A shift in the centre of gravity and a shift in opportunity
We are living in a golden age of science, with remarkable advances in every scientific field. These advances can and must play a central role in addressing the great challenges of the 21st century: inequality, climate change, pandemics, biodiversity loss, demographic shifts, antimicrobial resistance, food security, energy and water scarcity. It has been an honour and pleasure to bring together the diverse voices in this special section to explore these issues.
However, despite this golden age there is a growing danger that with science increasingly concentrated in a small number of wealthy countries, rather than being a lever to reduce inequality, science may instead exacerbate it. This concentration of scientific capacity compromises not only global equity but also our collective ability to address challenges that transcend borders. If ‘science is done somewhere else, not here, and not by me’ mistrust will grow, and we will fail to maximise the potential for science to address the collective challenges we face and ensure equitable progress, collective security and opportunity.
The choices that countries make today about science for health and economic growth will define the health of their communities, their economic growth and national resilience in the 21st century and our collective security. We can choose to concentrate scientific capacity in a few countries, allowing inequality to grow, or we can work together to ensure that every country has access nationally or regionally to the scientific foundation needed to protect its people’s health and build prosperity. The national paths forward require honest leadership to meet the challenges that countries face and equally honest investment that matches warm words to address those challenges through science. This is not just a moral imperative – it is the only pathway to a secure, prosperous and healthy future for all.
Can any country afford not to invest in science?
Jeremy Farrar
Science has been central to improvements in clinical and public health and is increasingly crucial to a country’s economic growth, prosperity, resilience and security. Scientific advancements not only contribute to healthier populations, but science also drives sustainable growth by fostering innovation, creating jobs and boosting productivity.
This creates a virtuous circle. Building such a virtuous circle requires strategic decisions, investments and long-term commitment by governments. Science ecosystems encompass diverse elements: strong and inclusive education systems, research infrastructure, trusted career paths, peer review, regulation and the private sector. The structure and focus of a science ecosystem will be country-specific but there are many universal features of successful ecosystems.
The imperative of domestic investment
Investing in science means financing that is secured and sustained over the long term. This can only be guaranteed using domestic resources. Reliance on external assistance can be unreliable and may create power imbalances; governments should ring-fence specific revenues for investments in science while offering incentives to attract international inward investment as well as private and international investment. These are long-term national investments, with commitments needed over many decades, independent of changes in individual administrations. Short-term, stop-start funding of science will waste limited resources and fail to build a sector that can contribute to health and economic growth.
National investment in science is required to improve not only health but also economic growth, and to address national and regional challenges, offering opportunities that secure long-term resilience and security. Robust, sustained science ecosystems also provide the best available scientific advice to be integrated permanently into all arms of government – critical for making evidence-informed policy and for facilitating equitable, faster access to knowledge and products and trust.
Rebuilding trust through local ownership
Despite this scientific golden age, we also live in an era of growing suspicion of science, with mistrust and misinformation identified as one of the biggest global threats. Building back and strengthening trust in science are more essential than ever, and best achieved through local and regional support for science ecosystems that welcome international partnerships.
Investing in public engagement and understanding to inform the public about how science contributes to people’s lives would help counter the misinformation plague and underpin the necessary political support. When communities see science happening in their midst, by them and for them, and contributing to their prosperity and addressing challenges, they develop a stake in scientific advancement.
Addressing global health challenges
The Covid-19 pandemic demonstrated both the power of science and the dangers of scientific nationalism. Like every crisis, the pandemic amplified existing social divisions and inequalities. We saw how quickly scientific achievements could be undermined by unequal access and distribution. The same pattern risks repeating itself with other 21st-century health challenges.
Science for health must extend beyond the development of medicinal products and biotechnological solutions to cover the broad spectrum of health determinants, including environmental, behavioural and social determinants. A One Health approach is essential, with interdisciplinary research and cross-sectoral collaboration among the fields of human, animal and environmental health.
Political choices and future directions
What are the political choices that must now be made? Countries face fundamental decisions about how to organise and sustain science ecosystems with domestic resources and ownership. Three overarching questions demand attention:
- How can countries best structure and finance their science and research ecosystems for maximum health and economic impact?
- How can countries organise their scientific advice to government in ways that ensure that the best available evidence informs policy?
- How can countries protect their populations from misinformation and provide information on the benefits of investing in science for human health and development?
The answers require moving beyond the traditional model of science as the preserve of wealthy countries, almost all of which have become rich because of decades of national investment in science and technology. Instead, we must recognise science and technology as essential infrastructure investments – as fundamental to sustainable economic growth and opportunity as roads, telecommunications or energy. This means establishing principles, transparent and trusted systems that underpin and protect sustained, efficient government support for science, including research, careers, innovation, regulation, manufacturing and employment.
Governments must determine priorities aligned with national and regional needs and strengths, and then focus inevitably limited resources in thoughtful, strategic ways. This will mean multiple choices: what and how to focus on; what areas of science to support; which sectors; which models of support – universities or dedicated institutes, multiple or a limited concentrated number; which career paths, incentives and training, in-country or internationally or both; whether to conduct peer reviews; what role for the government in direct funding decisions; and what kind of engagement with the private sector and philanthropy. So many models have been tried around the world, but none is perfect: each country needs to review and adapt them to its local context.
A call for global cooperation
The effects of Covid-19 remind us that infectious diseases and pandemics are not the only global challenges we face. Climate change, demographic shifts, access to clean water, antimicrobial resistance, and the rise of non-communicable diseases and mental health – like the corona and influenza viruses – challenge every country and transcend borders. They will not be defeated by insular scientific nationalism or by blaming others. Doing so only leaves everyone more vulnerable.
Rather, these challenges can be solved by enhancing international cooperation while building strong domestic science ecosystems. The international institutions established after the Second World War grew out of enlightened self-interest. They require reform, and they are reforming – but they are needed today more than ever. ▪
