# Burden-weighted portfolio targets for every major cancer funder

Source: https://onco.cc/ideas/idea-fund-burden-weighted-portfolio/  
OnCo record `idea-fund-burden-weighted-portfolio` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Funders would publish how their spending compares with deaths and years of life lost per cancer, and commit to shift a fixed share of money each year towards the biggest gaps.

## Summary

A burden-weighted formula sets a target share for each cancer type and each stage of the pipeline (prevention, detection, metastasis, delivery) using disability-adjusted life years and deaths from GLOBOCAN and the Global Burden of Disease study, adjusted by a tractability discount. Funders publish actual versus target and are held to a rebalancing rule of, for example, moving 10% of the discretionary portfolio per year towards under-funded areas. Analyses of NCI and UK spending have repeatedly shown lung, pancreatic, oesophageal, liver and stomach cancers receive far less per death than breast, leukaemia and prostate.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: If the five largest public and charitable funders adopt a published burden-weighted target with a 10% annual rebalancing rule, the ratio of research spend per death between the best- and worst-funded common cancers falls by at least half within five years, and grant applications in under-funded cancers rise in proportion.
- Rationale: Portfolio targets work where they are transparent and measured: the UK Research Councils shifted spending towards dementia after a published burden comparison, and Gavi rebalanced vaccine investment using disease-burden weights. Peer review alone cannot rebalance because it scores proposals, not portfolios; the proposals that arrive already reflect where money has been.
- Proposed test: One funder pilots the formula on a defined pot (for example 20% of new awards) for three years, tracks application volume, success rates and quality scores by cancer, and compares the burden alignment of the pilot pot with the rest of its portfolio.
- Maturity: speculative
- Actor: policy

## Sources

- GLOBOCAN (IARC Global Cancer Observatory): https://gco.iarc.fr/
- Global Burden of Disease: https://www.healthdata.org/research-analysis/gbd
- International Cancer Research Partnership: https://www.icrpartnership.org/

## Connected records

- ideas: [A formal patient-burden score in grant peer review](https://onco.cc/ideas/idea-fund-patient-burden-review-criterion/), [A public dashboard of research money per death for every cancer](https://onco.cc/ideas/idea-fund-dollars-per-death-dashboard/), [Judge funding programme officers on burden alignment and trials completed](https://onco.cc/ideas/idea-fund-programme-officer-incentives/), [Mandatory machine-readable portfolio reporting for all large cancer funders](https://onco.cc/ideas/idea-fund-cross-funder-portfolio-registry/)
- cancers: [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- institutions: [Cancer Research UK](https://onco.cc/institutions/cruk/), [International Agency for Research on Cancer (IARC / WHO)](https://onco.cc/institutions/iarc/), [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- bottlenecks: [Funding follows fashion, not burden](https://onco.cc/bottlenecks/b-funding-allocation/)

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