Background Assessment of the spending on health research in India is not available to understand gaps.

Objectives We analyzed this for fiscal years 2007–08 to 2011–12.

Methods We compiled a list of health research institutions in India from various sources and sent to them questionnaires requesting data on funding for health research projects from 2007–08 to 2011–12. We assessed funding for diseases compared with their contribution to disease burden in India as estimated by the Global Burden of Disease Study 2013, and classified research projects for basic, clinical and public health research. We estimated research spending by pharmaceutical companies in India from the Prowess database.

Result Of the 1,325 eligible institutions, 880 (66.4%) responded, reporting funding for 15,418 eligible health research projects. Adjusting for non-participation, Indian Rupees 42 billion (US$925 million) was available to institutions in India for health research over the five-year period. While the major non-communicable diseases, i.e. ischemic heart disease, COPD, stroke, low back and neck pain, and depression caused 20% of the disease burden in India, only 4% of the disease-specific funding was for these causes. Injuries caused 12% of the disease burden but had only 2% of the funding. There were such mismatches for some major communicable diseases too. US$4.64 billion was spent by the pharmaceutical industry in India on basic and clinical research during this five-year period. Considering the institutional and industry health research funding together, only 3% was spent on public health research. Annual per-capita spending on health research was less than US$1, equivalent to 1% of the health spending and 0.06% of the per-capita GDP in India.

Conclusion Strategic mechanisms are needed in India to address the modest health research funding, funding mismatches for the leading causes of disease burden, and meagre funding for public health research, to enable health research to more effectively improve population health.