Wang, Victoria Min-Yi (2025) On the unfairness of the “fair-share principle” for health research. [Preprint]

Text 20250529 On the unfairness of the fair-share principle for health research - PhilSci Arxiv.pdf Download (335kB)

Abstract

How ought scarce health research resources be allocated, where health research spans “basic”, translational, clinical, health systems and public health research? In this paper I first outline a previously suggested answer to this question: the “fair-share principle” stipulates that total health research funding ought to be allocated in direct proportion with suffering caused by each disease. Second, I highlight a variety of problems the fair-share principle faces. The principle is inattentive to problems of aggregation and distribution of harms incurred from disease and benefits accrued from research, and neglects considerations of cost-effectiveness. Moreover, the principle fails to recognise that using Global Burden of Disease Study estimates as proxies for “suffering” underdetermines health research resource allocation. Importantly, in drawing on these estimates, which are disease-centric and only take “proximal” causes of health loss into account, the fair-share principle disregards the social determinants of health. Along with them, the principle ignores public health research, which often focusses on “distal” causes of health loss to improve population health and reduce health inequalities. Following the principle therefore leads to inequitable priority-setting. I conclude that despite relatively widespread appeals to it, the fair-share principle is not an ideal to aim for during priority-setting.

---

Export/Citation:

EndNote | BibTeX | Dublin Core | ASCII/Text Citation (Chicago) | HTML Citation | OpenURL

Social Networking:

Share |

---

Item Type:	Preprint
Creators:	Creators Email ORCID Wang, Victoria Min-Yi v.m.wang@sms.ed.ac.uk 0000-0002-2657-6118
Keywords:	Global Burden of Disease Studies, Health Equity, Health Research, Philip Kitcher, Priority-setting, Public Health
Subjects:	Specific Sciences > Medicine > Epidemiology General Issues > Ethical Issues General Issues > Science and Policy
Depositing User:	Victoria Wang
Date Deposited:	29 May 2025 13:10
Last Modified:	29 May 2025 13:10
Item ID:	25502
Subjects:	Specific Sciences > Medicine > Epidemiology General Issues > Ethical Issues General Issues > Science and Policy
Date:	May 2025
URI:	https://philsci-archive.pitt.edu/id/eprint/25502

Monthly Views for the past 3 years

Monthly Downloads for the past 3 years

Plum Analytics

Actions (login required)

View Item