Put Your Money Where Your Disease Is

She decided to support those with ALS by becoming wheelchair-bound.

Remember the ice bucket challenge? Have you ever worn pink to support the fight against breast cancer? Fundraisers are becoming better and better at recruiting the public in the effort to cure diseases. However, it is also true that some ailments receive much more attention and funding than others. To analyze which diseases might be under-researched or short on funding, I’ve compiled some data from across the web. I’ll look at where industry, the government, and charities are focusing their spending.

This is not an indictment of anyone for giving or not giving to a charity. If you feel compelled to donate to a particular cause, I would encourage you to do so. This article isn’t a call for more or less taxpayer money to go towards research. I simply want to draw attention to the disparities in funding, so that in the future, we will think more carefully about allocating our resources.

There are several important criteria to consider when distributing funds to researching a certain disease. 1) The incidence of the disease. How many individuals does it affect? For the purposes of this article, I will primarily be discussing incidence rates in the United States. 2) The death rate. Obviously, diseases with higher mortality rate should be given higher priority. It is difficult to balance the importance of death rate vs. incidence rate. An infection like the common cold affects a huge number of people, but should it be given priority over a more deadly diseases? We must also consider how much the disease will affect your quality of life. Diabetes will, on average, have a greater impact on an afflicted person’s life than a flu virus will. Perhaps the best measure of these first two factors is the cost of disease burden. This quantifies the overall impact of the disease on our economy. 3) Curability of the disease. The common cold comes in hundreds of viral varieties. Every year, rather than put forth the huge cost and effort required to develop vaccines for all of them, we try to select those we think will be most common. Your flu shot could potentially be more effective, but for many reasons, which I’m calling “curability,” we don’t spend as much money on these diseases. The lure of a potential cure will cause more money to flow towards research.

Who Funds Research

Obtained from “The Anatomy of Medical Research”

This graph illustrates who exactly funds medical research. The amount of annual funding has slowed after the recession, but has had a healthy growth rate for years. Private companies fund over two-thirds of research. Government is the next largest contributor, primarily through the NIH. Foundations and charities make up a sliver of the contributions to research, although every bit helps.

The NIH

Obtained from “NIH Disease Funding Levels and Burden of Disease”

Research has been conducted to determine where the NIH allocates its funds, compared to the actual burden each disease places on our society. The above table is ranked from most under-funded to most over-funded. A negative value indicates that a disease receives less funding than anticipated, and a positive value indicates it receives more funding than expected. As you can see, AIDS is the most drastically over-funded disease by every metric. Depression, on the other hand, receives relatively little money. This is undoubtedly due to our public mental health stigma, but it also reflects the curability factor. HIV is a specific virus which we can try to eradicate, whereas depression is a more ubiquitous and less-understood affliction. Among the cancers, breast cancer receives by far the most funding, with lung cancer being the most overlooked.

Donations

Images obtained from Donations vs. Deaths

The general public also gives more to some diseases than others. Donations do not form a particularly large portion of research funding, but it does reflect how people’s perceptions of a disease will alter their donations. Chronic diseases tend to be less funded because they appear less suddenly in a person’s life. The shock value of a disease compels more people to donate for it. Mental health issues are again underrepresented, perhaps because of stigmas in our society or perhaps because they are more difficult to cure. Marketing campaigns by foundations are perhaps the most effective strategy to accumulate donations. The ALS Ice Bucket Challenge and the Susan G. Komen campaigns help to draw in abnormally large amounts of funds.

Industry

Obtained from “The Anatomy of Medical Research”

It is difficult to uncover exactly where companies are allocating their research funds; as private organizations, they are not obligated to reveal their budgets. But the above graphic can illustrate where they are focusing their funds. Anticancer drugs are the far most common in clinical trials. Similar to the public funding, or perhaps because of it, cancer is the number one target for industry. Infectious diseases are next, followed by diabetes. Again, mental health and other chronic diseases are underrepresented. Perhaps if more basic science is conducted to better understand these afflictions, we will see companies develop more drugs toward their treatment.

Next time you look to donate to medical research, consider the impact of your donation. Public policy can also be changed to better allocate our resources. Not all funding is created equal; websites like charitynavigator.org, combined with awareness of the data, can help us to make the biggest possible impact on our societal health.

“No one has ever become poor by giving.” — Anne Frank

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