Ford School professor Shobita Parthasarathy is calling for a change in innovation policy to center “equity as a public value” as the scientific community ponders “the next 75 years of science policy.” In her essay Innovation as a Force for Equity, for Issues in Science and Technology, Parthasarathy first looks back on 75 years of policy, in which significant investments in research by the National Science Foundation (NSF) and the National Institutes of Health (NIH), often relying on market activity, led to many technological and medical successes. However, Parthasarathy, who directs U-M’s Science, Technology, and Public Policy program, affirms, “innovation isn’t benefiting everyone, and sometimes it amplifies inequality. Whether the internet or insulin, many people in the United States lack access to crucial innovations. Meanwhile, machine learning algorithms and many other technologies reflect and reproduce social biases, including racial biases.”
Sometimes when healthcare treatments or technologies are inaccessible to underserved populations, the diffuse U.S. healthcare system is blamed. Yet the very nature of how the innovations were designed can address those issues from the start. The barriers can be price, distribution, infrastructure or a lack of information. “Policymakers and scientists could make systematic efforts to consider these concerns at the roots, when early-stage research is funded and patent rights are awarded. They could make technology design and development choices that maximize equity rather than, for example, market viability. Put simply, innovation and health care equity need to be relinked in our public policies,” she writes.
Noting that most federal funding goes to only a handful of universities, she writes further that the U.S. innovation system represents a narrow range of interests and that the resulting demographic homogeneity has a real impact on innovation. Emphasis on the private sector is flawed as well, as it is less interested in innovation at the community level, in public policy, or in infrastructure. “This approach doesn’t only limit our understanding of health inequalities, it perpetuates the false understanding that the solution to health problems lies in individualized, commodified technologies.”
Parthasarathy suggests that agencies that fund science could encourage their grantees to consider whether their technologies might exacerbate inequality, and help guide them to develop more socially just designs.
Specifically, she offers tangible steps:
- Reconsider who the “experts” are. “Innovation policy customarily favors the knowledge of biomedical scientists and engineers, physicians, and industry representatives over that of patients, social scientists, ethicists, or historians. But taking equity seriously means ensuring that technologies reflect societal needs and priorities and are also rooted in the realities on the ground.”
- Reimagine innovation. “The current approach excludes categories of innovation that are likely to be particularly effective in promoting equity and inclusivity such as low-tech interventions and new approaches to public policy, built infrastructure, urban and suburban planning, and pollution prevention and remediation practices. Another reform that could make equity part of early-stage innovation would be to require equity impact assessments as a condition of grant funding, including how they will evaluate the equity impacts of their proposed project, and how they will address inequities reflected in or amplified by their intervention.”
- Create new systems for accessibility. Funding agencies, and the policymakers who guide their priorities, have emphasized the market as the primary mechanism for translating technology to society. Patents and other forms of IP play a key role. But while patents can stimulate innovation in some cases, they can also have an inhibitory effect. And IP can make technologies inaccessible, which is particularly problematic in areas such as health. As well, research funding agencies should create offices that identify and support non-market-based approaches to health innovation. For example, there is little investment in translating research that might improve built infrastructure, pollution remediation programs, or social, environmental, and health policies. These efforts would ensure wider accessibility to the fruits of federally funded research.
The Biden administration’s proposed Advanced Research Projects Agency for Health (ARPA-H), modeled on the famed Defense Advanced Research Projects Agency, could produce breakthrough advances for common diseases. “For ARPA-H to further the administration’s strong equity objectives, the program must foster innovation that is based in interdisciplinary and community-based insights and be transferable beyond the marketplace,” she writes.
Parthasarathy concludes, “Ensuring that innovation policy truly serves all people requires bold, systemic change. Inequality is baked into the U.S. approach to innovation policy. Driven by scientists’ and market priorities, the current approach emphasizes standardizable, scalable, and commodifiable technologies that are designed to work at an individual level rather than benefit communities or address much needed infrastructure failures or policy requirements. Sometimes, this personalized, commodified approach leads to crucial, lifesaving interventions. But often these interventions are inaccessible to the most vulnerable. Institutions involved in innovation policy invariably abdicate responsibility for this disparity.”
“To ensure truly equitable progress, we need to leverage a diverse range of knowledge to determine which endless frontiers to investigate and how to study them.”
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