Research output is forever increasing — an average of seventy-five trials, and eleven systematic reviews per day, on the last count, which adds up to over twenty-seven thousand trials per year — but does this mammoth volume of studies deliver answers to the questions that really matter? Some have argued that research prioritisation is flawed because patients and clinicians are not sufficiently involved in setting research agendas, and because over half of studies are done without reference to systematic reviews of prior evidence.
Consequently there is a huge, and avoidable burden of waste in the research process. It’s not that we need less research rather than more (the banal conclusion of so many published studies) — but that we need more of the right kind of research, done in the right way. So how does research funding correlate with the burden of disease? An analysis of US National Institutes of Health funding streams shows that certain areas are “overfunded” relative to their burden in the US (such as HIV/AIDS, breast cancer, and diabetes) and others, largely including conditions associated with substance use or mental health, are badly underfunded (such as lung cancer, chronic obstructive pulmonary disease, alcoholism, and depression). On a global scale, the same inequity holds, but to an even greater degree. There is no evidence that this situation has changed following more explicit recommendations regarding priority setting for research.
Earlier this year, PLoS Medicine issued a Call for Papers, in conjunction with the World Health Organization, on the theme of “No Health Without Research”. The aim of this Collection was to highlight case studies and policy articles which demonstrate how key functions of national health research systems can be strengthened. A particular focus in the Call was on how countries can prioritise health research questions in order to generate the kind of evidence which is truly relevant to their health needs. We have had a fantastic response to the Call for Papers. Articles accepted for publication in PLoS journals are being selected by a joint WHO/PLoS panel for inclusion in the Collection, and potentially may also be highlighted in the WHO’s World Health Report for 2012.
Some of the articles chosen for inclusion in the Collection show what can be done: a Viewpoint published in PLoS Neglected Tropical Diseases discusses the special issues faced by researchers conducting trials in resource-limited settings, and how these can be overcome through global collaboration. An Essay from researchers at the Wellcome Trust and Makerere University, Uganda highlights networks which are strengthening research capacity for maternal, neonatal and child health in Africa. And a paper published in PLoS ONE describes the outcomes of a distance training model for building research ethics capacity in Peru. There is still time to have your paper included in this Collection.
We urge authors with studies describing initiatives aimed at strengthening key components of national health research systems to submit as soon as possible to stand a chance of possible inclusion in the Collection. Submit your paper / presubmission enquiry or contact us on email@example.com with queries. The Collection is being constantly updated with new content throughout 2011 and 2012, in the run up to the publication of the World Health Report 2012. We hope that by the time the World Health Report is published in 2012, the Collection will provide an abundance of compelling examples showing how the gap between research needs and relevant research output can be narrowed.