10/90 gap

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10/90 gap refers to the statistical finding of the Global Forum for Health Research that only ten per cent of worldwide expenditure on health research and development is devoted to the problems that primarily affect the poorest 90 per cent of the world's population.

The Global Forum for Health Research website offers the following overview of how the term has evolved:

"In 1990, the Commission on Health Research for Development estimated that only about 5% of the world's resources for health research (which totaled US$ 30 billion in 1986) were being applied to the health problems of developing countries, where 93% of the world's burden of ‘preventable mortality’ occurred. Some years later, the term '10/90 gap' was coined to capture this major imbalance between the magnitude of the problem and the resources devoted to addressing it.

Since then, the landscape of health research for development has changed in important ways:

• global expenditure on health research has more than quadrupled to over US$ 125 billion in 2003;

• there are many more actors engaged in funding or conducting health research relevant to the needs of developing countries;

• but the epidemiology of diseases has shifted substantially, so that many developing countries are now experiencing high burdens of non-communicable diseases such as cancer, diabetes, heart disease and stroke, as well as continuing high burdens of infectious diseases and injuries.

As a result of these changes, the total global expenditure applied to research relevant to all the health problems of developing countries cannot be estimated with any meaningful degree of accuracy.

Nevertheless, studies by the Global Forum for Health Research and others continue to demonstrate that health research applied to the needs of developing countries remains grossly under-resourced in may areas and the term ‘10/90 gap’, while not representing a current quantitative measure, has become a symbol of the continuing mismatch between needs and investments."

Among other efforts to address this issue are recent proposals for a Global R&D treaty, and the creation of the nonprofit pharmaceutical company OneWorld Health which develops new and affordable medicines for neglected diseases.

The 10/90 gap has been critiqued on the grounds that "neglected diseases" actually comprise a relatively small disease burden compared to pneumonia, diarrhea, tobacco and obesity-related diseases.

The 10/90 gap is a hedge of Pareto's principle and is a non-exact version that has been incorporated into philanthropic culture.