Structural Innovations for Academic Medicine

The performance and effectiveness of research depend on far more than the resources available. They are essentially also a question of the structures in which research is organized and the mechanisms which regulate the distribution of resources. Due to its close links with healthcare, medical research is often integrated in structures and mechanisms which do not provide good conditions for the free development of research potential. Funding is therefore also being provided under the Health Research Programme for measures which promote or trigger the necessary structural changes.

Integrated Research and Treatment Centres (IFB)

By funding the Integrated Research and Treatment Centres, the BMBF is supporting closer links between research and the treatment of patients in important areas of disease. The Centres are intended to sharpen the profile of the medical faculty and the respective university hospital. This will strengthen exchanges between basic and patient-related clinical research.

One aim is to provide stronger support for junior scientists by encouraging independent work at an early stage and by offering more attractive career prospects. Suitable interdisciplinary organizational structures must be developed which can effectively support these aims. Excellent basic research and the relevant experience in patient-oriented research are the fundamental preconditions for a Research and Treatment Centre.

Renowned scientists from at home and abroad considered applications from medical faculties and university hospitals in two rounds of funding. A total of eight candidates are receiving funding:

• Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin
• Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School
• Centre of Chronic Immunodeficiency (CCI), University Medical Centre Freiburg
• Integrated Centre for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders, LMU, Munich
• Integrated Research and Treatment Centre Adiposity Diseases, Leipzig University
• Centre for Sepsis Control and Care, University Hospital Jena
• Centre for Thrombosis and Hemostasis of the Johannes Gutenberg University Mainz
• Comprehensive Heart Failure Centre, University Hospital Würzburg

Each of these universities receives funding of up to 25 million euros for the first five-year funding phase.

Competence networks in medicine

The establishment of competence networks in medicine is one measure for the trans-regional pooling of expertise in a specific disease area. The BMBF initiated the competence networks in the late 1990s because although Germany has great expertise in medical research, this is widely scattered and not sufficiently visible. It still takes an average of ten years before research results actually reach the patient in his sickbed. But the transfer of information in the other direction is also insufficient. Burning issues in day-to-day medicine are not taken up adequately by research.

The BMBF is currently funding or has funded 22 competence networks on diseases which cause great suffering for patients and high costs for the healthcare system. All in all, the BMBF is providing about 225 million euros for the 17 networks of the first generation. The 17 competence networks in medicine have proven to be a highly successful funding model. They have created structures which must now be used, developed further and, above all, made more flexible in the new "Disease-related Competence Networks". Approximately 46 million euros will be made available by 2012 for the five "Disease-related Competence Networks" in the fields of Degenerative Dementias, Adiposity, Diabetes, Asthma/COPD and Multiple Sclerosis.

Many results of this funding measure are described in the BMBF's brochure "Von der Forschung in die Versorgung - Kompetenznetze in der Medizin".

Development of medical research in the new Länder

Under a special funding measure, the BMBF started to fund clinical research in Eastern Germany directly after German unification. This funding was based on recommendations regarding academic medicine in the new Länder issued by the Science Council in 1991. The aim was to promote the development of efficient clinical research at Eastern German universities and to thus contribute to a homogeneous and differentiated research environment. Funding took place in three consecutive measures (NBL 1, 2, 3) between 1991 and 2008. Funding totalled more than 150 million euros.

The first two funding rounds (NBL1, NBL 2) focused on improving methodological know-how and the pilot development of independent research structures in priority areas. The aim of the third round "Improving the Efficiency of Clinical Research in Medical Faculties in the New Länder including Berlin (Charité)" involved supporting innovative internal processes in the faculties receiving funding, thus leading to the more efficient use of the resources provided for research and to an enhancement of existing scientific strengths in the sense of profiling.

The documentation of the symposium which was held in Greifswald on 10/11 May 2007 to conclude this funding measure can be found at http://www.gesundheitsforschung-bmbf.de/_media/Dokumentation_gesamt.pdf.