By Dr. Luz Mendoza
Tropical disease research is the systematic study of infections that hit warm, humid regions hardest—dengue, leishmaniasis, Chagas disease, leptospirosis, and plenty of others. Related terms you will see in the literature include neglected tropical diseases (NTDs), vector-borne transmission, field epidemiology, and health systems research. For Spanish-speaking students and professionals in Peru, none of this is abstract. It is the difference between a fast outbreak response in Iquitos and one that arrives late, between a diagnostic test that works in Lima and one that fails in a jungle health post without refrigeration. This article explains why funding for this work stays persistently low, what that means for laboratories and communities, and where the money does—and does not—flow.
The Funding Gap in Numbers
Global health funding leans heavily toward three diseases: HIV, tuberculosis, and malaria. Policy Cures Research reported that basic research and product development for neglected diseases received about US$4.1 billion in 2022, but most of that went to those three infections. Chagas, leishmaniasis, and leptospirosis—all present in Peru—got a small fraction. The World Health Organization’s Global Observatory on Health R&D points out that countries with high NTD burdens often have the lowest domestic research investment. That creates a double gap: limited international interest and thin local budgets.
In Peru, the National Council for Science, Technology and Technological Innovation (CONCYTEC) has expanded competitive grants, but the amounts remain small next to pharmaceutical clinical trial investments, which tend to chase diseases with paying markets. A leishmaniasis drug trial in the Amazon can cost as much as a hypertension trial in Lima, yet the potential commercial return is far lower. That is the core economic problem: tropical disease research is a public good, not a market opportunity.
Why the Market Fails Tropical Diseases
Think of drug development like preparing ceviche for a big event. If you know hundreds of guests will pay for the dish, you buy the best fish, hire extra hands, and invest in refrigeration. If only a few families in a remote village need the meal, and they cannot pay much, the incentive to invest in the same preparation disappears. Tropical disease research follows the same logic: the people most affected often have the least ability to pay, so companies and investors direct resources elsewhere.
This is not a moral judgment; it is an economic reality. The result is a pipeline with few new drugs, diagnostics, or vaccines for diseases that affect millions. Benznidazole and nifurtimox, the two main drugs for Chagas disease, were developed more than 50 years ago. Both have significant side effects and limited efficacy in chronic adults, yet investment in better alternatives has been sporadic. The same pattern appears in leishmaniasis, where pentavalent antimonials remain first-line in Peru despite toxicity and treatment failures.
How Underfunding Shapes Daily Lab Work
In a well-funded laboratory, a broken thermocycler is replaced within days. In a tropical disease lab in Peru, the same equipment may sit idle for months while researchers write small grant applications or share machines between institutions. This is not inefficiency; it is adaptation under constraint. At field sites in Madre de Dios or San Martín, teams often carry their own liquid nitrogen tanks, improvise cold chains, and reuse extraction kits beyond manufacturer recommendations—not because they want to, but because the alternative is stopping the work entirely.
Underfunding also affects human capacity. Young biologists and medical technologists train in molecular techniques, then leave for better-paying jobs in clinical laboratories or industry. The result is a constant loss of skilled personnel. A colleague in Iquitos once told me that her lab trained twelve PCR technicians in five years; only three remained in tropical disease research. The others moved to Lima or abroad. This brain drain is a direct consequence of short-term grants and low salaries.
Field Sites and the Cost of Distance
Peru’s geography magnifies every funding problem. A study in the high jungle may require boat transport, generator fuel, and satellite communication. Grants rarely cover these costs fully, so researchers often pay out of pocket or rely on personal networks. In one leptospirosis project in Loreto, the team spent more on transport and sample preservation than on laboratory reagents. The grant covered reagents; it did not cover the reality of reaching the communities where leptospirosis actually occurs.
This distance also affects data quality. Samples that travel for days without proper refrigeration may degrade, leading to false negatives or inconclusive results. Underfunding forces trade-offs: do you collect fewer samples with better preservation, or more samples with higher risk of degradation? Neither choice is ideal, but both are common in tropical disease research.
The Role of International Donors and Their Priorities
International donors such as the Bill & Melinda Gates Foundation, Wellcome Trust, and the National Institutes of Health (NIH) have funded important tropical disease work in Peru. However, their priorities shift over time. A few years ago, Zika attracted significant funding; when the outbreak subsided, many projects ended abruptly. The same pattern occurred with Ebola and, more recently, COVID-19. Tropical disease research is often reactive rather than sustained.
This creates a boom-and-bust cycle. Laboratories hire staff and buy equipment during a funding surge, then struggle to maintain them when the money moves elsewhere. The result is wasted infrastructure and lost institutional memory. A more stable funding model would support core laboratory capacity independent of specific outbreaks, but that is rarely how global health financing works.
Domestic Funding: Progress and Limits
Peru has made progress in domestic research funding. CONCYTEC’s FONDECYT (National Fund for Scientific and Technological Development) has supported projects on dengue, bartonellosis, and antimicrobial resistance. The Ministry of Health’s National Institute of Health (INS) also conducts surveillance and research. Yet the total budget remains small relative to the disease burden. In 2023, Peru’s public investment in research and development was below 0.2% of GDP, far below the 1% target recommended by many scientific organizations.
Domestic funding often prioritizes applied research with immediate policy relevance. That is understandable, but it leaves little room for basic science—understanding vector biology, pathogen evolution, or host immune responses—that underpins future interventions. Without basic research, applied research eventually runs out of new ideas to test.
What Underfunding Means for Patients and Communities
The most visible consequence is delayed diagnosis. In many jungle health posts, dengue is diagnosed clinically because rapid tests are unavailable or unaffordable. Leptospirosis, which can mimic dengue in early stages, is often missed entirely. This leads to inappropriate treatment and preventable deaths. Underfunding of research means fewer validation studies for point-of-care tests that could work in low-resource settings.
Communities also lose trust when research projects come and go without lasting benefits. A team may collect blood samples, publish a paper, and leave. If the community never learns the results or sees an improvement in services, they may be less willing to participate in future studies. This is a hidden cost of underfunding: the erosion of community partnerships that take years to build.
Case Study: Bartonellosis in the Andean Valleys
Bartonellosis, caused by Bartonella bacilliformis and transmitted by sand flies, is endemic in Andean valleys between 500 and 3,200 meters above sea level. The disease has two phases: an acute febrile phase with severe anemia, and a chronic phase with skin lesions. Despite being described more than a century ago, bartonellosis remains understudied. Diagnostic confirmation often requires microscopy or PCR, which are unavailable in many affected areas.
Funding for bartonellosis research has been minimal compared with dengue or malaria. This is partly because the disease is geographically limited to Peru, Ecuador, and Colombia, and partly because it affects mainly rural, low-income populations. The result is a weak evidence base for treatment and prevention. Some clinicians still rely on chloramphenicol or ciprofloxacin without clear data on resistance patterns. A well-funded research agenda could answer basic questions about transmission dynamics and drug efficacy, but that agenda does not currently exist.
The Hidden Costs of Short-Term Grants
Most tropical disease research in Peru is funded through short-term grants of two to three years. This creates several problems. First, it discourages longitudinal studies that require years of follow-up. Second, it forces researchers to spend significant time writing proposals instead of doing science. Third, it makes it difficult to maintain laboratory infrastructure and trained staff between grants.
Think of chicha fermentation: if you stop feeding the culture, the fermentation stops. The same is true for research teams. A lab that loses its funding for six months may lose its most experienced technician, and rebuilding that capacity takes years. Short-term grants are like intermittent feeding—they keep the culture alive but never allow it to reach full productivity.
What Can Be Done: Practical Steps
Several changes could improve funding for tropical disease research in Peru and similar countries. First, domestic governments could increase research budgets and create dedicated funding lines for NTDs. Second, international donors could shift from outbreak-specific funding to core capacity building. Third, regional collaboration—such as the Pan American Health Organization’s technical cooperation—could pool resources and avoid duplication. Fourth, universities could offer more stable career paths for tropical disease researchers, reducing brain drain.
None of these steps is easy, and none will happen quickly. But the alternative—continuing the current pattern of underfunding—means more preventable illness and death in communities that already face significant health challenges.
Frequently Asked Questions
Why is tropical disease research underfunded compared with other diseases?
Tropical diseases mainly affect low-income populations in low- and middle-income countries. Because these patients have limited ability to pay for drugs and diagnostics, pharmaceutical companies have little financial incentive to invest. Public and philanthropic funding fills some of the gap, but it is not enough to meet the need.
How does underfunding affect diagnostic testing in Peru?
Underfunding means fewer validation studies for point-of-care tests, less equipment maintenance, and fewer trained technicians. In many jungle health posts, dengue and leptospirosis are diagnosed clinically because rapid tests are unavailable or too expensive. This leads to misdiagnosis and delayed treatment.
What diseases are most affected by underfunding in Peru?
Bartonellosis, leishmaniasis, Chagas disease, and leptospirosis are among the most underfunded relative to their burden. Dengue receives more attention, but even dengue research is often reactive, increasing during outbreaks and declining when cases drop.
Can domestic funding replace international donors?
In theory, yes, but Peru’s current research budget is far too small. Increasing domestic funding to at least 1% of GDP would help, but it would require sustained political commitment. In the meantime, international donors remain essential, even if their priorities shift over time.
Next Steps for This Blog
This article is part of a series on research systems in Peru. A natural follow-up would be a glossary of key terms in tropical disease epidemiology, or a field note from a specific laboratory in Iquitos or Cusco. If you have questions about a particular disease or funding mechanism, send them through the contact page. I read every message and use them to plan future articles.