Priorities of health research in India: evidence of misalignment between research outputs and disease burden

This study examines whether and how India’s research efforts address the country’s health needs. It does so by investigating the degree of alignment between the burden of diseases in India and research efforts being undertaken in health and biomedical sciences by Indian institutions. WHO data from Global Health Estimates on Disability-Adjusted Life Years (DALYs) is used as the indicator of disease burden, and the number of publications on Web of Science as the proxy measure of research efforts. We find that the alignment between publications and DALYs in India is much lower than in high-income countries (HICs) and considerably lower than in countries such as China or Brazil. This is due to some areas of disease having little research efforts even though they have a high burden, while others receive large amounts of attention in spite of a low burden. For example, cardiovascular and respiratory diseases contribute to ~ 23% of the disease burden in India but only have a ~ 6% share of the total publications. In contrast, cancers contribute to ~ 5% of the burden, while their publication share is almost 25%. We discuss some major driving factors behind this misalignment, such as market demand associated with diseases prevalent in HICs, the academic prestige of certain disease areas, and funding opportunities in global health. We also explore whether the disparity is due to weaknesses in healthcare delivery systems in India (e.g., in neonatal conditions) rather than a lack of research.