Vaccine Initiative and programmes to deal with acute respiratory infections, tuberculosis, micronutrient deficiencies and worm infections, suffer from weak and uncertain donor funding. In general, the problems of constrained funding for research are compounded by donors' limited capacity to stay abreast of the latest research proposals and to assess the relative priorities for funding this research.
The development of a global mechanisms for better coordination of international health research would include well-defined networks of research centres, informal consultative bodies, and large global funds that pool donor assistance. Examples of these institutional arrangements in other sectors, such as the Consultative Group for International Agricultural Research and the Global Environment Facility, may provide models for improving the coordination of international health research.