Despite calls by health integrity groups for governments to crack down on rampant research waste, numerous public funders have failed to put into place appropriate safeguards for taxpayer-funded clinical trials, a new study shows.
Published in JAMA, the study led by Nicholas DeVito of the University of Oxford warns that most of the world’s largest public medical research funders have failed to put into place basic safeguards to ensure that the results of the clinical trials they fund actually contribute to scientific progress:
In Germany, the United Kingdom and the United States, some public funding bodies performed well, but others failed to meet expectations
Public funders in Australia, China, France, Italy, and Spain performed poorly across the board
Only four of the world's twenty top funders earned full marks for demanding that all trials they fund are registered and their results reported, and for ensuring grantees’ compliance with these rules through audits:
Britain’s Medical Research Council (MRC)
Germany’s Deutsche Forschungsgemeinschaft (DFG)
The United States’ National Institutes of Health (NIH)
The European Union’s Horizon 2020 programme
A coalition of health integrity groups led by Transparency International last year called on governments worldwide to make clinical trials transparent, identifying public research funding as a priority entry point:
“In future, to help ensure that public funding for medical research actually benefits the public, government funders should only give taxpayers’ money to institutions and individuals that verifiably comply with best practices in clinical research. Taking this simple first step would deliver significant transparency gains at minimal cost.”
Around half of all clinical trials conducted worldwide do not report their results, and hence make no contribution whatsoever to the global search for new treatments and cures. As a result, an estimated $85 billion invested into medical research go to waste every year. The new study suggests that while there has been some progress, there is still a long way to go before all trials are registered and reported.
As the four transparency pioneers listed above demonstrate, curbing research waste is entirely feasible.
The next step will be for patients and taxpayers in Australia, China, France, Italy, and Spain to ask their politicians why they are still allowing public funds to be wasted on clinical trials that fail to adhere to global transparency norms, and why they have not yet signed up to the WHO Joint Statement on public disclosure of results from clinical trials.
The Oxford study team selected the top 20 non-commercial funders of health research globally and examined their policies on clinical trial transparency and research waste. Between them, these funders spent $41 billion on health care research in 2013 alone. Disappointingly, the study noted that even those funders that audited grantee compliance did not make their audit results public.
Two of the world’s two biggest philanthropic funders were also covered by the study. At the time they were assessed, in spring 2017, neither the Gates Foundation nor the Wellcome Trust required their grantees to share the results of their research.
Around the same time, both organizations pledged to strengthen their policies and conduct regular audits of their grantees’ performance. AllTrials have announced that they will soon conduct a follow-up survey to monitor whether major philanthropic funders have lived up to this promise.
To learn more about how this research waste undermines the search for effective vaccines for HIV, tuberculosis and malaria, and threatens to undermine achievement of the Sustainable Development Goals more broadly, please see this related blog on the Policies for Equitable Access to Health (PEAH) website.