Evolution of public funding for collaborative health research towards higher level patient-oriented research: A comparison of the European Union Framework Programmes to the program funding by the United States National Institutes of Health

Abstract Public research funding agencies increasingly seek to steer health research toward higher levels of translation and societal relevance. Yet it remains unclear to what extent such policy shifts are effectively implemented and reflected in funded projects and scientific outputs. This study examines the evolution and changes in the orientation of health research portfolios since 2008 within European funding (Framework Programmes FP7, Horizon 2020 and Horizon Europe funding for collaborative health research, FP-HR, and ERC Life Sciences grants), compared with NIH funding for collaborative research (P01, U01, and UM1). Using large-scale text analysis and supervised classification, we analyze both project descriptions and the associated scientific publications. At the project level, the EU FP-HR programs show pronounced shifts toward population-level, diagnostic, and health systems-oriented research, whereas investigator-driven ERC life sciences, and NIH P01 and U01, display greater stability with a predominance of basic biomedical research. Publication-level analyses reveal more moderate changes, with basic biomedical research remaining a central component, including in EU FP-HR, indicating partial translation of funding priorities into outputs. By jointly analyzing projects and publications, this study identifies and distinguishes between changes in funder expectations and realized research trajectories, highlighting how strategic funding shapes research portfolios within enduring epistemic and institutional constraints.