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Should health research funding be proportional to the burden of disease?

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  • Joseph Millum

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.

Suggested Citation

  • Joseph Millum, 2023. "Should health research funding be proportional to the burden of disease?," Politics, Philosophy & Economics, , vol. 22(1), pages 76-99, February.
    • Handle: RePEc:sae:pophec:v:22:y:2023:i:1:p:76-99
    DOI: 10.1177/1470594X221138729
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    References listed on IDEAS

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    1. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    2. Fleurbaey, Marc, 2015. "Equality Versus Priority: How Relevant Is The Distinction?," Economics and Philosophy, Cambridge University Press, vol. 31(2), pages 203-217, July.
    3. Leslie A Gillum & Christopher Gouveia & E Ray Dorsey & Mark Pletcher & Colin D Mathers & Charles E McCulloch & S Claiborne Johnston, 2011. "NIH Disease Funding Levels and Burden of Disease," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-9, February.
    4. Parfit, Derek, 2012. "Another Defence of the Priority View," Utilitas, Cambridge University Press, vol. 24(3), pages 399-440, September.
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