{"entity":{"id":"idea-fund-burden-weighted-portfolio","kind":"idea","name":"Burden-weighted portfolio targets for every major cancer funder","aka":[],"tldr":"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.","asOf":"2026-09-08","links":[{"label":"GLOBOCAN (IARC Global Cancer Observatory)","url":"https://gco.iarc.fr/"},{"label":"Global Burden of Disease","url":"https://www.healthdata.org/research-analysis/gbd"},{"label":"International Cancer Research Partnership","url":"https://www.icrpartnership.org/"}],"tags":[],"related":["idea-fund-dollars-per-death-dashboard","idea-fund-cross-funder-portfolio-registry"],"cancers":["pancreatic","esophageal","hcc","gastric","nsclc"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["nci","cruk","iarc"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-funding-allocation"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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","cost":"small","horizonYears":3},"route":"/ideas/idea-fund-burden-weighted-portfolio/","neighbours":{"idea":[{"id":"idea-fund-patient-burden-review-criterion","kind":"idea","name":"A formal patient-burden score in grant peer review","route":"/ideas/idea-fund-patient-burden-review-criterion/"},{"id":"idea-fund-dollars-per-death-dashboard","kind":"idea","name":"A public dashboard of research money per death for every cancer","route":"/ideas/idea-fund-dollars-per-death-dashboard/"},{"id":"idea-fund-programme-officer-incentives","kind":"idea","name":"Judge funding programme officers on burden alignment and trials completed","route":"/ideas/idea-fund-programme-officer-incentives/"},{"id":"idea-fund-cross-funder-portfolio-registry","kind":"idea","name":"Mandatory machine-readable portfolio reporting for all large cancer funders","route":"/ideas/idea-fund-cross-funder-portfolio-registry/"}],"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"institution":[{"id":"cruk","kind":"institution","name":"Cancer Research UK","route":"/institutions/cruk/"},{"id":"iarc","kind":"institution","name":"International Agency for Research on Cancer (IARC / WHO)","route":"/institutions/iarc/"},{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"bottleneck":[{"id":"b-funding-allocation","kind":"bottleneck","name":"Funding follows fashion, not burden","route":"/bottlenecks/b-funding-allocation/"}]}}