A comparison between health research output and burden of disease in Arab countries: evidence from Palestine

Abstract

BackgroundResearch conducted on conditions responsible for the greatest disease burden should be given the highest priority, particularly in resource-limited settings. The present study aimed to assess the research output in relation to disease burden in Palestine and to identify the conditions which are under- or over-investigated, if any.MethodsWe searched PubMed and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and December 2015. We categorised the condition studied in included articles using the Global Burden of Disease (GBD) taxonomy. Data regarding burden of disease (percentage of deaths and disability-adjusted life years (DALYs)) was obtained from the Palestine profile in the GBD study. We examined the degree of discordance between the observed number of published articles for each disease/condition with the expected number based on the proportion of disease burden of that disease/condition.ResultsOur search identified 2469 potentially relevant records, from which 1650 were excluded following the screening of titles and abstracts. Of the remaining 819 full-text articles, we included 511 in our review. Communicable (infectious) diseases (n = 103; 20%) was the condition with the highest number of published studies. However, cancer (n = 15; 3%) and chronic respiratory diseases (n = 15; 3%) were the conditions with the lowest number of published studies. Research output was poorly associated with disease burden, irrespective of whether it was measured in terms of DALYs (rho = −0.116, P = 0.7) or death (rho = 0.217, P = 0.5). Cardiovascular disease, cancer, and maternal and neonatal deaths accounted for more than two-thirds of the total deaths in Palestine (67%), but were infrequently addressed (23%) in published articles.ConclusionsThere is evidence of research waste measured by a mismatch between the health burden of certain diseases/conditions and the number of published research reports on those diseases/conditions in Palestine. A national research priority-setting agenda should be developed to meet the local community’s need for quality evidence to implement independent and informed health policies.

Non-communicable diseases research output in the Eastern Mediterranean region: an overview of systematic reviews

“…Similar observations were emphasised in a recent scoping review of NCD research in the region spanning the years 2000 until 2013, noting higher publication rates and the most rapid increases overtime in high-income countries [9]. With the exception of Iran, our findings of limited research productivity of systematic reviews on NCDs in the region (on average 2 publications per country) and of reviews evaluating interventions for the same NCD condition or in a single population align with the larger body of literature indicating a relative scarcity of high-evidence research [9,17]. Reasons for the relatively lower quantity and quality of scientific productivity in the EMR include deficient research funding [27], instability of countries during conflicts [28,29], poor research infrastructure, inadequate human resources and capacity, and difficulty in accessing biomedical databases and high-quality journals [30].…”

“…These have scarcely begun to be explored in the global literature, with one study relying solely on the Cochrane database of systematic reviews [13] and another covering a single NCD condition, diabetes [14]. Previous NCD reviews in the region have either had broader scope of inclusion criteria incorporating studies of various methodologies including primary studies [9], or were focused on a distinct theme in NCD research (e.g cost analyses or genetics in NCD research) [15,16] or a single country [17]. However, no previous study has appraised NCD-related evidence generated from exclusively systematic reviews.…”

Neglected tropical diseases in Brazil: lack of correlation between disease burden, research funding and output

“…Several studies have suggested that diseases that impose a high health and economic burden on society should ideally receive more attention from both funders and the research community [1–3]. However, this has not been the case for most low‐ and middle‐income countries (LMIC).…”

“…Research output has been used as a proxy indicator of research prioritisation [9]. The analysis of the balance between the burden of disease and its research output is likely to reveal health conditions that may be relatively under‐ or over‐studied [1]. Highlighting a possible disparity is therefore critical in guiding stakeholders and policymakers on the allocation of limited health research resources.…”

Biomedical and health research geography in the Eastern Mediterranean Region

“…In fact, it is estimated to have only 1.1% of global research resources in 2013 (81). A study on health research outputs in Palestine indicates the presence of a mismatch between the health burden of certain disease conditions and the number of published research reports on those diseases (82). Such discordance between research output and disease burden was also demonstrated in a study that covered research on noncommunicable diseases in seven Arab countries (68).…”