{"title":"Should health research funding be proportional to the burden of disease?","authors":"J. Millum","doi":"10.1177/1470594X221138729","DOIUrl":null,"url":null,"abstract":"Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/AIDS research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific opportunities are equal, each patient merits research into their condition proportional to the burden of disease for which that condition is responsible. This claim—the proportional view—is widely accepted but has never been fully specified or defended. In this paper, I explain what is required to specify the view, attempt to do so in the most charitable way, and then critically evaluate its normative underpinnings. I conclude that a severity-weighted proportional view is defensible. I close by drawing out five key lessons of my analysis for health research priority-setting.","PeriodicalId":45971,"journal":{"name":"Politics Philosophy & Economics","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Politics Philosophy & Economics","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1177/1470594X221138729","RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 2
Abstract
Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/AIDS research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific opportunities are equal, each patient merits research into their condition proportional to the burden of disease for which that condition is responsible. This claim—the proportional view—is widely accepted but has never been fully specified or defended. In this paper, I explain what is required to specify the view, attempt to do so in the most charitable way, and then critically evaluate its normative underpinnings. I conclude that a severity-weighted proportional view is defensible. I close by drawing out five key lessons of my analysis for health research priority-setting.
卫生研究的公共资助者受到了广泛的批评,理由是他们对特定疾病研究的资金分配没有反映出不同疾病所造成的相对负担。例如,美国国立卫生研究院(National Institutes of Health)在艾滋病毒/艾滋病研究上的预算占比要大得多,在偏头痛研究上的预算占比要小得多,而这两项研究对美国疾病负担的相对贡献则要小得多。这种批评隐含着一种规范的主张:只要科学机会是平等的,每个病人都值得研究他们的病情,与病情所造成的疾病负担成正比。这一观点——比例观点——被广泛接受,但从未被充分说明或辩护过。在本文中,我解释了具体说明观点所需的条件,试图以最宽容的方式这样做,然后批判性地评估其规范基础。我的结论是,严重性加权比例观点是站得住脚的。最后,我从我的分析中总结了卫生研究确定优先事项的五个关键经验教训。
期刊介绍:
Politics, Philosophy & Economics aims to bring moral, economic and political theory to bear on the analysis, justification and criticism of political and economic institutions and public policies. The Editors are committed to publishing peer-reviewed papers of high quality using various methodologies from a wide variety of normative perspectives. They seek to provide a distinctive forum for discussions and debates among political scientists, philosophers, and economists on such matters as constitutional design, property rights, distributive justice, the welfare state, egalitarianism, the morals of the market, democratic socialism, population ethics, and the evolution of norms.