National Institutes of Health Funding for Tuberculosis Comorbidities Is Disproportionate to Their Epidemiologic Impact.

"Potential conflicts of interest. All authors: No reported conflicts of interest."

"Funding Table 2 shows the total funding for each comorbidity in the yearly searches. In each search, studies that focused on the relationship between HIV and TB received substantially higher funding (eg, $87.6 million in 2018–2019) as compared to all other risk factors. In 2 search years, TB-tobacco use received no funding, and in 2018–2019 it received only $192 000. TB-undernutrition, despite having the largest PAF for incident TB, often received less funding than TB-HIV, TB-diabetes, and TB-alcohol use. A detailed list of studies along with study description is available in Supplementary Table 2. Table 2.Funding for Each Search, Compared to the Population Attributable FractionComorbidityFunding 2009Funding 2014Funding 2018–2019Population Attributable Fraction (2019)Undernutrition$1.4 million$1.2 million$1.2 million19.0%$2.8 million$2.4 millionAlcohol use$582 000$455 000$5 million8.1%$1.2 million$910 000HIV$14.2 milliona$24.6 millionb$87.6 million7.7%$28.4 million$49.2 millionTobacco use$0$0$192 0007.1%$0$0Diabetes$619 000$2.5 million$6 million3.1%$1.2 million$5 millionFor direct comparison with 2018–2019 funding levels, italicized figures represent the yearly funding doubled, that is, if 2 years were included instead of only 1 year. Funding levels are shown as United States dollars.Abbreviation: HIV, human immunodeficiency virus.aTwenty-seven studies were excluded as they did not have an abstract.bForty-five studies were excluded as they did not have an abstract. Financial support. This work was supported by the Warren Alpert Foundation (grant number 6005415) to P. S.; the Burroughs Wellcome Fund/American Society for Tropical Medicine and Hygiene (100000861 and 100001949) postdoctoral fellowship to P. S.; the National Institute of Allergy and Infectious Diseases (grant number 5T32 AI-052074-13 and K01AI167733-01A1 to P. S.); and the Civilian Research and Development Foundation (grant number DAA3-19-65673-1 and 100004419), as well as federal funds from the government of India's Department of Biotechnology (501100001407) and the Indian Council of Medical Research. Financial support."