Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Biomedical research: lessons from the last decade’s crisis and austerity-stricken small countries for the current COVID-19-related crisis

The 2007–2008 economic crash has had long-lasting effects on Greece’s biomedical research landscape. It has exposed a gap in support for countries that are classified as high income but are living under austerity measures. A new model is needed for optimal utilization of the intellectual and natural resources that such countries can offer to improve the global research landscape.

Many countries were afflicted by the most recent decade-long financial crisis and its accompanying austerity measures. In Greece, Spain, Portugal and other countries, funding scarcity has greatly impeded the performance of expensive biomedical research in particular1. This field was particularly hit because the crisis took place while there was, at the same period, an explosion of costly, resource-expensive studies of biological pathways, precision medicine, big-data science, super-resolution imaging, robotics and high-throughput experimental technologies.

There are several long-standing programs that support research in low- and middle-income countries. For instance, such countries could benefit from the Research4Life programs AGORA, Hinari, OARE, ARDI and GOALI, or they could be entitled to request waivers for full tuition fees for their graduate students in leading foreign academic institutions. These countries face fundamental difficulties of their own, and such programs are sorely needed. In contrast, when small, high-income, developed countries are stricken by decreases in their gross domestic product, they cannot benefit from the developmental policies and remedial programs available to developing countries. Therefore, they could be fairly described as ‘research resource–poor countries’.

Should developed but crisis-stricken countries receive an extramural research boost as an act of solidarity and science diplomacy, or, instead, should they consider themselves a lost case? Using our country, Greece, as an example, we argue for a third alternative, one that many other countries around the world would find applicable now and in the future: to look locally for ‘attractive niches’ and ‘hidden pearls’ of added value to global biomedical research (Table 1 and 2). This notion becomes more important during the post-austerity years, given Greece’s situation as part of a broader policy gap, in the sense that while a remedial mode for middle- and low-income countries exists, there is not one suitable for small, high-income, research resource–poor countries. Such support is especially important for Greece and many other equally unprepared or not-well-equipped countries, not only as a consequence of the recent austerity period but also because another economic breakdown will probably follow the current COVID-19 pandemic, which will probably impose fiscal budget shifts from research (often considered a luxury during an epidemic, unless it is epidemic related) to the health sector.

Table 1 Natural resources for life and health sciences
Table 2 Natural resources for biotechnology

Greece, like many other countries, has become a place of remarkable contradiction. It has a large number of well-trained scientists, but the vast majority of them are unemployed, under-employed or seeking work abroad. Policymakers have promised to address several long-standing structural problems in research funding1, yet the total spending on research and development remains quite limited2. In particular, research funding in Greece has been consistently limited, especially for basic research, and of note, it has been unequally distributed, because of the following: (a) barely existent structural changes oriented toward innovation; (b) lack of matching between university curricula and the skills required by the generally meager industry; (c) indecisive policies on research priorities (leading, in turn, to the disintegration of strong research groups); (d) a lack of consideration of cost-effectiveness during policy formulation; (e) a vast, albeit improving bureaucracy; (f) high corruption indices (inversely linked to innovation performance); (g) a lagging behind in alignment with the goals of the United Nation’s Sustainable Development Agenda and those of the World Health Organization (for example, supporting research on traditional, environmentally burdensome energy forms instead of long-term planning for the upcoming climate crisis); and (h) frequent political party–guided non-meritocratic science policies. These conditions intensified during the austerity years, which led research performance to even lower capacities3,4,5,6,7,8,9,10.

Despite the conditions described above, Greece has managed to survive scientifically and to score high in terms of the academic productivity of its scientists, such as publication metrics and citations, in part because of the strong mindset of its human capital―namely, its stamina for research despite adversities and compliance with the concept of the Greek ‘philotimon’, which describes a set of several human virtues. This is in contrast to a relative paucity in filings for new patents, based on the locally prevailing idea of considering science purely as a search for the truth that is incompatible with generation of personal profit.

In light of such traits, it should be recognized that research resource–poor countries, by their own nature, cannot contribute equally to highly complicated, costly projects that require advanced expensive experimentation; thus, mutual respect and appropriately balanced acknowledgment of intellectual properties and co-authorships in inter-country collaborations are crucial for success. Treating these countries through an equity perspective rather than an equality perspective is warranted at all times, and even more so during epidemics. Furthermore, diversity issues that embrace the inclusion of resource-poor countries in the eligibility criteria for major international grant proposals should be advocated. Bold ideas could potentially emerge in every research corner of the world; these, coupled with the possibility of addressing complex experiments to be conducted on a collaborative or outsourcing basis, could potentially yield truly impactful results11. Building up scientific collaborations, in which research resource–poor countries could offer a competitive advantage (e.g., based on their scientists and research niches), can lead potentially to scientific breakthroughs. This notion could strengthen science equity in the global research agenda. Particularly in light of recent actions in other diversity-inclusive policies (e.g., gender equity12), publishers of high-caliber journals, including multidisciplinary ones, should be encouraged to develop country diversity indices, as the importance of publication metrics cannot be overstated.

In addition, young scientists could be involved in exchange programs between research resource–rich countries and resource-poor countries; notably, as part of ‘brain-regain’ efforts (such as the so-called ‘2017 Hellenic Pasteur Institute Declaration’ in Greece, a document signed by notable scientists of the country and its diaspora to advocate for political interventions on ‘brain regain’), after completion of their studies in the former countries, they could be asked to return to secure jobs in their home countries, which would allow them to transfuse the knowledge obtained abroad into new regional research hubs. On the basis of appropriate strategies, support for young scientists should include protected and sustained, albeit competitive, funding from grant applications and the establishment of a solid formal network of collaborations with resource-rich countries13. Doing so can be the best antidote to ‘brain drain’ and ‘brain deficit’ (terms in ref. 14). We call this approach the ‘twinning of laboratories’, akin to the twinning of towns, which, far from ‘scientific colonialism’, could be mutually beneficial in various scientific fields (e.g., research on endemic infections and local rare diseases, cultural anthropology and so on).

The examples described above, which stem from a range of research fields, hopefully illustrate how a small, resource-poor country’s well-educated research force and rich natural diversity represent a model for dealing with the global research agenda during crises and austerity times. Providing resources to local and foreign collaborating scientists should be sustained, and quality checkpoints assessing alignment with international scientific standards (including bioethical, biosecurity, biosafety and biobanking principles and guidelines, as well as commonly accepted standards of reproducibility, such as integrity, validation methodologies and data openness15) should continue to be met. Ultimately, these examples will pave the way for other small countries to look into their own human and natural resources to develop their competitive advantages in the emerging economically harsh global era.

References

  1. Mentis, A. A. & Chrousos, G. P. Eur. J. Clin. Invest. 49, e13167 (2019).

    Article  Google Scholar 

  2. Press, W. H. Science 342, 817–822 (2013).

    CAS  Article  Google Scholar 

  3. Allen-Ramdial, S.-A. A. & Campbell, A. G. Bioscience 64, 612–618 (2014).

    Article  Google Scholar 

  4. Kollias, G. & Lambris, J. D. Nat. Immunol. 16, 1206–1208 (2015).

    CAS  Article  Google Scholar 

  5. Nature 572, 153 (2019).

  6. Featherstone, K. Nature 518, 167 (2015).

    CAS  Article  Google Scholar 

  7. Synolakis, C. & Foteinis, S. Nature 461, 167 (2009).

    CAS  Article  Google Scholar 

  8. Nature 409, 545 (2001).

  9. Herrmann, B. & Kritikos, A. S. I. Z. A. J. Eur. Labor Studies 2, 14 (2013).

    Article  Google Scholar 

  10. Mastellos, D. C. et al. Nat. Immunol. 20, 1409–1413 (2019).

    CAS  Article  Google Scholar 

  11. Smith, D. R. EMBO Rep. 16, 14–16 (2015).

    CAS  Article  Google Scholar 

  12. Silver, J. K. Br. Med. J. 367, l5888 (2019).

    Article  Google Scholar 

  13. Ahmed, A., Daily, J. P., Lescano, A. G., Golightly, L. M. & Fasina, A. Am. J. Trop. Med. Hyg 102, 494–496 (2020).

    Article  Google Scholar 

  14. Ioannidis, J. P. FASEB J. 18, 936–939 (2004).

    CAS  Article  Google Scholar 

  15. Amann, R. I. et al. Science 363, 350–352 (2019).

    CAS  Article  Google Scholar 

  16. Zhang, Z. et al. J. Clin. Invest. 125, 1708–1712 (2015).

    Article  Google Scholar 

  17. Pietri, P., Papaioannou, T. & Stefanadis, C. Nature 544, 416 (2017).

    CAS  Article  Google Scholar 

  18. Higgs, D. R., Engel, J. D. & Stamatoyannopoulos, G. Lancet 379, 373–383 (2012).

    CAS  Article  Google Scholar 

  19. Ebenesersdóttir, S. S. et al. Science 360, 1028–1032 (2018).

    Article  Google Scholar 

  20. Gurdasani, D. et al. Cell 179, 984–1002.e1036 (2019).

    CAS  Article  Google Scholar 

  21. Brewster, R. et al. Trends Microbiol. 27, 824–835 (2019).

    CAS  Article  Google Scholar 

  22. Xu, H. et al. Diabetes 66, 2054–2058 (2017).

    CAS  Article  Google Scholar 

  23. Oulas, A. et al. Environ. Microbiol. 18, 1122–1136 (2016).

    CAS  Article  Google Scholar 

  24. Mathieson, I. et al. Nature 555, 197–203 (2018).

    CAS  Article  Google Scholar 

  25. Makri, A. Nature 559, 15–16 (2018).

    CAS  Article  Google Scholar 

Download references

Acknowledgements

The opinions expressed herein may not necessarily reflect those of the institutions with which the authors are affiliated. Part of this Comment was presented at a meeting on science policy and its future that took place in Athens, Greece (12 September 2019).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to George P. Chrousos.

Ethics declarations

Competing interests

G.P.C. served as vice‐president and member of the Greek National Council of Research and Technology/Innovation (2010–2015).

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chrousos, G.P., Mentis, AF.A. & Dardiotis, E. Biomedical research: lessons from the last decade’s crisis and austerity-stricken small countries for the current COVID-19-related crisis. Nat Med 26, 644–646 (2020). https://doi.org/10.1038/s41591-020-0859-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41591-020-0859-7

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing