including the best research strategies against infectious diseases of poverty. Implementation of the actions proposed in this report should help improve current research prioritization processes, guide investment strategies and enhance commitment to using research to promote global health equity. If, like the Millennium Development Goals, these options for action are focused on by policy-makers, funders and researchers, they should lead to well-planned, effective, and powerful health interventions and have a real chance of saving millions of lives in years to come. 11 1 Why research infectious diseases of poverty? 11 AUTHORS Professor Sian Griffiths Director, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China Professor Xiao-Nong Zhou Director, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China report fellow Allison Thorpe In chapter 1: • Poverty and infectious disease – a problematic relationship • Infectious disease – the true burden on communities • The value of research: new ways to end old diseases • Moving beyond the Millennium Development Goals • The cost of inaction – social and economic consequences • Tackling disease – a need for investment • Ten reasons to research infectious diseases of poverty Research is the key to making things happen for poor populations. This introductory chapter of the Global Report examines the need for research into the infectious diseases that disproportionately affect poor and marginalized communities – the socalled “infectious diseases of poverty”. It examines the link between poverty and disease and outlines ten reasons to support research for such diseases. Such research represents unfinished business of global relevance, work that the world can no longer afford to neglect. 12 Why research infectious diseases of poverty? Chapter 1 Global Report for Research on Infectious Diseases of Poverty 13 Why research infectious diseases of poverty? Why research infectious diseases of poverty? 13 According to the latest published data in 2012, infectious (including parasitic) diseases were together responsible for the death of more than 8.7 million people worldwide in 2008 ( 1). The majority of these deaths were of poor people living in low and middleincome countries, with many of the deaths occurring in children under five years of age. Given the sketchy data, misdiagnosis and under-detection that are typical of health systems in impoverished areas, these num - bers are almost certainly underestimated. Infectious diseases have shaped societies, driven conflict and spawned the marginal - ization of infected individuals and communi - ties throughout history. Today they are sig - nificant agents in the appalling poverty afflicting so much of the world. Their impact is felt not only in massive loss of life but also in high-levels of morbidity and the accompa - nying impact on families, communities and weak and under-resourced health systems in low and middle-income countries. Stepping up research into the causes of infectious dis - eases and how to treat them effectively and prevent them from spreading would, if acted on, have an enormous impact on efforts to lift people out of poverty and would help build a better world for future generations. Poverty and infectious disease – a problematic relationship According to The World Bank, the global rate of extreme poverty (less than US$ 1.25 a day) has been falling over the past two decades and will likely meet the Millennium Develop - ment Goal (MDG) for 2015 (2–5). Much of this improvement reflects rapid economic growth in China and India, yet many African countries with a high burden of infectious diseases are lagging behind. For example, almost 50% of African countries are far from halving extreme poverty. However, from a global health perspective, often there are criteria broader than income with which to determine who is actually “liv - ing in poverty”. Social and economic condi - tions underpin poverty and can directly and indirectly affect health status and health out - comes. Major epidemics emerge and chronic conditions cluster and persist wherever poverty is