02623nas a2200277   4500000000100000008004100001260005300042653000900095653002200104653001100126653001700137653001900154100002000173700001500193700002300208700002000231700002500251700001600276700001700292245011800309856007300427300000900500490000700509520181500516022001402331       2025                            d  c12/2025bSpringer Science and Business Media LLC10aDALY10aHealth innovation10aBrazil10aGlobal south10aPublic Funding1 ade Oliveira JHP1 aArruda IES1 ade Sena Júnior MR1 ade Oliveira FHC1 ade La Roca Soares MF1 aGadelha CAG1 aSobrinho JLS00aBeyond DALY: public funding of health innovation in Brazil as a political strategy for equity in the Global South  uhttps://link.springer.com/content/pdf/10.1186/s12889-025-25539-2.pdf  a1-120 v263 a<p><strong>Background</strong></p>

<p>Disability-adjusted life years (DALYs) are widely used to prioritize public funding for science, technology and innovation (ST&amp;I) in health. In universal systems such as Brazil’s Unified Health System (SUS), however, allocation decisions may also incorporate broader political and social considerations. Objective: To assess whether Brazilian public ST&amp;I funding for neglected tropical diseases (NTDs) and Zika (2006–2019) aligned with disease burden measured by DALYs, and to examine how observed funding patterns reflect political commitments to health equity and innovation in the Global South.</p>

<p><strong>Methods</strong></p>

<p>Cross-sectional analysis of national research calls (2006–2019). Actual disbursements were compared with expected values proportional to the DALY distribution for each disease. Associations between DALYs and funding were evaluated using Spearman correlation.</p>

<p><strong>Results</strong></p>

<p>High-burden diseases—including tuberculosis, Chagas disease and schistosomiasis—received less funding than expected, while Zika and leprosy obtained disproportionately higher investments. Overall, the correlation between DALYs and funding was weak and not statistically significant; a significant negative trend emerged within a subgroup of major NTDs.</p>

<p><strong>Conclusions</strong></p>

<p>DALYs did not operate as the sole criterion guiding Brazil’s ST&amp;I funding. Political urgency, social mobilization and SUS operational priorities influenced allocation, indicating that ST&amp;I functions not only as a technical instrument but also as a political strategy to reduce health inequities and foster context‑appropriate innovation for vulnerable populations in the Global South.</p>
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