Exploring Why Global Health Needs Are Unmet by Public Research Efforts: The Potential Influences of Geography, Industry, and Publication Incentives
31 Pages Posted: 5 Oct 2019
Date Written: September 24, 2019
It has been ben well established that research is not addressing health needs in a balanced way: much more research is conducted in diseases with more burden in high income countries than in diseases in lower income countries. In this study we document the persistence of these imbalances using WHO data on Global Burden of Disease against bibliometric information as a proxy for research efforts: we find that disease more prevalent in high income countries generate ten-fold more research than those in low income countries. Then we investigate some of the potential drivers for these imbalances. First, we look at the geographic distribution of disease burden and research. We observe that countries drive their research according to national health needs while contributing a bit to global needs. Since research is heavily concentrated (about 80%) in high income countries, this results in a relative lack of attention to disease in lower income countries. However, a new finding is that diseases with a similar burden in high and middle income countries are also under-researched even in relation to their burden in both high and middle income countries. Second, we find that disease focus of global industrial R&D is very similar to the disease focus of public research, suggesting that public and industrial priorities are coupled. Third, we look into publication journal and citation patterns across diseases to inquire into the influence of academic prestige and evaluation practices. No bias is found in representation of diseases among the 25% most prestigious journals. However, in middle income countries citation rates are found to substantially decrease for diseases most prevalent in low and middle income countries, which may constitute a disincentive to address them. We discuss how all three driving factors can potentially affect the relative lack of response of research to global health needs. We make publicly available the correspondence table between WHO ICD-10 disease definitions and PubMed MeSH descriptors.
Keywords: Disease burden, publication data, health needs, research
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