Twenty years of USAID and NIH eye health funding for Sub-Saharan Africa: A descriptive analysis of a bibliometric dataset

• U.S. federal agencies funded a large proportion of SSA eye health research • These agencies predominantly funded SSA trachoma research • USAID-funded publications increased over two decades prior to recent dissolution • Sustained funding may be essential for preventing avoidable blindness Given recent United States Agency for International Development (USAID) cuts and restructuring of National Institutes of Health (NIH) foreign subawards, we identify the proportion of eye health research publications from Sub-Saharan Africa (SSA) funded by the U.S. government, trends over twenty years, and publication characteristics associated with U.S. government funding between 2003 and 2022. A descriptive, bibliometric analysis. Eye-health research publications in SSA A systematic literature search of eye-health publications in SSA was performed. Following eligibility screening, 1,777 publications were included for manual data extraction and statistical analysis. Outcome measures included U.S.-government-, USAID-, and NIH-funded publications. USAID and the NIH funded 10% (98/960) and 16% (153/960) of SSA research publications that cited a funding source, respectively. The annual percentage of USAID-funded publications increased (p<0.001), but NIH-funded publications did not change (p=0.961), between 2003 and 2022. USAID- and NIH-funded publications were primarily focused on trachoma; listed as a funder for 19% (94/507) and 22% (113/507) of trachoma publications that cited funding sources. Publications in journals with medium (>2.5-4) and high (>4) impact factors had 6.3 [4.0, 10.0] (p<0.001) and 9.7 [6.2, 15.6] (p<0.001) times the odds of NIH funding vs no or low (0-2.5) impact factors. Randomized trials had 9.1 [6.3, 14.3] (p<0.001) times the odds of NIH funding vs other designs. USAID and the NIH were important funders in two decades of SSA eye-health research, especially related to trachoma control. Sustained U.S. federal investment and securing diversified funding sources may be essential for continued progress toward preventing avoidable blindness.