Healthcare is political, whether we like it or not. The United States is currently in a period of confusion and upheaval, with leadership at the Centers for Disease Control (CDC) walking out of their jobs in protest only to be met by cheering crowds on the way.
Funding for future research is facing unprecedented uncertainty. Once considered the world’s leader in science and technology, it was already well known that the United States was falling behind when it comes to healthcare innovation. Could this be an opportunity for the UK to step in and fill the gap?
The first European settlers arrived in the Americas in the 16th Century and the first permanent English settlement was established in Jamestown, Virgina in 1607. They chose the name of their new home in honor of their King, James I. Everything between England and the settlers was fine for a while but then some feelings got hurt, a little tea got spilt, some musket balls were fired and the relationship was never quite the same after that. Whilst the UK and what eventually became the United States of America has settled into a mostly happy alliance for the past two hundred-odd years, we’ve made a habit of good-natured ribbing and as much emphasis on our differences as our similarities.
For much of the past century, our two countries have also engaged in a playful game of both healthy rivalry and strong collaboration. Seven of the top ten universities in the world are in the United States; the other three are in the UK. As recently as 2023, they both entered the Atlantic Declaration, an economic partnership that included scientific leadership as one of its pillars. Both countries benefit from international brain drain, each having at one point in time hosted Albert Einstein on their soil, laying a claim to a brilliant mind that neither was responsible for creating. Like a well-managed divorce, we’ve embraced our similarities, respected our differences and tried to keep the peace at Christmas dinner. Wouldn’t it then make sense, when we see our friends struggling to offer them a helping hand?
The UK government is trying to do just that, along with the rest of Europe. In June, Britain announced the Global Talent Fund to attract research to UK soil. Combined with Royal Society commitments, there is now some £115M available for the American talent that is now facing sudden uncertainty when it comes to research dollars. While the European Commission is offering more, the UK has a few other things going for it. Primarily in that we all speak relatively similar languages and have some vague recollection of living together.
The National Institute of Health is the government body in the US that supports innovation and research in healthcare. It originated as a laboratory division of the Marine Hospital Service and was instructed to study infectious diseases to identify cases on incoming ships and prevent outbreaks of disease such as cholera. According to their website (as of the writing of this article), the NIH invests almost all of its annual $48B (£35.5B) budget in medical research. However, earlier this year, the current administration began terminating grants to research areas not aligned with their politics. Lawsuits began flying but last month, the US Supreme Court upheld the cutting of $2B (£1.5) in research grants. Plans for next year remain up in the air, with the administration indicating upwards of a 40% reduction in budget for the NIH has to play with.
In the UK, the National Institute of Health and Care Research (NIHR) plays a similar role. With funding from the Department of Health and Social Care, their goal is to improve the “health and wealth” of the UK through research grants. In past years, the NIHR has provided more than £1.2B in grant funding and that number is going up, not down. Even accounting for the differences in population size, the NIH budget far outweighs that of the NIHR but if one is going up and the other is going down, at some point the balance will have shifted.
When it comes to the type of innovation, the UK is also creeping up on its old friend. The 2024 World Index of Healthcare Innovation scores countries on several factors including the quality of innovation and choices consumers have. For last year, the US ranked #7 overall, with a quality ranking of 14, whereas the UK came in 11th partly due to a higher quality ranking of #8. So close!
As co-founder of a British women’s health care company, I am quite pleased to be sitting right where I am. Even as an American who now has seasonal affective disorder as a side-effect. Last April, we were delighted to announce a £1M NIHR grant which was a long process and only a drop in the bucket of what we need but also a huge contribution. With 2% of venture capital funding going to women’s health, government grants are often the lifeline of innovation for companies such as ours. Would I rather be sitting in the US wondering if my NIH grant cheque will arrive or taking advantage of the opportunities that exist here?
Maybe this is an opportunity for the UK to step into the shoes once held by the US and prove an alternative space for healthcare innovation. It’s not just the NIHR. Innovate UK. SBIR grants. EIC funding. SEIS tax schemes. The UK has more that can attract innovation than just common ancestry and the ability to converse.
