The COVID-19 pandemic has highlighted the significance of tailoring health research to the specific needs of individual countries. However, India’s investment in healthcare research is limited, with a misalignment between funded research areas and health challenges.
Disease burden, a composite metric of mortality and morbidity, represented through Disability Adjusted Life Years (DALYs) by the World Health Organization, is a measure of a population’s health. A recent collaborative study by the IISc in Bangalore and the Leiden University in The Netherlands shows a mismatch between India’s health-related research publications and DALYs.
Chart 1 | The chart shows India’s relative disease burden — a disease’s share in total DALYs between 2000 and 2019 — against the disease’s share in health research publications in the same period.
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Only diseases with a relatively high burden in India are plotted. Misalignments can be observed in Chart 1 with some diseases cornering a high share of health research publications, disproportionate to their burden. For instance, the share of Diabetes Mellitus in total DALYs was 3.1%, but its share in publications was 7.5%. On the other hand, the share of Neonatal conditions in the DALY was 12.3%, but its share in publications was only 1.3%.
Chart 2A | The chart plots the relative disease burden against research efforts for neonatal conditions for the world (W), high-income countries (HIC), upper-middle income countries (UMIC), India (IN) and lower income countries (LIC).
While the research share remains the same across regions, the burden is much higher in India and low-income countries.
Chart 2B | The chart plots the relative disease burden against research efforts for cardiovascular diseases for the world (W), high-income countries (HIC), upper-middle income countries (UMIC), India (IN) and lower income countries (LIC).
The chart shows that cardiovascular diseases were under-researched across all economic groups. For instance, while they formed over 20% of DALYs in high-income countries and around 22% in upper-middle-income nations, their share in total health research publications stood at just 10%. India dedicated merely 5% of its research to cardiovascular diseases, though such diseases formed 16% of its disease burden.
Chart 2C | The chart plots the relative disease burden against research efforts for cancer for the world (W), high-income countries (HIC), upper-middle income countries (UMIC), India (IN) and lower income countries (LIC).
The chart shows that despite their limited impact globally and in India, cancer (all types) received substantial research attention due to their pronounced effects on high-income countries. While all cancers contributed to less than 5% of India’s burden, they accounted for nearly 22% of its research publications.
Chart 2D |The chart plots the relative disease burden against research efforts for tuberculosis for the world (W), high-income countries (HIC), upper-middle income countries (UMIC), India (IN) and lower income countries (LIC).
Tuberculosis serves as an example of a disease with a good match in terms of its considerable research focus relative to its burden. With a 7% disease burden, India dedicates 5% of its publications to TB. The rising threat of multidrug-resistant TB even intensifies India’s commitment. (Chart 2D)
Chart 2E | The chart plots the relative disease burden against research efforts for malaria for the world (W), high-income countries (HIC), upper-middle income countries (UMIC), India (IN) and lower income countries (LIC).
The chart shows that India is channeling significant research efforts into diseases that have a lesser immediate impact domestically but pose a considerable global threat. For instance, despite having relatively low DALYs of malaria (about 0.5%) and HIV/AIDS (about 1%), the share of both in India’s research stands at about 2.5%.
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Predominantly, research focuses are shaped by the health needs of high-income countries due to their significant market demand that also drives private investments. Subsequently, prestigious scientific journals, all based in the global north, publish predominantly research on topics important to the global north. This consequently directs the flow of health funding in the global south away from its own needs.
Moumita Koley is an STI Policy Researcher, DST-CPR, IISc, and Consultant, International Science Council; Ismael Rafols is a senior researcher at CWTS, University of Leiden, and UNESCO Chair on Diversity and Inclusion in Global Science
Source: World Health Organization’s ‘Global Health Estimates’ on DALYs and the paper titled “Priorities of health research in India: evidence of misalignment between research outputs and disease burden”
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