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Is research responding to health needs?

Ismael Ràfols, Ingenio (CSIC-UPV), Universitat Politècnica de València; Alfredo Yegros, University of Leiden (Netherlands)
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When we compare the impact of each disease with the intensity of the research dedicated to it, we can observe substantial misalignments between effort and needs. Conditions such as depression or stroke, despite affecting millions of people worldwide, attract relatively little research. The same happens with health conditions prevalent in low- and medium-income countries such as malaria and tuberculosis: given their impact, they would deserve more investment in R&D.
Key points
  • 1
       Current research evaluation systems attach priority to scientific visibility (for example, publication in top specialised journals), which may be preventing the resulting knowledge from being as useful to society.
  • 2
       On a global level, cancer represents over 22% of global medical publications, even though its disease burden does not reach 10% of the total. Cardiovascular, infectious and parasitic diseases represent over 16% of disease burden, but less than 10% of publications.
  • 3
       In Spain, conditions such as stroke, depression, colon and lung cancer and chronic obstructive pulmonary disease are researched less than one would expect from their incidence levels.
  • 4
       To be more sensitive to social needs, research priorities must be based on evidence about health needs, information from other sectors affected by health R&D and on dialogue with patients.
Disease burden versus research effort, Spain
gasto+sanitarioEN-03_strat.png

This graph represents the impact of different diseases (as a percentage of the total burden of all diseases) against the proportion of scientific publications (as a percentage of the total of scientific publications on diseases). Those situated below the 45° line have a level of publications proportionately lower than their disease burden, therefore could be qualified as   “under-studied”. In those lying above the same line, there are relatively more publications than their disease burden. Conditions with a high disease burden on a worldwide level but little burden on a national level are usually researched more than the country needs, and constitute a contribution by local research to global health.

In health, everything counts

We can take the case of obesity as an example. Given that resources are limited, many of the sectors affected agree that more intense research is needed on social and psychological factors related with the food industry, consumer patterns and sedentary lifestyles, rather than prioritising biological knowledge or improving therapeutic focuses, such as surgery.

Global health, local research

All over the world, health equity is considered to be a shared value, and one that can be promoted by supporting research into global health. Furthermore, globalisation means that lifestyle habits and infectious diseases today have consequences for health across the planet. 

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