14. 12. 2005
Medical Research and Science in the Czech Republic
Cyril Höschl, Petra Ježková
On February 3, 2005 the Czech Medical Academy arranged a meeting of delegates from medical research and representatives from the Ministries of Health and Education, with the secretary of the Government Council for Research and Development and the director of the Research, Development and Human Resources Division of the Office of the Government of the Czech Republic, Dr. Marek Blažka. In his address, Dr. Blažka provided information about support of medical research and science in the present, as well as glimpses of the future.
With the entry of the Czech Republic to the European Union, the approvals process for scientific and research programs is changing, and resulting in the increase of financing for medical research. For example, there will come available for science and research in the Czech Republic a total of CZK 16.5 billion in the year 2005, subsequent to approval of the proposed national budget, and ultimately an additional CZK 4.25 billion in 2007. For a purposes of clarity this refers to 0.54% of the gross domestic product in the year 2005 and 0.68% GDP in 2007. This increase is unquestionably positive, as demonstrated by the correlation that countries with a high level of support and effectiveness in research have at the same time a high standard for provided care.
In future years the government will support a move in the direction of higher percentages of earmarked funds versus institutional funds (in the year 2006 approximately 90% of funding for science should be earmarked as opposed to 10% institutional). We still, however, have 70% of research projects proposed "from the bottom up", and only 30% of programs defined "from the top down". In comparable Western countries this ratio is roughly the opposite (here of course arises the question as to whether this is a good thing). According to the government it is also preferable to support cooperation than to exclusively finance individual institutions (institutional funds flow to a single institution, while earmarked funds more often support projects to which more than one subject contributes). From earmarked expenditure there should also be more projects financed cooperatively with private sources, which is another form of support for financing by private sources. In the year 2006 the institutional expenses of the Ministry of Health should drop by CZK 72 million, but total expenses for research and development will grow by 2.3% (CZK 20 million). For example, National Research Program II – TP 2 Health and Quality of Life will apportion CZK 332 million in the year 2006 (and in subsequent years CZK 440 and 560 million).
In comparison with foreign countries, Czech health department lacks a program for applied science and research financed cooperatively by users, such as insurance firms and others. Another problem is that Czech medical research is largely focused in other directions than those specified by its priorities. In other words, medical research focuses to a great extent on areas in which global levels are not being met, while sufficient support is not reaching projects in fields with a higher chance of achieving international success. Altogether our medical research is far behind, in comparison for example with industrial research, in the obtainment of support from EU structural funds.
According to analyses posted on the website www.vyzkum.cz, which evaluates the output of our science and research in comparison with the rest of the world, the gap between growing investments in science and its relatively decreasing output is constantly growing. As an example, in the original fifteen EU member states the average number of scientific journals published in the years from 1999-2003 is 115, in the Czech Republic merely 45. Ahead of us are, for example, Hungary (with 50 publications), Slovakia (76), and of course the Netherlands (165). Among those of our disciplines comparable in output with the EU average there belong mathematics and engineering, while the medical sciences continue to lag behind. If we follow this trend (or rather, this directional indicator of our development) we can see visible improvement in the conditions of neuroscience, behavioral science and psychiatry. On the other hand, stagnation is evident for example in molecular biology and pharmacology (according to ISI data).
What will be important for the future of science and research financing is also the evaluation of individual project quality. According to available data from 2004 assessments, results of any kind whatsoever were missing from a total of CZK 2.6 billion worth of projects! The majority concern projects without results, or cases in dispute (e.g. for legislative reasons), or so-called interrupted and unfinished projects (amounting to approx. CZK 700 million). Dr. Blažka stated that an average of one research result in three is achieved in Czech medical research. This situation should improve in the year 2005, due for example to the regularisation of legislation, a decisive listing of non-impacted journals which can be classified as output results, etc.
Dr. Blažka brought his address to a close with the following words: "Even if I were to concede that in reality – due to poor entry of data into the information system – the number of projects with undocumented output is smaller, this changes nothing for our effort to apportion resources in the future to those providers who can properly document their meaningful utilisation."
After the lecture, a tumultuous discussion followed, and Dr. Blažka was showered with a variety of questions. We hope that similar success will be achieved by the next conference on the topic of science and research, being prepared by the Czech Medical Academy for Spring of 2006, and that this time a more positive note will resound for Czech science and research.