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Objectives: To describe the type of evidence and the clinical benefit of cancer medicines assessed for funding in Australia by the Pharmaceutical Benefits Advisory Committee (PBAC) and to assess it with the European Society of Medical Oncology Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS)., Methods: All data on applications submitted to PBAC between 2010 and 2020 were extracted from PBAC Public Summary Documents available online. ESMO-MCBS ratings were retrieved from the ESMO-MCBS website., Results: Then, 182 cancer indications for 100 cancer medicines were examined by PBAC, including 124 (68.1 percent) for solid tumors and 58 (31.9 percent) for hematological cancers. A total of 137 (75.3 percent) indications were recommended for PBS funding and 40 (21.9 percent) were rejected. Randomized clinical trials (RCTs) were the main source of evidence in 154 indications (84.6 percent), single-arm studies in 28 (15.4 percent) indications. Statistically significant improvement in overall survival (OS) was reported in 80 (44 percent) of the indications, with a median OS gain of 3.0 months (range 0.9-17.0) for solid tumors and 8.2 months (range 1-49.1) for hematological cancers when mature OS data were available. The ESMO-MCBS score was available for 99 solid tumor indications, of which 51 (51.5 percent) showed substantial clinical benefit according to ESMO-MCBS, including 40 (54.1 percent) of PBAC-recommended indications and 9 (42.9 percent) of PBAC-rejected indications. There was no association between the ESMO scoring and PBAC decision., Conclusions: Most cancer medicines indications considered by PBAC were supported by RCTs. A minority showed a substantial improvement in OS.

Reflecting sex and gender characteristics in biomedical research is critical to improving health outcomes and reducing adverse effects from medical treatments. This study investigates the impact of sex/gender-specific funding policies and journal editorial standards on the integration of sex/gender analysis in biomedical research publications. Using data from the United States, Canada, the United Kingdom, and other countries between 2000 and 2021, we assessed how these policies influenced research output in the fields of medicine and life sciences. Our findings show that countries with progressive funding policies and journals promoting sex/gender-based reporting have significantly improved research quality and publication rates. This highlights the importance of coordinated policy efforts and editorial practices in advancing integrated sex/gender research. We recommend continued global efforts from policymakers, funding bodies, and journals to embed sex/gender perspectives in scientific inquiry, ensuring more effective and equitable biomedical advancements., (© 2024. The Author(s).)

"Medical scientists" are postgraduate investigators who are engaged in biomedical research, and either hold a biomedical PhD or are qualified in medicine but do not participate in patient care. Medical scientists constitute ~40% of staff at medical faculties and >90% at nonuniversity medical research institutions in Germany. However, medical scientists in Germany face limited long-term career prospects and a lack of dedicated training and support programmes. They also face time limits on their career progression arising from national academic employment legislation, and imminent reforms by the German government are likely to make this worse. Nevertheless, recent developments in the educational landscape including the introduction of increasingly focused MSc, pre-PhD, and doctoral programmes to train medically aware basic scientists, as well as improved general recognition of the roles and relevance of medical scientists in health research, are encouraging. Physiologists have taken essential steps to improve the recognition of medical scientists in Germany by introducing a "specialist physiologist" qualification; this initiative could be applied to support medical scientists in other fields and countries. In this review, we describe the particular challenges facing medical scientists in Germany and make recommendations that may apply to other academic systems., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Background and Objectives: The lung and sleep health of adults is heavily influenced by early factors, both genetic and environmental; therefore, optimizing respiratory health begins in childhood. Multiple barriers impede improvements in lung and sleep health for children. First, the traditional siloing between general pediatric care in the community, pediatric pulmonary and sleep subspecialty care, and the research community limits the translation of knowledge into practice. Additionally, identifying and addressing health disparities remains a challenge. The 2021 NHLBI-sponsored workshop "Defining and Promoting Pediatric Pulmonary Health (DAP 3 H)" was a first step in defining critical gaps in our current healthcare system in identifying and optimizing lung and sleep health in children. The workshop identified key opportunities including measuring pulmonary function in young children, sleep-focused outcomes, developing biomarkers, and longitudinal research cohorts. To expand on the work of DAP 3 H and continue initiatives to improve childhood lung and sleep health, the Pediatrics & Pulmonary Network: Improving Health Together conference was held in 2023., Study Design: A modified Delphi process was applied to form consensus surrounding gaps, barriers, and action items, with the goal of identifying the most urgent opportnities for improving childhood lung and sleep health., Results: Cross-cutting foundational principles were identified as: (1) Authentic Stakeholder Collaboration & Engagement, (2) Reach & Implementation in Real World Settings, (3) Understanding Current Landscape & Resources and (4) Purposeful Diversity, Equity, & Inclusion Initiatives., Conclusions: To improve lung and sleep health in children, these principles should be the foundation for research design, development, and implementation., (© 2024 Wiley Periodicals LLC.)

Introduction: Industry funding in surgical education offers benefits but presents conflicts of interest. This study defines the prevalence and extent of industry funding to fellowship program directors (FPDs) across pediatric surgical specialties., Materials and Methods: This was a retrospective cross-sectional analysis of FPDs in pediatric surgical specialties. Data were amalgamated from the Centers for Medicare and Medicaid Services and the Accreditation Council for Graduate Medical Education. Characteristics of FPDs were obtained from academic websites and medical licensing boards. Personal industry payments from 2016 to 2022 were analyzed, and temporal trends were elucidated. Comparisons were made by year, surgical specialty, and control groups with nonparametric tests., Results: A total of 241 FPDs were identified, with 206 (85%) receiving industry payments over the study period. The specialties with the highest prevalence of industry funding to FPDs were pediatric orthopedic surgery (100%), pediatric urology (96%), and pediatric surgery (85%). Total industry payments aggregated to $7.3 million dollars with the majority awarded to pediatric orthopedic surgery (91%). Most industry payments were for royalties or licensing (57%) and consulting fees (31%). Median total industry payments per FPD differed between subspecialties (P < 0.001) and was highest in pediatric orthopedic surgery ($7009, interquartile range [IQR], $1771-$50,239) and lowest in pediatric otolaryngology ($116, IQR, $75-$1626). Male FPDs had higher median total industry payments than female FPDs ($1643, IQR, $172-$8731 versus $193, IQR, $84-$712, P < 0.001)., Conclusions: Industry payments to FPDs in pediatric surgical specialties are highly prevalent, but the magnitude varies by specialty. Future work is needed to establish mechanisms that promote equitable partnerships between academia and industry for pediatric surgery training., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Investigator-initiated clinical studies (IICSs), also referred to as non-commercial, academic or independent clinical studies, address important research questions that are usually neglected by industry despite their high societal value. Indeed, industry may direct their focus and resources on studies that will yield results and products that can ultimately generate revenue for the company. Conversely, IICS research questions include (a) refining or getting new indications of available treatments (drug repurposing); (b) optimisation, by comparing various health products or treatment regimens; and (c) innovation, especially for advanced therapies. Multinational IICSs increase the scientific quality of the data by exchange of research ideas, scientific techniques and tools. Participation of patients from different geographical, social and ethnic backgrounds equally adds to the value of study results and yields more generalisable evidence than a study confined to a single geographical location. Multinational IICSs are generally sponsored by non-profit/academic organisations and publicly funded. Funding has been already identified as a main challenge for the conduct IICS and especially for clinical trials (IICTs, IICS where a medical intervention is directly tested). Main barriers to the conduct of multinational IICTs with public funding include: Limitations of budget and duration of the eligibility of costs Lack of flexibility to move funds transnationally Tendering rules Complexity in the reporting of the eligible costs to funders We describe why there is a need to support multinational IICS, what should be their objectives and what are the current funding mechanisms in Europe. Strategies for funding multinational IICS should evolve to mitigate identified barriers, thus facilitating research that can provide answers to highly relevant questions in healthcare which are less likely to be answered by studies funded by the pharmaceutical and medical device industry., (© 2024. The Author(s).)

Clinical Relevance: Few studies have investigated the economic burden of keratoconus to patients and society including a patient's lifetime expenditure. Analysing disease cost is important in advocating funding and planning for appropriate management and treatment., Background: Keratoconus can be an expensive disease, including costs associated with visual rehabilitation and surgery. This study aimed to assess direct and indirect expenditures incurred by keratoconus subjects, to estimate the lifetime per capita cost and the total costs of keratoconus per year in Auckland, New Zealand., Methods: A cross-sectional study where participants with keratoconus were recruited from public and private clinics to complete an anonymous questionnaire. A keratoconus health expenditure questionnaire was used to assess direct and indirect expenditures for participants. Estimated lifetime per capita costs and total direct and indirect costs associated with keratoconus were calculated., Results: Responses from 110 participants were recorded. Most participants (55.5%) were between the ages of 21 and 30, 59.1% were male, and Pacific People were over-represented (14.5%) compared to the national population. The prevalence of visual rehabilitation was low with 74.5% of participants never wearing contact lenses and 32.7% of subjects wearing spectacles purchased over 24 months prior. Few participants (26.5%) had subsidised care, including private health insurance with optical cover or the contact lens subsidy. Total direct and indirect costs are estimated to be NZD 30.9 million per year with an estimated lifetime per capita out-of-pocket cost of NZD 79,254., Conclusion: Subjects with keratoconus experience significant direct and indirect costs with limited subsidisation from the government and private health insurance. The significant out-of-pocket costs required for managing keratoconus are likely a significant barrier to accessing appropriate visual rehabilitation in New Zealand.

The present study examines the training environment and sponsorship dynamics in Hungarian artistic swimming, with a particular focus on competitiveness. Through the utilization of a linear regression method ample aspects were identified, such as coach qualifications, funding sources, and facilities, that positively impact the number of qualified competitors. The availability of funding sources, when coupled with governmental assistance, has a favorable effect on the number of competitors, whereas membership fees have a deleterious impact. Furthermore, the findings indicate that increased water availability and increased publicity enhance artistic swimming recognition, whereas improved land-based training conditions may lead to a decline in the number of competitors. This paper discusses how different aspects of training programs can be integrated to improve overall athleticism, prevent injury, and enhance the competitive ability of artistic swimmers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Máté, Vveinhardt and Fekete.)

Background: Over the last two decades, substantial investments have been directed towards supporting fundamental and applied research in Alzheimer's disease (AD), breast cancer (BC), and prostate cancer (PC), which continue to pose significant health challenges. Recently, the Joint Research Centre (JRC) of the European Commission (EC) conducted a retrospective analysis to examine the major scientific advancements resulting from EU-funded research in these disease areas and their impact on society., Methods: Building upon this analysis, our subsequent investigation delves into the methodological approaches-both animal and non-animal models and methods-employed in AD, BC, and PC research funded under past EU framework programs (FP5, FP6, FP7, and H2020), and explored the notable research outputs associated with these approaches., Results: Our findings indicate a prevalent use of animal-based methodologies in AD research, particularly evident in projects funded under H2020. Notably, projects focused on drug development, testing, or repurposing heavily relied on animal models. Conversely, research aimed at clinical trial design, patient stratification, diagnosis and diagnostic tool development, lifestyle interventions, and prevention-outputs with potential societal impact-more frequently utilised non-animal methods. Advanced investigations leveraging imaging, computational tools, biomarker discovery and organ/tissue chip technologies predominantly favoured non-animal strategies., Conclusions: These insights highlight a correlation between methodological choices and the translational potential of research outcomes, suggesting the need for a reconsideration of research strategy planning in future framework programs., (© 2024. European Union and Humane Society International 2024.)

The authors describe the phases (conceptualizing, actualizing, and ensuring success of science) necessary for developing a successful research grant application for funding. Emphasis is on the development of an important and novel research question, clear conceptualization of the study, development of specific aims, theory to guide the study, a well-designed approach, and the role of teamwork to enhance success. The challenges that can occur during these phases of grant writing are also addressed., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the authorship and/or publication of this review.

Neurosurgical education and training are the essential tenets for the development of a sustainable workforce. However, opportunities for training are limited in most parts of the world due to socioeconomic constraints and an inadequate workforce. This global deficit has triggered a huge drive to expand training opportunities. Although training programs are increasing numerically, most of these programs focus on basic residency training with no opportunities for fellowships and continuing education. Herein, we use the Foundation of International Education in Neurological Surgery as a global success model to elucidate on the role of fellowships, distant continuing education, and funding in neurosurgery., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The medical technology sector is characterised by a constant influx of innovations with the potential to revolutionise patient care. In France, there are several pathways for medical devices to enter the market, from diagnosis-related group tariffs to reimbursement lists. However, traditional regulatory pathways can delay market access for innovative technologies. In response, France has established Early Access Programs to expedite patient access to medical devices. This paper looks at three of these Early Access Programs for medical devices. Innovation Funding, introduced in its final version in 2015, provides temporary coverage for innovative devices and facilitates data collection for informed funding decisions. Transitional Coverage (PECT), established in 2021, targets CE-marked devices for rare or serious conditions. Transitional coverage for digital health applications (PECAN), introduced in 2022, covers digital medical devices, either therapeutic or for patient monitoring. Innovation funding has been granted to 16 technologies out of 35 applications (46%) since 2015. 6 technologies out of 11 (64%) applications benefit from PECT. PECAN, in its first year, has granted a telemonitoring solution with a favourable opinion. The French experience could provide valuable lessons for the development of a harmonised European framework to ensure that innovative medical technologies benefit those who need them, while maintaining high safety standards., Competing Interests: Declarations of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: To describe the characteristics of National Institutes of Health (NIH) cancer survivorship grants funded over the past 5 years and identify gap areas for future efforts and initiatives., Methods: Research project grants (RPG) funded during Fiscal Year (FY) 2017 to 2021 focused on cancer survivorship were identified using a text mining algorithm of words from the NIH Research, Condition, and Disease Categorization (RCDC) thesaurus with survivorship-relevant terms. The title, abstract, specific aims, and public health relevance section of each grant were reviewed for eligibility. Grants meeting the eligibility criteria were double coded to extract study characteristics (e.g., grant mechanism, study design, study population)., Results: A total of 586 grants were funded by 14 NIH Institutes from FY2017 to FY2021, and the number of newly funded grants increased each FY, from 68 in 2017 to 105 in 2021. Approximately 60% of all grants included an intervention study, and interventions most often focused on psychosocial or supportive care (32.0%). The most common primary focus of the grants was late- and long-term effects of cancer treatment (46.6%), and least often financial hardship., Conclusions: The results of this portfolio analysis indicate overall growth in the number and breadth of grants over the last five years, although notable gaps persist., Implications for Cancer Survivors: This review of current NIH grants suggests a need for expanded research to understand and address survivor needs to ensure that the over 18 million cancer survivors in the United States have optimal quality of life and health outcomes., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Introduction: Diagnostics can contribute to the improved quality of antibiotic prescribing. However, there is potential to enhance the use of point-of-care tests (POCTs) in general practice. This paper presents fit-for-purpose policy recommendations related to funding and pricing for POCTs applied for community-acquired acute respiratory tract infections (CA-ARTIs)., Methods: The development of the recommendations was informed by an analysis of the current status of funding and pricing policy frameworks for CA-ARTI POCTs in European countries, and an identification of barriers and facilitators for their uptake. Draft recommendations were developed and subsequently revised based on written and verbal feedback from meetings with experts., Results: The proposal includes four recommendations for policy interventions related to funding and three recommendations regarding pricing policies. Two of the funding policy-related recommendations concern physicians' remuneration, and two relate to product-specific reimbursement (public coverage) of the CA-ARTI POCTs. The pricing-related recommendations include a proposal to explore the introduction of price regulation, to pilot subscription-fee procurement models and to enhance more strategic approaches in public procurement of CA-ARTI POCTs., Conclusions: Optimised pricing and funding policies could make a difference in enhancing uptake of CA-ARTI POCTs. It is crucial for the successful implementation of policies to consider country settings. Additionally, supportive policy action is recommended, including the systematic use of health technology assessment, stakeholder communication, and monitoring and evaluation., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Introduction: The National Institutes of Health (NIH) is the primary federal agency in the United States (US) that supports biomedical research, training, and clinical trials. NIH funding creates patents and jobs and thus helps the regional and national economy grow. Therefore, NIH funding would be expected to flow equitably to all 50 US states. However, there is a significant geographic disparity in the level of NIH funding received by various states. To that end, in 1993, authorized by Congress, NIH initiated a funding program called the Institutional Development Award (IDeA) to support states, called IDeA states, which received low levels of NIH funding. However, whether this approach has helped reduce the geographic disparity in NIH funding is unclear., Methods: In the current study, we analyzed data on various NIH funding mechanisms awarded to 23 IDeA states vs. 27 non-IDeA states, as identified by NIH. We compared these data to the population size, federal taxes paid, and the number of PhDs and Post-doctoral Fellows(PDFs) trained in IDeA vs. non-IDeA states., Results: The non-IDeA states received 93.6% of the total NIH funding, whereas IDeA states received only 6.4%. On average, one Institutional Training Grant was received for every 24 PhDs trained in non-IDeA states, while IDeA states received one such grant for every 46 PhDs trained. The non-IDeA states comprised 84.3% of the US population, whereas IDeA states comprised 15.7%. Thus, on a per capita basis, non-IDeA states received $120 from NIH, whereas IDeA states received $45 per person. For every million dollars contributed by the non-IDeA states toward federal taxes, they received $7,903 in NIH funding, while the IDeA States received only $4,617. For FY 2022, the NIH funding created an economic activity of $90.6 Billion in non-IDeA states and only $6.3 billion in IDeA states. When total NIH funding to the states was analyzed for the years 1992, 2002, 2012, and 2022, IDeA states received 4.7% of the total NIH funding in 1992, which increased to 7.2% in 2002 but dropped to 6.8% in 2012 and 6.5% in 2022. This demonstrated that IDeA states' share of NIH funding remained relatively unchanged for the past 20 years., Discussion: Eliminating the geographic disparity in NIH funding is crucial for achieving equitable health outcomes across the US, and for the IDeA states to successfully train future generations of physicians and scientists, as well as grow the regional economy. Although the NIH IDeA programs have helped enhance the research capacity in IDeA states, the funding currently constitutes less than 1% of the total NIH budget. Thus, it is critical to increase NIH funding to IDeA states to improve health outcomes for all Americans., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Caulder, Zhang, Nagarkatti and Nagarkatti.)

Background and Objectives: Conducting high-quality randomized clinical trials (RCTs) is challenging and resource intensive. Funders and academic investigators depend on limited financial resources and, therefore, need empirical data for optimal budget planning. However, current literature lacks detailed empirical data on resource use and costs of investigator-sponsored RCTs. The aim of this study is to systematically collect cost data from investigator-sponsored RCTs from Switzerland, Germany, and the United Kingdom (UK)., Methods: Principal investigators were asked to share their RCT cost and resource use data and enter it into an online case report form. We assessed cost patterns, cost drivers, and specific cost items, examined costs by study phase (planning-, conduct-, and finalization phase), compared planned with actual RCT costs, and explored differences in cost patterns across countries, medical fields, and intervention types., Results: We included 93 RCTs which were initiated in Switzerland (n = 53; including eight conducted in low- and lower middle-income countries), Germany (n = 22), and the UK (n = 18). The median total trial cost in our RCT sample was $645,824 [interquartile range (IQR), $269,846-$1,577,924]. The median proportion of the total costs spent for planning phase was 27.5% [IQR, 20.6%-39.7%], for conduct phase 57.3% [IQR, 44.4%-66.3%], and for finalization phase 12.7% [IQR, 8.5%-19.3%] with little variation across countries. The items that contributed most to the total costs were protocol writing (7.2%; IQR 3.8%-10.6%), data management (5.0%; IQR 2.2%-8.1%) and follow-up (4.5%; IQR 2.3%-8.4%). Of the 66 RCTs with an available original budget, 46 (69.7%) exceeded the budget by over 50%. Use of routinely collected data to assess primary outcomes was independently associated with lower per patient- and lower total trial costs., Conclusion: Over a quarter of total trial costs were incurred in the planning phase, which is typically not fully funded. Two-thirds of RCTs exceeded their budget by more than 50%. Investigators and funders should consider empirical cost data to improve budgeting and funding practices., Competing Interests: Declaration of competing interest B.S. and M.B. report an unrestricted grant from Moderna for a study outside of the submitted work. There are no competing interests for any other author., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Innovative medicines and vaccines can provide direct health benefits to patients and populations by preventing, treating and curing diseases, and also drive wider socioeconomic and productivity gains. However, researching and developing them is complex and risky. Funding for life sciences R&D has different sources: public, charitable/NGO, and private sector. We believe there is consensus that all are required, although there is less understanding about their respective roles, synergies, and funding priorities. The purpose of this paper is to provide an overview of the current life sciences innovation ecosystem in Europe, highlighting challenges for funding and innovation of new therapies and our proposed options to address these., Methods: The basis of this paper stems from the reflections made by the co-authors during a webinar with title "Collaboration for new therapies: maximising funding and innovation," in March 2023, with further targeted literature reviews., Results: We identify eight challenges in the European life sciences ecosystem, some closely related, and nine options that we think might be helpful to address them. Each option on its own can have different levels of 'impact', but collectively will provide synergies among them, and thus maximize their impact., Discussion: It is critical to ascertain how the strengths of each actor can be leveraged to bring new medicines/treatments to market, quicker and more efficiently. We need a trusted environment, with strategic collaborations between the public and private sectors, and policy initiatives and incentives should be targeted to strengthen the infrastructure with the aim of fostering such optimal alliances., Competing Interests: VA is employed by MSD. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mestre-Ferrandiz, Meulien, Ostwald and Acha.)

This paper describes how a team of researchers, policy stakeholders and community members came together to co-create prevention-oriented and community-informed solutions to address loneliness in women-The Loneliness Project. Our aim is to encourage community partnerships and collective effort to address public health approaches to loneliness by developing a shared understanding of the issue from multiple perspectives and through the co-creation process, highlighting the key factors for co-creating a funding application for a community demonstration project., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Corsini, Dorman, Scott, Wright, Turnbull, Williams, Bates, Reading, Everuss, Peng, Pearse and Eckert.)

Background: There are critical disparities in the neurosurgical care provided around the globe due to challenges in resource allocation, training, and infrastructure. Global neurosurgical collaborations have replaced classical mission trips to address these disparities. However, the development of these collaborations and the impact of research funding on their growth have not yet been systematically studied. In this article, we use a graph theoretical approach to investigate trends in funding and co-authorship between and among authors from high-income countries (HICs) and authors from low- and middle-income countries (LMICs)., Methods: A bibliometric search of the global neurosurgical literature returned 307 articles between 1985 and 2020. A connectivity analysis was conducted to compute the number of co-authorships between HIC-HIC, LMIC-HIC, and LMIC-LMIC authors. The number of connections, summarized as either a global sum of connections or an average number of connections per manuscript, were analyzed in the context of time and funding through parametric statistical tests., Results: An exponential increase in co-authorship collaboration was observed over time, especially after 2015. Notably, LMIC-LMIC collaborations appear to be rising at over twice the rate of other collaboration types. The presence of funding, in general, was associated with increased co-authorship of manuscripts by LMIC and HIC authors together (P = 0.033). A significant majority of the funding associated with LMIC-HIC co-authorships was supplied through charitable organizations and government grants (P = 0.034, P = 0.009, respectively). Most LMIC-LMIC co-authorships had no funding., Conclusions: This work shows significant and rapid growth in international neurosurgical partnerships, especially in HIC-LMIC and LMIC-LMIC collaborations. Also, a significant positive relationship exists between research funding and LMIC-HIC co-authorship trends. This work encourages us as a community to continue to expand our translational collaborations with LMIC neurosurgeons and establish funding mechanisms independent of HIC authors., (Copyright © 2024 Elsevier Inc. All rights reserved.)