Proportionate research funding based on relative burden of conditions of communication and swallowing

To the Editors: Bourne and colleagues1 describe an important disconnect between the relative burden of musculoskeletal conditions and investment in clinical research in Australia. A similar disproportionate allocation of funding is looming in conditions of communication and swallowing, which affect one in seven Australians.2 These disorders typically concern vulnerable populations of early development and ageing, including those with autism, stroke and neurodegeneration.

To examine the alignment between disease burden and research investment, we conducted a database search of National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) funding over a 10-year period (2004–2013), focusing on grants for research into communication and swallowing disorders.3 Grants included those for people support, projects, programs, and linkage and discovery. Of the 12 000 grants awarded by the NHMRC and ARC, 154 met the criteria for communication and swallowing disorders. The monetary value of these grants totalled about $61 million (1.1% of all funding awarded). Funding for hearing impairment research (42%) represented the bulk of the grants, followed by funding for stuttering (17%), language (16%), speech (7%), literacy (3%) and swallowing (3%). Mixed-focus research accounted for 12% of funding.

In acknowledgement of the significant burden of communication and swallowing conditions in Australia, the federal government has initiated a Senate inquiry into the health, social and economic impact of these conditions.4 The inquiry's remit is to investigate (i) the prevalence of communication and swallowing disorders; (ii) the availability, adequacy and projected demand of speech pathology services provided by all sectors (public and private); and (iii) the social and economic cost of failing to treat these conditions.

These data, along with studies by Bourne and colleagues1 and Mitchell and colleagues,5 signal the need for further consideration of the way in which medical and health dollars are allocated by Australia's premier funding agencies. The Senate inquiry may offer an opportunity to explore the role of proportionate research funding based on burden of disease within a group of disorders that are vastly underrepresented in the current grant environment.