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The Changing Geography of Medical Research

Zhou, H.; Garg, P.; Fetzer, T.

2025-09-30 public and global health
10.1101/2025.09.29.25336909 medRxiv
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We examine whether research systems reallocate scientific effort as health needs change. We assemble a global disease-location panel for 204 countries and territories (1990-2021) by linking diseasespecific publication output to disease burden in the same place and year. Using large language models, we extract diseases from article text, map them into a standardized disease classification, and classify research funders by type. Empirically, we estimate how publication output co-moves with disease burden within countries and diseases over time, and we use event-study difference-in-differences designs that exploit plausibly exogenous variation from the timing of outbreak alerts. We find that responsiveness to endemic burden has increased over time but remains highly uneven across locations; outbreak alerts trigger rapid, statistically significant research surges that have strengthened in recent years; and funding composition is strongly associated with adjustment dynamics, with philanthropic and government-supported research contributing disproportionately to responsiveness growth in lower-income settings.

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