Drawing on a study of priorities in health research, Moumita Koley, Ismael Rafols and Alfredo Yegros argue a metascience approach can refocus Indian research towards areas that are most needed by Indian society and that are understudied globally.
India recently launched a new funding agency, the Anusandhan National Research Foundation (ANRF). Its mission is to redefine its research and innovation landscape. During the first meeting of the ANRF Governing Board, chaired by Prime Minister Narendra Modi, emphasis was placed on steering research towards addressing societal needs. This poses a challenge for Indian research, balancing engagement in global science, with meeting the localised needs of Indian society.
Achieving this type of localised impact from research requires rethinking India’s research funding strategy. Specifically, it means shifting away from response-based funding relying solely on academic notions of quality (the traditional “free play of intellects” model) to an evidence-informed strategy that prioritises societal relevance, equity, and sustainability. The ANRF has the potential to drive this transformation, but it requires a move away from the conventional top-down model where policy decisions are made by a few science leaders and adopting a strategy-based on meta-research.
The ANRF has the potential to drive this transformation, but it requires a move away from the conventional top-down model where policy decisions are made by a few science leaders and adopting a strategy-based on meta-research.
In a recent case study, we identified a clear example in Indian health research where a metascience approach could serve to better align Indian research priorities and needs. The most common assessment of a population’s health is calculated by the WHO with a composite metric of mortality and morbidity, the ‘burden of disease’. This metric estimates the years of life lost due to a given condition, this is the ‘Disability Adjusted Life Years’ (DALYs). We can therefore use this measure to compare the extent to which Indian research publications cover the country’s disease burden.
What we found was a larger mismatch between India’s health-related research and health needs than in other countries. Specifically, we see that the correlation between health needs (estimated by DALYs) and health research efforts (estimated by number of publications) by disease stands at 0.28 for India, while this value is 0.60 for high-income countries (HICs), and is also higher for fellow BRICS nations, Brazil (0.41) and China (0.52).
This stark misalignment in research priorities arises from a focus on diseases like cancer and Alzheimer’s, which, despite their limited impact in India, receive disproportionate attention (Fig.1). While cancers account for less than 5% of the country’s overall disease burden, it is the subject of nearly 22% of India’s health research publications. Similarly, Alzheimer’s contributes just 0.5% to India’s Disability-Adjusted Life Years (DALYs) but sees over 2% of research output. This focus is partly due to the fact that these diseases are more common in high-income countries, making them attractive research areas for Indian scholars seeking visibility in global journals. These areas may also see more global collaboration and funding opportunities from pharmaceutical companies.
Fig.1: Relative disease burden (estimated by % of DALYs by WHO) vs. research efforts (estimated by % of publications in Web of Science) for all cancers and Alzheimer’s diseases for the World (W), High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), India (IN), and Lower Income Countries (LIC).
In contrast, neonatal conditions (approximately 14% of India’s disease burden, the highest for a single disease category) account for just 2% of health research publications. Diarrheal diseases, contributing around 7% of the country’s disease burden, attract only 1% of research attention (Fig.2). These figures are notably low because such diseases are not major health concerns in high income countries. In high-income countries, infrastructures (e.g. in water, communications and transportation), well-established medical interventions and effective healthcare delivery systems have largely mitigated their impact. Addressing these gaps will not necessarily require more research on medical responses to these conditions, but rather a strengthening of India’s healthcare delivery systems. This makes a compelling argument for research to focus on how to improve public health systems.
Fig.2: Relative disease burden (estimated by % of DALYs) vs. research efforts (estimated by % of publications) for neonatal conditions and diarrheal diseases for the World (W), High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), India (IN), and Lower Income Countries (LIC).
Certain diseases are understudied globally. In high-income countries, cardiovascular diseases account for over 20% of the overall disease burden, and this figure is around 22% in upper-middle-income nations (Fig.3). Yet, research publications in these world regions only devote 10% of their total health research output to this area. The lack of balance is even more pronounced in India, where cardiovascular diseases make up 16% of the country’s disease burden (and increasing), but just 5% of health research publications focus on them. A similar trend is observed with respiratory diseases, which contribute 7% to India’s health burden, but receive only 1% of the research attention.
Fig.3: Relative disease burden (estimated by % of DALYs) vs. research efforts (estimated by % of publications) for cardiovascular and respiratory diseases for the World (W), High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), India (IN), and Lower Income Countries (LIC).
Indian funding agencies should consider funding research particularly in areas in which the population is most vulnerable. For example, a Lancet study highlights that Cardiovascular diseases are the leading cause of death and disability in India, posing a significant public health challenge. By adopting a structured and evidence-driven funding strategy, ANRF could refocus efforts to address areas of need and contribute to global knowledge at the same time.
This is easier said than done, as India’s research evaluation system currently favours quantity of publications over quality. The Indian National Ranking Framework (NIRF) was introduced in 2016 by the Ministry of Human Resource Development to help Indian universities understand their strengths and weaknesses. NIRF was modelled on the THE and QS rankings and much like these rankings factors publication in high impact journals indexed in Scopus or Web of Science heavily in its assessments. The indicators used for research quantity and quality are both prone to gaming. The effects of which are now becoming increasingly visible.
If new funding agencies like ANRF are to make a difference, citizens might also expect them to take a scientific approach to their own missions.
Retractions from India are also on rise and in terms of total retractions, Indian stands third globally. Recently, Retraction Watch released an investigation, which exposes an Indian “paper-mill” farm’s activity and how they are helping institutions to publish more papers and gather citations which then help them improve rankings significantly. These incidents show that authorities like the Ministry of Education and University Grant Commission (UGC), as well as the new ANRF, also need to focus on improving research culture for meaningful change to take place.
As public funding for research increases globally, governments and citizens expect science to contribute to address the key problems and challenges they face. If new funding agencies like ANRF are to make a difference, citizens might also expect them to take a scientific approach to their own missions.
