Experts fear a push to cut the UK’s aid budget will slash spending on global health research, handicapping international public-private programmes that have helped combat the world’s deadliest diseases over the last decade. In a letter addressed to the foreign secretary, Dominic Raab, last week, prominent parliamentarians sought reassurance that the planned cuts would not lead to “dramatic reductions” in investment for devastating diseases such as tuberculosis, malaria, Aids and a clutch of neglected tropical diseases. The letter’s signatories include the former health secretary Jeremy Hunt, the chair of the science and technology select committee, Greg Clark, the chair of the international development committee, Sarah Champion, and the Tory peer Nick Herbert, the letter’s lead signatory. Of particular concern is the fate of international product development partnerships (PDP) – projects that leverage the expertise and infrastructure of big pharmaceutical companies, smaller biotechnology firms and academic institutions to fight diseases where “market failure” prevents large-scale private sector investment. In 2018, the UK government was the second-biggest donor providing $230m (9.2% of all public funding) for neglected disease research and development. In the last 10 years, the PDP model has helped develop and introduce more than 65 products, including drugs and diagnostics, that have reached more than 2.4 billion people. “Anything that is done to damage that progress would be absolutely tragic. I think we understand the power and importance of infectious diseases much more now than we did a year ago … that’s where the nervousness comes from,” said Sir Mike Ferguson, the governor of the Wellcome Trust. Many existing PDP contracts are due to expire in March 2021. “One of the easier ways of dealing with cuts is sort of not breaking open existing contracts but … once they expire, just don’t renew them,” said Willo Brock, the senior vice-president of external affairs at PDP called TB Alliance. Brock said TB Alliance and at least two other PDPs had received “signals” from the UK government that they should expect delays in funding. “If there are simple cuts across the board, we’re all going to have to figure out a way to deal with it … Covid has hit us all. I think the signals became worrying when it’s sort of like … we need to make drastic changes and we may cut complete programmes.” Raab in November pledged to prioritise measures to tackle Covid and promote wider international health security. The letter’s signatories point out that “any cut in the global health research budget would be entirely inconsistent with this commitment.” “We’re not just speculating on these cuts,” said Herbert. “This is on the basis of concerns that have been raised to us by either scientists or those involved in research programmes. “We’re not criticising the government for something it has not yet done – we’re warning that it should not do this, and that it would be inconsistent with the priorities it itself has set out, and with all the learning from Covid.” A government spokesperson did not offer details on whether the aid cut would adversely impact global health research, but reiterated the commitment to “spend more than £10bn next year to fight poverty, tackle climate change and improve global health”. The UK’s contribution to international PDPs – typically in the range of 20% to 30% of their total budgets – ultimately serves the UK, said Ferguson. “Quite a big proportion of it flows back to the UK – for all the right reasons. PDPs operate totally independently and decide where they can get the best quality of science and research and development done, and often that’s back in the UK,” he said. For example, in the last five years roughly 60% of what the UK government put into the Medicines for Malaria Venture (a PDP Ferguson is a director of) goes back into the UK, he said. The UK’s stamp of approval has been essential for PDPs to be able to reach agreements with other donors, added Brock. “It’s that leverage, that strength of jointly working on this – every pound UK government puts in gets matched two or three times … which is essential to really achieve results.”