This piece was originally published on Bill of Health, the blog of Petrie-Flom Center at Harvard Law School.

Academia often treats all areas of research as important, and two projects that will publish equally well as equally worthy of exploring. I believe this is misguided. Instead, we should strive to create an academic culture where researchers consider and discuss a project’s likely impact on the world when deciding what to work on.

Though this view is at odds with current norms in academia, there are four reasons why a project’s potential to improve the world should be an explicit consideration. First, research projects can have massively different impacts, ranging from altering the course of human history to collecting dust. To the extent that we can do work that does more to improve people’s lives without imposing major burdens on ourselves, we should. Second, the choice of a research project affects a researcher’s career trajectory, and as some have argued, deciding how to spend one’s career is the most important ethical decision many will ever make. Third, most academic researchers are supported by public research dollars or work at tax exempt institutions. To the extent that researchers are benefitting from public resources, they have an obligation to use research resources in socially valuable ways. Fourth, most researchers come from advantaged backgrounds. If researchers pick projects primarily based on their own interests, the research agenda will provide too few benefits to populations underrepresented in academia.

One might push back on this view by arguing that the research enterprise functions as an effective market. Perhaps academic researchers already have strong incentives to choose projects that do more to improve the world, given these projects will yield more funding, publications, and job opportunities. On this view, researchers have no reason to consider a project’s likely positive impact; journal editors, grant reviewers, and hiring committees will do this for them.

But the academic marketplace is riddled with market failures: some diseases receive far more research funding than other, comparably severe ones; negative findings and replication studies are less likely to get published; research funders don’t always consider the magnitude of a problem in deciding which grants to fund; and so on. And although these problems warrant structural solutions, individual researchers can also help mitigate their effects.

One might also argue that pursuing a career in academia is hard enough even when you’re studying the thing you are most passionate about. (I did a year of Zoom PhD; you don’t have to convince me of this.) On this view, working on the project you’re most interested in should crowd out all other considerations.

But while this may be the case for some people, this view doesn’t accord with most conversations I’ve had with fellow graduate students. Many students enter their PhDs unsure about what to work on, and wind up deciding between multiple research areas or projects. Given that most have only worked in a few research areas prior to embarking on a PhD, the advice “choose something you’re passionate about” often isn’t very useful. For many students, adding “choose a project that you think can do more to improve the world” to the list of criteria for selecting a research topic would represent a helpful boundary, rather than an oppressive constraint.

Of course, people will have different understandings of what constitutes an impactful project. Some may aim to address certain inequities; others may want to help as many people as possible.

People also will disagree about which projects matter most even according to the same metrics: a decade ago, many scientists thought developing an mRNA vaccine platform was a good idea, but not one of the most important projects of our time.

But the inherent uncertainty about which research is more impactful does not leave us completely in the dark: most would agree that curing a disease that kills millions is more important than curing a disease that causes mild symptoms in a few.

In practice, identifying more beneficial research questions involves guessing at several hard to estimate parameters—e.g., How many people are affected by a given problem and how badly? Are there already enough talented people working on this such that my contributions will be less important? And will the people who read my paper be able to do anything about this? The more basic the research, the harder these kinds of questions are to answer.

My goal here, though, is not to provide practical advice. (Fortunately, groups like Effective Thesis do.) My point is that researchers should approach the question of how much a given project will improve the world with the same rigor they bring to the work of the project itself. Researchers do not need to arrive at the best or most precise answer every time: over the course of their careers, seriously considering which projects are more important and, to some extent, picking projects on this basis will produce a body of work that does more good.

This piece was originally published on Bill of Health, the blog of Petrie-Flom Center at Harvard Law School.

The Biden administration plans to greatly increase funding for the National Institutes of Health (NIH) in 2022, presenting the agency with new opportunities to better align research funding with public health needs.

The NIH has long been criticized for disproportionately devoting its research dollars to the study of conditions that affect a small and advantaged portion of the global population. For instance, three times as many people have sickle cell disease — which disproportionately affects Black people — than cystic fibrosis — which disproportionately affects white people. Despite this, the NIH devotes comparable research funding to both diseases. These disparities are further compounded by differences in research funding from non-governmental organizations, with philanthropies spending seventy-five times more per patient on cystic fibrosis research than on sickle cell disease research.

Diseases that disproportionately affect men also receive more NIH funding than those that primarily affect women. This disparity can be seen in the lagging funding for research on gynecologic cancers. The NIH presently spends eighteen times as much on prostate cancer than ovarian cancer per person-years of life lost for every case, and although this difference is partly explained by the fact that prostate cancer is far more prevalent than ovarian cancer, this disparity persists even after prevalence is accounted for. Making matters even worse, funding for research on gynecological cancers has fallen, even as overall NIH funding has increased.

Disparities in what research is funded are further compounded by disparities in who gets funded. Black scientists are also about half as likely to receive NIH funding than white scientists, and this discrepancy holds constant across academic ranks (e.g., between Black and white scientists who are full professors). This disparity is partly driven by topic choice, with grant applications from Black scientists focusing more frequently on “health disparities and patient-focused interventions,” which are topics that are less likely to be funded. Recent calls to address structural racism in research funding have led the NIH to commit $90 million to combatting health disparities and researching the health effects of discrimination, although this would represent less than two percent of the Biden administration’s proposed NIH budget.

The disconnect between research funding and public health needs is also driven by the fact that the NIH tends to fund relatively little social science research. For instance, police violence is a pressing public health problem: in 2019, more American men were killed by police violence than by Hodgkin lymphoma or testicular cancer. But unlike Hodgkin lymphoma and testicular cancer, which receive tens of millions of dollars of research funding from the NIH every year and additional funding from non-governmental organizations and private companies, the NIH funds little research on police violence. For instance, in 2021, only six NIH funded projects mentioned “police violence,” “police shooting,” or “police force” in their title, abstract, or project terms, while 119 mentioned “Hodgkin lymphoma” and 24 mentioned “testicular cancer.”

While many view the NIH as an organization focused exclusively on basic science research, its mandate is much broader. Indeed, the NIH’s mission is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.” Epidemiologists, health economists, and other social science researchers studying how societies promote or undermine health should thus receive NIH funding that is more proportionate to the magnitude of the health problems they research.

Research funding disparities have multiple causes and warrant different solutions, from prioritizing work conducted by scientists from underrepresented backgrounds, to ensuring that there is gender parity in the size of NIH grants awarded to first-time Principal Investigators. To address the broader problem of scientific priorities not reflecting the size of health problems, the NIH should instruct grant reviewers to consider how many people are affected by a health problem, how serious that health problem is for each person affected by it, and whether a disease primarily affects marginalized populations. In addition, the NIH should commit to funding more research on public health problems — like police violence — that cause substantial harm but receive relatively little attention from the health research enterprise.

As the NIH prepares for a massive influx of funding, it must follow through on its commitment to address health research funding disparities.