Open Research: Advancing Innovation in Public Health

Unlock knowledge to advance life-saving innovation.

Toward the end of West Africa’s Ebola outbreak, researchers uncovered vital research on the virus: data had been published in 1982 that could have helped speed up treatment, but it was not viewable or usable due to paywalls and copyright laws [1]. The discovery was heartbreaking – a lesson on lost time, perhaps when time mattered the most. When the Zika outbreak was declared a public health emergency in 2015, the Gates Foundation, other funders and researchers heeded this lesson and called for increased access to research to advance innovation [2].

The Gates Foundation and the World Health Organization led the charge to adopt a bold new policy that elected to forgo the existing restrictions on access to and re-use of research and data. Going forward, all research on Zika, would be free, accessible and re-usable by all. This would enable researchers from around the world to share cutting-edge information and build on each other’s work, so we could get to ground-breaking solutions quicker [2].

The Bill & Melinda Gates Foundation, the largest public health donor, has long been a leader in advancing innovation and research on the world’s greatest health challenges. Each year, the Gates Foundation awards hundreds of millions in prize money for to spur innovation to address some of the most pressing global health issues [3].

Spurred by the Zika Open Innovation initiative, last year, the Gates Foundation launched an organization-wide policy committing to make a 100 percent of research published with Gates Foundation funding to be freely and immediately accessible, with the underlying data re-usable by all with proper attribution. To help make this a reality, the Gates Foundation launched a new platform, called Chronos, where grantees can share early research findings and collaborate with each other. The platform also connects grantees with journals offering open research options, given that according to the new policy grantees can only publish in journals without paywalls [4].

As background, most scientific research today is not openly available or usable. Instead, it lives behind time embargoes, paywalls and copyright licenses, preventing it from being accessed and used by others.

A growing movement for open research seeks to change this because limitations on the use of scientific discoveries affect the efficiency of research, increase costs, and ultimately delay or even impede scientific progress. If published research and data were freely accessible and re-usable by researchers from across sectors and around the world, urgently needed solutions could be greatly accelerated. Scientists could quickly cross-check important studies, catching potentially consequential mistakes. Medical providers could access the latest technical guidance, improving patient care. And students all around the world could build on each other’s work [5].

While there are many benefits to increased sharing of data and research – as demonstrated by rapid progress against Zika – the Gates Foundation’s policy has been met with pushback both internally and externally. Researchers funded by the Gates Foundation have expressed concern that their findings may be misused or misrepresented, given that anyone, anywhere can use their research in any way. They have also cited concerns about not receiving appropriate credit for their work. Additionally, many view open research as contradictory to the traditional paradigm of academic advancement. At many institutions, climbing the academic ladder has often been tied to publishing exclusive studies in prestigious journals. Researchers are worried that restricting their publishing options to open research platforms will prevent them from attaining tenure [6].

Changing the status quo will be difficult – but it’s also necessary. Innovation doesn’t happen in a silo – and the speed of innovation needed to address disease outbreaks and other pressing challenges requires greater collaboration. Sharing information freely and fully will be essential to generating new life-saving and life-changing innovations. The Gates Foundation as a leader in the space is well suited to enact change.

In the short term, as the Gates Foundation rolls out its new open research policy, it will need to take measures to communicate the benefit of the policy clearly. In addition, it will need to ensure that research and data are not misused – and when it is used, it is properly cited. This could include requiring researchers to notify the primary author before using the data. Longer term, the Gates Foundation could open the Chronos platform to researchers beyond their own grantees, bringing together more minds to advance innovation. Furthermore, increasing research collaboration will require the Gates Foundation to work with the broader research community to untie the value of research from the name of the journal it is published in.

Open Questions

  1. If a researcher builds on another researcher’s work and the outcome leads to a profitable innovation, who gets the profit from the innovation? Should the profit be shared between all contributors?
  2. How can the tenure system change to encourage a more collaborative environment?

(Word Count: 797)

 

Sources

[1] Bernice Dahn, Vera Mussah and Cameron Nutt. April 7, 2015. “Yes we were warned about Ebola.” The New York Times. https://www.nytimes.com/2015/04/08/opinion/yes-we-were-warned-about-ebola.html

[2] World Health Organization. Zika Open. http://www.who.int/bulletin/online_first/zika_open/en/

[3] Bill & Melinda Gates Foundation. https://www.gatesfoundation.org/

[4] Bill & Melinda Gates Foundation. Open Access Policy. https://www.gatesfoundation.org/How-We-Work/General-Information/Open-Access-Policy

[5] Richard Wilder and Melissa Levine. December 19, 2016. “Let’s Speed Up Science by Embracing Open Access Publishing. STAT News. https://www.statnews.com/2016/12/19/open-access-publishing/

[6] Ganesh Kumar NMeador KG and Drolet C. October 1, 2018. “Challenges in Open Access Publishing.” National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pubmed/30073306

 

 

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18 thoughts on “Open Research: Advancing Innovation in Public Health

  1. Very interesting! And, sadly, heartbreaking, too.

    To your first question, everyone should profit, but disagreements inevitably will arise as to what the fair proportion of profit to which innovator is fair. Perhaps well-endowed charitable organizations, such as the Gates Foundation, could offer financial compensation to original innovators to allow others to improve the work further or face fewer barriers to using it for crucial missions.

    As for your second question, I’m not sure I know enough about he tenure process to answer confidently, but maybe if a school advertised that the research came from one of its researchers it would make publishing articles in a more open forum more appealing.

  2. The “democratization of information” idea reminded me a lot of the mission statement of organizations like Wikipedia and Google. I’m hesitant to take that further and democratize academic research for the arguments you’ve laid out – there is an industry that revolves around publications that uphold certain standards. Academics are also judged on the citations a paper receives, and open information would disrupt the established system. I think there is something to be said in the arena of public health, and perhaps journals related to the field ought to lead the way in opening access to test the impact of doing so on academia and innovation.

  3. Thanks a lot for sharing the article. I agree with you in many ways – innovation cannot happen in silos and the most innovative solutions are often team efforts. Having said that, you pointed out the clear deal-breakers for open innovation to happen: Incentives of researchers. The core that needs to be looked at is – how do we incentive our researchers beyond exclusive publications? One way the Gates Foundation could do this is to give credits to publishers/ researchers whose articles are most clicked and most-read, rather than “cited” – that could be a new way to measure the importance of a specific research finding. Rather than relying on citations, new technologies and especially the fact that most research is assessed online can help measure the time individuals spent on articles, which could be used as an indicator of its relevance (similar to how YouTube rankings work or similar to how news-websites optimize their article-positioning).

    Coming to your question, I believe that the person who gets the patent first should receive the royalties as the patent requires an overall thought-process and not just a small contribution to a larger problem.

  4. To your first question, profits from a profitable innovation should be shared among contributors. As I understand, whole point of this open innovation initiative is to foster collaboration among health researchers. Like in any other industry, there are people whose main motivation was to make money, and whose main motivation was to help people. If some researchers start making money on the foundations of other researchers, I do not think this initiative will be sustainable. Similarly, in healthcare industry, some developers are paid royalty fees even if they do not hold a patent. For manufacturer, the reason behind that is to pay costly development effort to developer and fasten the money making process. If profits are fully allocated the one who did the final touch, there is no incentive left for initial research efforts.

  5. Thanks for sharing your very interesting perspective on a very important topic. In an ideal world, open innovation in research would be incredible! But, as someone who has spent the past four years at highly academic, research-driven institutions, I have firsthand experience with the paradigm you highlighted in your post. Unfortunately, I don’t see this trend changing anytime soon. Researchers’ future work and salaries (to some degree) depend on the journals they publish in. They are highly incentivized to guard their findings until they are published and because of this, the term “scooping” has become common to describe what happens when one researcher beats another to publish similar work. Limited funding in today’s research environment only exacerbates the issue and concentrates the most cutting-edge research and collaborations in the top academic institutions (the rich get richer). Your question of who should benefit from innovations that build on similar work is not a trivial one. A specific recent example of the controversy that arises in these situations is the battle for credit and patents over CRISPR-Cas9 technology, which revolutionized DNA editing and is driving therapeutic development efforts of numerous biotechnology companies [1]. The short answer is, it’s complicated and often has to be settled legally.

    [1] https://www.sciencemag.org/news/2017/02/how-battle-lines-over-crispr-were-drawn

  6. Your article made me think about how we can find an incentive model to best solve this problem of open innovation in research. Perhaps a revenue sharing model could work. Research could be licensed out to other prospective researcher with strict conditions that should the research in any way lead to discovery or invention, the original research would be entitled to share of the profits. Thus, rather than a prospective researcher having to pay a large up front licensing fee, they would only be required to pay if that research led to a successful outcome (and in turn they could pay for it out of profits). Under this model, innovation would flourish, researchers would be appropriately cited and (potentially) remunerated. Perhaps the greatest outcome could by the efficient use and investment in quality research backed by an incentive model that allows revenue sharing in any venture that is successful because of it.

  7. Great article. It touches upon a sensitive and controversial area in public health — as a society, how can we erase the significant R&D and costs involved with creating live-saving medicines so that they can be more readily accessible to people who need it most. Gates Foundation’s disruptive approach is commendable. Interestingly, my best friend is the program manager for the Ebola crisis management for a major non-profit and I would imagine that she would also agree with you.

    I am sure if you had more time and space, you could have talked about TRIPS and other global drug policies that influence limits in the market.

    My biggest concern, to which previous commentators have touch upon, is this approach may not be appropriate for the end user. The individuals who require these medicine are the most vulnerable. They too deserve the highest level of care. Given that this is a matter of life and death, I want absolute certainty that the medicines developed underwent the strictest protocols and industry standards.

  8. Thanks for the contribution — I had no idea about the ebola research that you referenced and I suspect this is something much of the world would like to know about. In the case of Zika, it’s great to see the progress that can be made when private industry/regulation are on the same page…I doubt there’s anyone in the world that’s against using existing knolwege to create life saving cures in an expedited manner. With that said, if the paywall model doesnt work, I think its incumbent upon us to determine another way to monetize this research/hard work in the event that it leads to something truly valuable…the individual that discovered that data in 1982 deserves compensation for their work in any case.

  9. Thank you so much for choosing such an important topic and for raising such difficult questions. I agree with many of those who have already commented that there are benefits to making scientific research less esoteric and more accessible. Choice of research topics is heavily influenced by well funded interest groups, and making research free to access would disempower these powerful lobbying groups. However, the question that you raise around attribution when scientists start building on each other’s work is an important one. We would have to decouple scientists’ career advancement opportunities from the rate at which they publish and perhaps link them to other metrics that incentivise collaboration. For example, scientists could be assessed on how many collaborative projects they have undertaken with colleagues in the field when they are considered for posts.

  10. Thank you for sharing! When reading your article, I thought one key takeaway was the tension in incentives for people in the field between social good and economic gain, which is a common tension in the medical field. Researchers who care less about economic gain and solely care about advances in medicine to maximize social good would be likely buy in to this open innovation theory for medicine. Despite the importance of collaboration and ensuing open innovation to tackle modern medicine issues, that pursuit at the expense of individual economic gain and recognition is unfathomable for many. As a result, I think about the tenure and royalty questions in a similar way about how do you realign incentives and ensuing compensation in the industry. I do think that individual institutions can create their own internal incentive systems to reward collaboration, but I think a larger governing body would have to tie payout of grants, etc. to these institutions based on their track records of collaboration and achievement of joint research.

  11. What an interesting essay. Let me add some thoughts from the Gates Foundation (BMGF) perspective —

    To your first question, I don’t think that publishing on a platform like Chronos creates any new issues for profit sharing or attribution. Those same risks exist for research that sits behind a paywall, it is just that less people have access to the information. In that sense BMGF creates a net benefit by opening access without creating a net new issue. That does not mean that attribution is not a broader concern though.

    What is potentially more complicated for the Foundation is when BMGF funding leads to a patent which is used to make profitable product. There the patent protects the intellectual property, but pricing and access to the technology could be limited. If the Foundation required open access to that technology then many would be reluctant to accept the funding in the first place and the world might miss out on an important innovation. As it turns out the Foundation is more nuanced on its thinking about patents. Instead of requiring global open access, it typically requires concessional pricing on that patent for low income countries and public markets and then allows market-based pricing to high income countries and the private sector. I think that is the right approach.

    Your second question is less clear cut though. I see two possible ways that BMGF could help make sure that research that it funds is valued by tenure boards: i) it could establish a peer review system and invest to turn chronos into a prestigious (but open access) journal, and/or ii) it could fund current journals to also be open access and allow grantees to publish there if they are accepted. Either approach could give the academic status that researchers need.

  12. This is such an important and heartbreaking issue – thanks for shedding light on it. I agree that the Gates Foundation. I haven’t ever done academic research before and am not sure how the system works. From my understanding, one measure of a paper’s success is the number of citations a paper receives. If I were to see a paper by author X, write a paper of my own and cite author X, wouldn’t that actually be a good thing? Or is it only rewarded under certain conditions — for example, do I also need to be published in a list of approved, related publications? Do I need to have certain credentials? It seems like from a citations perspective, making research open might actually be a good thing, provided that these papers are properly cited. If we can ensure faithful citations of papers, would the problem go away?

    On the topic of profit sharing, the original researchers whose works were piggy-backed upon should definitely also have a share of the profits. I can see how this becomes a legal and logistical nightmare, though, and it’s unclear how much cut of the profit each party would get. What happens if one researcher builds upon another researcher’s work, who builds upon yet another’s, as is typically what happens in research? The complications are endless.

  13. I think in this case, the greater public good outweighs the profit motive of individual people and institutions – but, like most negative externalities – unless there is some intervention on the form of the government, we will have a tragedy of the commons situation in which individuals profit at the expense of the whole. I actually think this might be a case where the application of a government mandate is called for – in the 14th and 15th centuries, the plague wiped out whole swathes of the population. Given how extensive international travel is today, a disease of that magnitude could wipe out a large portion of the population unless a cure is found in time.

  14. I think that basic research should be open to everyone and I believe that creating platforms that facilitate the access to this basic research is absolutely essential to avoid situations as the ones that you mention (Ebola). However, in my view, only the “inventor” of the profitable innovation should benefit from it, even if it is based on prior basic research. Plus, I believe that this policy should incentivize researches to go a step further and find ways to apply the conclusions of their studies.

  15. Interesting topic – thanks for sharing. While the benefits of having an open-access platform to academic research are many, my one and only concern is that of ensuring publications are peer-reviewed. A researcher cannot publish in a respected journal before that paper has been reviewed and approved by several leading academics in the field. If people lost trust in the accuracy/credibility of the research published on an open platform, no one would use it anymore. So as one of the comments mentioned above, I think that ensuring all publications are indeed peer-reviewed is essential for any reputable open access platform. However, managing the peer-review of thousands of research articles will cost money, so how can such a platform, which does not charge people for using it, remain financially sustainable? One way is for a charitable foundation to bank-roll it, but I think a better way is to involve global governments to fund such initiatives.

  16. A tenure system “publishing exclusive studies in prestigious journals” is fundamentally flawed. Publishing works on open platforms with increasing opportunities for viewership and impact should be valued higher than costly, field-specific journals. Having works published in prestigious journals inevitably involves substantial capital investment which accompanies politics. In turn, I believe tenure should rely on merit and the tangible actions taken as a result of your research.

  17. Awesome writing! I love the application of open innovation in this context, especially when it can have such a huge impact on peoples lives. It’s absolutely more advantageous for society as a whole to work together to innovate, as opposed to work in small individual groups. In this case sharing really is caring. I’d love for ways for people to post projects that they’re working on and have people be able to sign up to work on those projects similar to the employees at Valve.

  18. Identifying who should gain the benefits from breakthroughs achieved in iterative research is a difficult question to answer, however a critical one, particularly to foster an environment where researchers feel incentivized to pursue their work in important fields such as the one highlighted. In my opinion, we might require new industry guidelines for intellectual property, that accounts for the movement towards open innovation practices.

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