Cross-disease spillover from research funding: Evidence from four diseases.

There is widespread appreciation for the role of research in addressing health problems. However, there is limited evidence on the extent to which research can be targeted to specific diseases. Analyses highlighting a concentration of research funding towards certain diseases have prompted growing scrutiny over the allocation of research funding. In this paper, we show that research funding targeted to a disease often results in publications relating to other diseases. Using data from the world's largest biomedical research funders, we estimated the frequency and direction of this cross-disease spillover by examining 337,573 grant-publication pairs for four diseases. We found the majority of our grant-publication pairs were cross-disease spillovers. We also found some variation between "rich" and "poor" diseases, in terms of the frequency and direction of cross-disease spillover. These differences are likely to be related to characteristics of the diseases themselves, as well as features of the research environment. One implication of frequent cross-disease spillover is that although more investment in areas of research such as neglected diseases is necessary, it may not be sufficient to improve the alignment between research funding and health needs.

Appraising research policy instrument mixes: a multicriteria mapping study in six European countries of diagnostic innovation to manage antimicrobial resistance.

This article provides prospective appraisal of key policy instruments intended to stimulate innovation to combat antimicrobial resistance (AMR). AMR refers to the ability of microbes to evolve resistance to those treatments designed to kill them, and is associated with the overuse or misuse of medicines such as antibiotics. AMR is an emerging global challenge with major implications for healthcare and society as a whole. Diagnostic tests for infectious diseases can guide decision making when prescribing medicines, so reducing inappropriate drug use. In the context of growing international interest in policies to stimulate innovation in AMR diagnostics, this study uses multicriteria mapping (MCM) to appraise a range of policy instruments in order to understand their potential performance while also highlighting the uncertainties that stakeholders hold about such interventions in complex contexts. A contribution of the article is the demonstration of a novel method to analyse and visualise MCM data in order to reveal stakeholder inclinations towards particular options while exploring interviewees' uncertainties about the effectiveness of each instrument's design or implementation. The article reports results from six European countries (Germany, Greece, Italy, the Netherlands, Spain and the UK). The findings reveal which policy instruments are deemed most likely to perform well, and why, across stakeholder groups and national settings, with areas of common ground and difference being identified. Importantly, the conclusions presented here differ from prominent policy discourse, with international implications for the design of mixes of policy instruments to combat AMR. Strategic and practical methodological implications also emerge for general appraisal of innovation policy instrument mixes.

From CBA to Precautionary Appraisal: Practical Responses to Intractable Problems.

The purpose of this essay is to critically review the design of methods for ethically robust forms of technology appraisal in the regulation of research and innovation in synthetic biology. It will focus, in particular, on the extent to which cost-benefit analysis offers a basis for informing decisions about which technological pathways to pursue and which to discourage. A further goal is to consider what (if anything) the precautionary principle might offer in enabling better decisions. And this, in turn, raises questions about why mention of precaution can excite accusations of unscientific bias or irrational, "anti-innovation" extremism. What does the polarized debate tell us about the politics around synthetic biology? In seeking more rigorous, timely, and practical ways to govern these remarkable new technologies, what might we be missing? The sophistication, diversity, and scope of synthetic biology may seem to make it a rather idiosyncratic area for exploring these general issues. It may seem to be a special case, with the bewildering pace of change amplifying the difficulties. But at root, some of the trickiest issues are just specific instances of familiar and long-standing conundrums in the governance of science and technology. The basic challenge is how to weigh up, for a wide range of potential options, the various pros and cons, as viewed from divergent perspectives, and find a way to justify the best course of action on behalf of society as a whole. This is the central problem addressed by a number of techniques in CBA. On the face of it, synthetic biology seems to present just one more application of these well-established and self-confident prescriptive methods. But there do emerge several obstinate, even prohibitive, difficulties for CBA. Although they are well acknowledged by the scholarly literature on and around this topic, they are often sidelined in practice. Yet all are central to the case for applying the concept of precaution to a field like synthetic biology. This essay will briefly explore multicriteria mapping, an appraisal method for exploring contrasting perspectives on emerging technologies, as one practical way to address them. The essay focuses on MCM, not because it presents any sort of panacea for appraisal, but because it is illustrative of the concrete implications of precaution. Setting out even just one among potentially many practical alternative methods at least refutes the last-ditch argument that CBA is the only operational choice.