Emerging disease require an array of responses—and we can't expect scientists to automatically target the best solutions, say Matthew Wallace and Ismael Ràfols.
In a few months, the Zika virus has gone from being the cause of a neglected tropical disease to a top priority for government and international agencies. Like so many diseases affecting the world’s poorest people, there is a lack of previous research leading many to believe that solutions lie in the development and application of new knowledge.
The virus poses challenges for disciplines such as public health, epidemiology and vaccine development, but it also poses fundamental science policy questions, namely how should we allocate funds across research areas, and how can efforts be most effectively coordinated?
Such challenges require a rapid response. There are many examples to draw on; our own work has looked at the research driven by the rise in avian influenza (H5N1) infections in humans beginning around 2003. This spurred many research lines worldwide aimed at mitigating the risk of a global pandemic, from the development of vaccines, to antivirals, to understanding the socioeconomic determinants of the disease.
The choice between avenues of public research hinges on preferences for different interventions, from the technological to the social, but also on ideas about how risk is distributed and how benefits should accrue. This can be linked to the many controversies that have plagued influenza research, from the dangers of dual-use research to the inequitable distribution of vaccines.
Most importantly, the fate of different research lines depends on the many interests and incentives that define public academic research. These include the editorial tastes of high-profile journals, the mandates and priorities of large institutions, and industry interests, especially among pharmaceuticals.
These diverse interests will shape how we study—and ultimately intervene in—challenges such as Zika. This means that, from the outset, one should think critically about where research is headed. Where are funders and journals focusing their attention? What directions have the most influential organizations, such as the World Health Organization, taken? What financial interests might come into play? We must remember that researchers are driven not only to help tackle the Zika problem, but also by factors such prestige and career progression.
Those who fund and do research need to consider projects as part of a portfolio, and consider their own portfolio within a broader global landscape of possible and existing research avenues. A portfolio perspective means considering the need for diversity—particularly in the face of high levels of uncertainty, as is the case with Zika. A focus on a single effect or intervention could be disastrous, potentially locking in a small number of technological trajectories for years to come. Zika is inherently tied to its local context; understanding and tackling it means considering not only the pathogen, but also questions of gender and poverty, among many socioeconomic and political issues.
Diversity in research does not simply mean trying everything and hoping something works. Rather, a portfolio approach implies trying harder to connect research to societal outcomes. Easier said than done, perhaps, as research may lead to unanticipated results. Even in the face of uncertainty, it is worth increasing efforts to make sure the supply of research matches demand, mapping out what capacity exists to tackle issues such as Zika and what types of new knowledge are required by public health officials, patients, health care practitioners and so on.
Finally, a research portfolio should be more than the sum of its parts. Efforts should be made to seek out synergies and complementarities and to find ways of coordinating among individual projects and programmes or portfolios around the world. Data-sharing and new tools to map the landscape of publications and funding are two of many ways that can foster a systemic approach that moves beyond disciplinary boundaries.
Calls for more research are both a technical and political imperative in response to the recent Zika outbreaks and, more broadly, inform a growing understanding of the need for better pandemic preparedness. One can think of such an event as a shock to the public research system, to which it can respond by injecting or reallocating funds and reconfiguring programmes or projects.
Despite the need to respond quickly, one cannot simply assume that the research system will self-optimise or that the most conventionally excellent science is most likely to yield a solution. Rather, in designing calls or programmes, there’s an opportunity for researchers and policymakers to take a broader view of the problem, reflecting on how the components of research are connected and on the implications for global public health. This will improve our chances of not only reducing the harm from Zika, but also mitigating the impacts of future pandemics.
Matthew L Wallace and Ismael Ràfols are at Ingenio (CSIC-UPV), Universitat Politècnica de València, Spain.
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This article also appeared in Research Europe