LINK: Diseases not sufficiently researched

polymathwannabe

This Chart Shows The Worst Diseases That Don't Get Enough Research Money

We have already covered this topic several times on LW, but what prompted me to link this was this remark:

Of course, where research dollars flow isn't —and shouldn't be— dictated simply in terms of which diseases lay claim to the most years, but also by, perhaps most importantly, where researchers see the most potential for a breakthrough.

[Edit: a former, dumber version of me had asked, "I wonder what criterion the author would prefer," before the correct syntax of the sentence was pointed out to me.]

Opinions?

This Chart Shows The Worst Diseases That Don't Get Enough Research Money

We have already covered this topic several times on LW, but what prompted me to link this was this remark:

Of course, where research dollars flow isn't —and shouldn't be— dictated simply in terms of which diseases lay claim to the most years, but also by, perhaps most importantly, where researchers see the most potential for a breakthrough.

[Edit: a former, dumber version of me had asked, "I wonder what criterion the author would prefer," before the correct syntax of the sentence was pointed out to me.]

Opinions?

It seems to me that research funding is surprisingly well calibrated with a bias for infectous diseases as opposed to what I as an amateur would call "structural failure" collecting ischemic heart disease, stroke, injury and so on.

Looking at the "overfunded" category the worst offenders are HIV and cancer. I suppose cancer research is overfunded because people donate to causes their loved ones suffered and cancer tends to kill old people with a lot of money. But I have no good explanation for the overfunding of HIV which is a completely preventable disease on the personal level by using a condom and refraining from using IV drugs. BTW, the most successful HIV reduction programs give out free needles and condoms, reducing the need for medical treatment and of course human suffering in the first place.

Looking at the "underfunded" category we have injury, ischemic heart disease, COPD, depression, stroke. Injury is something that disproportionally affects poorer people, so I use the reverse reasoning to cancer. I have no good explanation for the underfunding of the other diseases here, except for maybe depression which has a bit of a stigma to it. At best I'd guess that heart attack and stroke do not have the spectacular, drawn out suffering like cancer and HIV treatment have.

But I have no good explanation for the overfunding of HIV which is a completely preventable disease on the personal level by using a condom and refraining from using IV drugs.

Condom usage reduces the changes of getting infected via sex by ~90% not 99.9%.

9[anonymous]11y

I too was incredibly surprised to see how close everything lies to the 1:1 line. Most overfunded only 16% over the line? Most underfunded 11% below? Holy crap, the people behind that deserve a medal. [...] I suspect cancer is probably at least partially up because there's so many subfields of cancer that don't always behave like each other. There's breast cancer, skin cancer, pancreatic cancer... a lot of the time you need to do separate research on each, and that kind of duplication might spill over into money applied. Could HIV funding levels being a bit over the ratio be a result of recent declines in disease burden but an unchanged allocation? Antiretrovirals have massively decreased the burden on the big overhang of those who got the disease over the decade before they were developed, at least in developed countries, and at least until resistant strains develop. Or perhaps the desire to end an expanding disease, thus taking into account future levels of expanded burden? It's not like advances in treating HIV are intended only for the US where the only reason it's still expanding is that the people who are infected live on for decades while on average not 'replacing' thesmselves (you can see a small dip in the number of people with the disease in the nineties, as new infection rates declined but before antiretrovirals kept those with the disease alive longer). Most of the bad effect is centered in Africa where its growing much much more rapidly. And I don't think it being preventable really enters into these calculations, as prevention has obviously not actually worked in many places. Though prevention should obviously be a big fraction of the effort against it. As for Inury being underfunded, isn't it also the case that 'research' on injury has been going on for as long as there have been people, whereas molecular biology and germ theory and the like have opened up new vistas in treating communicable diseases and many other things only in the last century

1gwern11y

I found the 'injury' entry too, but I'm not sure it is a good target for improving. 'injury' is broad. I know what HIV is, and I have a good idea of what researchers might do to improve it ('develop a vaccine'; 'discover a new drug'), but what does one do with a category like 'injury'? Presumably this category embraces everything from burning yourself on a stove to falling on ice to heavy machinery at work killing you; there's not one or a few different problems there, but thousands of distinct ones which have next to no causal mechanisms in common. (And people are frustrated by cancers...!) So research may have counterintuitively low ROI: OK, so you managed to cut stove burns by say 10% using your extremely expensive public health campaign to switch as many houses as possible from electric coils to induction heating, but stove burns were only say 5% of all accidents in the first place so your ROI works out to be terrible compared to dumping even more money into HIV or something.