By Tanya Parish
(Inside Science Minds) -- As a research scientist working in global health, I was horrified by the sudden emergence of the Ebola virus in 2014, followed by Zika last year. Stories of death and deformity caused by these infectious diseases dominated the news, and money quickly flowed toward finding ways to prevent and cure them.
As a research scientist dedicated to battling tuberculosis, however, I also have a deeper concern.
The world is facing serious health risks from both short-term crises and long-term epidemics. Yet headlines declaring emergencies divert attention from the more persistent diseases like tuberculosis, an ancient scourge that still kills some 1.5 million people every year. It is counter-productive and short-sighted to be chasing and funding each new disease whenever fear strikes society, without regard to the bigger picture. We need a way to allocate research funding for health based on the importance of the disease.
It's not easy doing important science and research in a world driven by psychological impulses. Most science requires a long time to deliver anything useful and the ever-changing priorities of society mean decision makers rarely have the patience needed to stay the course. The focus on immediate problems soaks up resources, so that our medium-term and long-term problems don't get solved.
People are naturally frightened by catastrophic events and tend to worry more about their impact, compared with more predictable and less dramatic occurrences. Many are more scared of flying in airplanes than driving in cars, for example, even though the risk of injury or death is much greater on the road. Climate change is one of the deadliest threats to the future of humanity, and yet the hardest to address because it is a long-term problem and therefore easier to put off.
As with the terror of a well-crafted horror film, the fear of something new and unknown is very powerful. We are programmed to deal with the immediate, so that we can survive in the present. That is why the idea of a global pandemic spreading rapidly and out of control is very frightening, even if the chance of it happening is low.
Scientists pay the price for this short attention span. We are often in competition for scant resources – when new areas open up, existing funding may disappear, so we end up chasing newer projects even before our work is complete. Research funding gets reallocated, usually from a fixed pool, as it is rare that the overall funding pot for global health research gets increased.
The challenge of an erratic response to global health risks is aggravated by the fact that we have no consistent means to allocate research dollars.
In basic research, people are aiming to build new knowledge and they place a high priority on innovation. Experience, expertise and skills are important in approaching a hypothesis. In translational research – taking an idea and turning it into a drug or a vaccine – companies look at the potential return on investment. Foundations and non-profits try to fill in the gaps by looking at diseases of poverty.
The filter applied for funding decisions is even more prosaic. Funding depends on the agency awarding it and some agencies have multiple mechanisms. For example, much of the funding from the National Institute of Health comes via open calls for grants. These calls do not allocate money to particular diseases, but fund the best ideas, so grants are not always evenly distributed between different diseases. There is some mitigation in that independent reviewers do rate the significance of an area, which can include how big an impact a successful project would have. The NIH and other agencies may also have specific calls to address particular problems, and they sometimes earmark funding for specific diseases. Yet even this can fluctuate. NIH set aside money for Ebola, for example, and now that has been diverted to Zika research.
The way society reacts to risk, and the level of advocacy that develops around certain diseases, can also impact funding decisions directly. Long-simmering neglected diseases of poverty, such as tuberculosis or malaria, often suffer as a result.
As the world struggles with Zika, and girds itself for the next unpleasant surprise, it is crucial to educate people about risk and how best to evaluate it. I don't think it is realistic to say we could drive emotion or intuition totally out of the process, but we need to be able to do it in a more balanced, rational and thoughtful way.
We need a more scientific approach to funding scientific research. It won't be easy to evaluate short-term crises against long-term epidemics, but too many lives are at stake to shy away. Scientists have a key role to play in educating decision makers on risk and helping to get that balance right.
Tanya Parish is the Vice President of Drug Discovery at IDRI where she heads the TB Discovery Research group. Her work focuses on the discovery of new drugs that are effective at curing drug-sensitive and drug-resistant tuberculosis with the added goal of shortening the time it takes to cure the disease. Tanya has edited several books on mycobacteria and published numerous papers on the basic biology and genetics of M. tuberculosis. She is Editor-in-Chief of Microbiology (UK), on the Editorial Board for PLOS One, PeerJ and Frontiers in Cell and Infection Microbiology.
This article was originally posted on Inside Science.
