Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.
PLoS One. 2020 Feb 10;15(2):e0228542. doi: 10.1371/journal.pone.0228542. eCollection 2020.
The need to align investments in health research and development (R&D) with public health needs is one of the most important public health challenges in Japan. We examined the alignment of disease-specific publicly competitive R&D funding to the disease burden in the country.
We analyzed publicly available data on competitive public funding for health in 2015 and 2016 and compared it to disability-adjusted life year (DALYs) in 2016, which were obtained from the Global Burden of Disease (GBD) 2017 study. Their alignment was assessed as a percentage distribution among 22 GBD disease groups. Funding was allocated to the 22 disease groups based on natural language processing, using textual information such as project title and abstract for each research project, while considering for the frequency of information.
Total publicly competitive funding in health R&D in 2015 and 2016 reached 344.1 billion JPY (about 3.0 billion USD) for 32,204 awarded projects. About 49.5% of the funding was classifiable for disease-specific projects. Five GDB disease groups were significantly and relatively well-funded compared to their contributions to Japan's DALY, including neglected tropical diseases and malaria (funding vs DALY = 1.7% vs 0.0%, p<0.01) and neoplasms (28.5% vs 19.2%, p<0.001). In contrast, four GDB disease groups were significantly under-funded, including cardiovascular diseases (8.0% vs 14.8%, p<0.001) and musculoskeletal disorders (1.0% vs 11.9%, p<0.001). These percentages do not include unclassifiable funding.
While caution is necessary as this study was not able to consider public in-house funding and the methodological uncertainties could not be ruled out, the analysis may provide a snapshot of the limited alignment between publicly competitive disease-specific funding and the disease burden in the country. The results call for greater management over the allocation of scarce resources on health R&D. DALYs will serve as a crucial, but not the only, consideration in aligning Japan's research priorities with the public health needs. In addition, the algorithms for natural language processing used in this study require continued efforts to improve accuracy.
使卫生研发（R&D）投资与公共卫生需求保持一致，是日本面临的最重要的公共卫生挑战之一。本研究旨在分析日本特定疾病的公开竞争研发资金与该国疾病负担的匹配程度。
我们分析了 2015 年和 2016 年可公开获取的卫生公共竞争资金数据，并将其与 2017 年全球疾病负担（GBD）研究中获得的 2016 年残疾调整生命年（DALY）进行了比较。通过自然语言处理，使用每个研究项目的项目标题和摘要等文本信息，根据信息出现的频率，将资金分配给 22 个 GBD 疾病组。
2015 年和 2016 年，32204 个获批项目共获得 3441 亿日元（约合 30 亿美元）的卫生 R&D 公开竞争资金。约 49.5%的资金可用于特定疾病项目。与日本 DALY 相比，有 5 个 GBD 疾病组的资金显著且相对充足，包括被忽视的热带病和疟疾（资金与 DALY 的比例为 1.7%比 0.0%，p<0.01）和肿瘤（28.5%比 19.2%，p<0.001）。相比之下，有 4 个 GBD 疾病组的资金明显不足，包括心血管疾病（8.0%比 14.8%，p<0.001）和肌肉骨骼疾病（1.0%比 11.9%，p<0.001）。这些百分比不包括无法分类的资金。
虽然需要谨慎，但由于本研究未能考虑公共内部资金，且方法学不确定性无法排除，因此该分析可能提供了一个有限的视角，了解特定疾病的公开竞争资金与该国疾病负担之间的有限匹配程度。结果呼吁在卫生 R&D 资源配置方面加强管理。DALY 将成为与公共卫生需求保持一致的重要（但不是唯一）考虑因素。此外，本研究中用于自然语言处理的算法需要继续努力提高准确性。
