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Why we need a new strategy for health research in Europe

European Medical Research Councils - along with learned societies and patients’ groups - make the case for changes to the Horizon 2020 proposals – calling for increased spending on biomedical science and the creation of a European Clinical Research Fund


Professor Roger Bouillon of the EMRC Core Group
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Health and healthcare are highly valued in all societies. In Europe we collectively spend about 10 per cent of our GDP - or €2,730 per person, per annum, on healthcare.

Health research and health researchers are also highly esteemed. However, in Europe we spend only about €40 per person, per year, across the broad field of biomedical and health research. To put this in context, spending per capita on alcohol and tobacco is about 20-fold higher.

Through national research funding agencies, most countries in Europe spend in the region of 25-35 per cent of their overall research budget on biomedical and health-related research. In contrast, the European Union’s Framework Programmes have devoted less than 15 per cent of total funding to medical research.

And as things stand in the proposed Horizon 2020 plans, only around 11 per cent of the total budget of €80 billion will be dedicated to biomedical and health-related research. This, despite the fact that biomedical and clinical research generates more than 50 per cent of the research output in Europe, as measured by the number of journal papers and citations.

Multiple benefits from biomedical research

Both in absolute terms and relative to GDP, the US spends more on health care, at about €6,400 per head (at purchasing power parity exchange rates). In addition, about 50 per cent of all US public research funding goes to medical research, translating to public spending for biomedical research per capita that is about 3.5 times higher than in Europe.

It goes without saying that this situation is far from optimal for European citizen and societies – given that biomedical and health-related research generates multiple benefits:

1. First, patients (that is, sooner or later, all of us) benefit from better research, as it improves health and quality of life. There is ample evidence of the very high social impact of biomedical research, from vaccination and medical imaging, to drugs against infections, cardiovascular and metabolic disease, to the major progress in treating childhood cancers – which the large majority of children now survive.

This also translates into an important economic benefit, as amply demonstrated in the UK report, the Wellcome Trust RAND publication, ‘Medical Research: What's it worth?’ which points to a return on investment of more than 30 per cent per year over many years.

2. The health research community and healthcare providers gain important insights from better understanding of diseases, leading to improvements in prevention, diagnosis and treatment, and underpinning better decision-making and greater efficacy.

3. Industry is also highly dependent on public healthcare investment and research, and is increasingly drawn into collaborations with publicly-funded researchers, receiving public funding for projects to translate research through to treatments. Private investment by pharmaceutical companies in the US is 2-fold higher than in Europe and the gap is growing. For biotech and SME companies the difference is even greater. Moreover biomedical and clinical research is an important driver of innovation and high-quality employment.

4. Healthcare costs are rising rapidly around the world but a large percentage of these expenses are not productive (as much as 30 per cent in the US, according to recent 2012 report in the New England Journal of Medicine and in the Journal of the American Medical Association, and an unknown percentage in most European countries). Medical research could generate solutions to health problems so that health care budgets are better invested, leading to an improved cost-benefit ratio.

Tax payers are the losers

At its meeting in Prague on 4-5 October 2012, the Standing Committee of the European Medical Research Councils (EMRC) discussed the need to attract the attention of all parties involved.

First, the public at large should be better informed about the funding shortfall in Europe compared to the US, as they are not only the final tax payers, but also the first losers in the undesirable and unfortunate situation facing biomedical and health research.

Secondly, we call upon all patient organisations, scientific societies and medical academies, to convince our policy-makers to urgently change this research situation. 

Above all, we ask the European Commission, especially the Commissioners for Research and Health, and all members of the European Parliament, to amend the Horizon 2020 proposals to substantially increase the total amount of European investment in biomedical and health research. We ask them to increase investment in the field of biomedical and health research in general, to reach at least the same level as the national or regional funding agencies (an increase of 25-35 per cent).  

A European Clinical Research Fund

With due respect to the subsidiarity principle, EMRC proposes as a top priority that this extra European budget should be invested in a new funding mechanism, modelled on the principles of the very successful European Research Council, to support clinical or health research projects that require a multinational approach to be efficient. This would include clinical trials for rare diseases, research on new aspects of medicine such as personalised medicine, and for health research where large cohorts of patients and longitudinal follow–up over a lifetime are required to deliver statistically meaningful results.

A funding mechanism such as the one we propose is virtually totally lacking on a European scale today. Such a European Clinical Research Fund should be largely working with a “bottom-up” approach so that the best projects with the best return on investment would be funded.  A budget of  €1 billion per year, with gradual increases over time, seems most appropriate to allow the support of studies that can really make a difference for healthcare in Europe - and indeed the world.

In addition we ask the EU Parliament and Commission to start the process of overall strategic planning of health-related research in Europe and Horizon 2020, to promote innovation and combat the major challenges facing Europe and the world in this field. 

EMRC asks all parties involved to support such an innovative European initiative, which would fill a real gap in the European Research Area and would benefit all its citizens, and the world community.

Signed on behalf of all members of the Standing Committee of the European Medical Research Councils (EMRC) of the European Science Foundation (ESF):

Professor Roger Bouillon, MD, PhD, FRCP (London)
EMRC Core Group (2005-2012).

Emeritus Professor of Medicine, KU Leuven, Belgium

Roger.bouillon@med.kuleuven.be

 

Professor Liselotte Højgaard, R, MD DMSc
EMRC Chair (2006-2012).

Director, Professor, Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen and Danish Technical University, Denmark

liselotte.hoejgaard@rh.regionh.dk

Approved by all members of the Core Group and Standing Committee of the European Medical Research Councils (EMRC) of the European Science Foundation (ESF):

EMRC Core Group:

Professor Giovanni Pacini 2010-2012
Consiglio Nazionale delle Ricerche (CNR), Italy

Professor Martin Röllinghoff 2006-2012
Deutsche Forschungsgemeinschaft (DFG), Germany

Professor Stig Slørdahl 2008-2012
The Research Council of Norway (RCN), Norway

Professor Josef Syka 2009-2012
The Czech Science Foundation (GAČR), Czech Republic

Dr Mark Palmer 2006-2012
Medical Research Council (MRC), United Kingdom

Professor Isabel Varela-Nieto 2007-2012
Consejo Superior de Investigaciones Cientificas (CSIC), Spain

Dr Claire Giry 2012
Institut national de la santé et de la recherche médicale (Inserm), France

EMRC Standing Committee:

Professor Hans Lassmann
Österreichische Akademie der Wissenschaften (ÖAW), Austria

Professor Leopold Schmetterer
Fonds zur Förderung der Wissenschaftlichen Forschung in Österreich (FWF), Austria

Professor Pierre Gianello
Fonds National de la Recherche Scientifique (FNRS), Belgium

Professor Chantal Mathieu
Fonds voor Wetenschappelijk Onderzoek (FWO),
Belgium

Professor Bogdan Petrunov
Bulgarian Academy of Sciences (BAS),
Bulgaria

Professor Krešimir Pavelic
Croatian Academy of Sciences and Art (HAZU),
Croatia

Professor Niels Frimodt-Møller
Danish Medical Research Council (FSS),
Denmark

Professor Raivo Uibo
Estonian Research Council (ETAG),
Estonia

Professor Tuula Tamminen
Academy of Finland,
Finland

Dr Emmanuelle Wollman
Centre National de la Recherche Scientifique (CNRS), France

Professor Andrew Margioris
The National Hellenic Research Foundation (NHRF), Greece

Dr János Réthelyi
Hungarian Academy of Sciences (MTA) & Hungarian Scientific Research Fund (OTKA),
Hungary

Dr Jona Freysdottir
Icelandic Center for Research (RANNIS),
Iceland

Professor Limas Kupčinskas
Research Council of Lithuania,
Lithuania

Professor Marcel Levi
Netherlands Organisation for Scientific Research (NWO), Netherlands

Professor Anna Czlonkowska
Polish Academy of Sciences (PAN),
Poland

Professor Isabel Palmeirim
Fundação para a Ciência e Tecnologia (FCT),
Portugal

Professor Simona-Maria Ruta
National University Research Council (NURC),
Romania

Professor Richard Imrich
Slovak Academy of Sciences (SAV),
Slovak Republic

Dr Carlos Segovia
Institute of Health Carlos III (ISCiii),
Spain

Professor Mats Ulfendahl
Swedish Research Council (VR),
Sweden

Professor Haluk Topaloğlu
The Scientific and Technological Research Council of Turkey (TÜBITAK), Turkey

This motion is also supported by a growing list of science and patient organisations:

European Organisation for Research and Treatment of Cancer (EORTC)

A number of members of the Alliance for Biomedical Research in Europe:

  • European Association for the Study of Diabetes (EASD)
  • European Atherosclerosis Society (EAS)
  • European Association for the Study of the Liver (EASL)
  • European Cancer Organisation (ECCO)
  • European Federation of Neurological Societies (EFNS)
  • European Renal Association – European Dialysis and Transplant Association (ERA-EDTA)
  • European Respiratory Society (ERS)
  • European Society of Cardiology (ESC)
  • European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
  • European Society of Hypertension (ESH)
  • European Society of Human Reproduction and Embryology (ESHRE)
  • European Society of Radiology (ESF)
  • United European Gastroenterology (UEG)

References:

ESF-EMRC White Paper I
Present Status and Future Strategy for Medical Research in Europe
November 2007
http://www.esf.org/research-areas/medical-sciences/publications.html

ESF-EMRC White Paper II

A Stronger Biomedical Research for a Better European Future
September 2011
ISBN: 978-2-918428-35-0
http://www.esf.org/research-areas/medical-sciences/publications.html

Investigator-Driven Clinical Trials

ESF-EMRC Forward Look Report
March 2009
ISBN:  2-912049-95-4
www.esf.org/idct

Medical Research: What’s it worth?
Estimating the economic benefits from medical research in the UK.
Health Economics Research Group, Office of Health Economics, RAND Europe.
London: UK Evaluation Forum; 2008
ISBN: 978-1-84128-080-5
http://www.wellcome.ac.uk/About-us/Publications/Reports/Biomedical-science/WTX052113.htm
Eliminating Waste in US Health Care

Berwick DM; Hackbarth AD
JAMA
. 2012; 307(14): 1513-1513.
http://jama.jamanetwork.com/article.aspx?articleid=1148376

From an Ethics of Rationing to an Ethics of Waste Avoidance

Brody H
N Engl J Med
2012; 366: 1949-1951,
http://www.nejm.org/doi/full/10.1056/NEJMp1203365
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Related subjects: Horizon 2020, European Medical Research Councils, European Clinical Research Fund

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