EDITORIAL Resource allocation to brain research in Europe Olesen et al. present an estimation of resource alloca- tion to brain research in Denmark (Olesen et al.; EJN this issue). By directly contacting the sources of re- search grants they have estimated funding originating from charitable organizations, from public sources, and from industry. The total brain research funding per capita in Denmark was <50% of that of the USA. Whilst industry funding reached the goals in the Lisbon agreement for the EU of 2% of the gross national product, the public funding was much lower than the Lisbon goals of 1%, despite that the EU has selected brain research as a priority area within health related research (Olesen et al.; EJN this issue). Although the study may have significant weaknesses, it clearly dem- onstrates that Danish public funding of brain research is insufficient, and similar results would probably apply to many European countries if the Danish study would be copied. Brain diseases are prevalent and are indisputably the most burdensome and costly group of diseases in Eur- ope. They are responsible for 35% of the total disease burden in Europe and the estimated total costs of brain diseases in Europe are 386 billion € [1]. The costs of brain diseases equal the costs of cancer and heart diseases together [1,2]. If one subscribes to the principle that research efforts should be related to costs of a disease to the society, then, consequently, the allocation of resources to brain research should be similar to those allocated to cancer and heart diseases together. However, whilst the total founding of brain research in Europe was estimated at 4.1 billion €, cancer research received funding at a similar level, and, importantly, public grants to cancer research were almost twice as high [3]. How can this discrepancy be explained? Brain diseases cause approximately one-third of all burden of disease, but most of the costs are indirect costs, and brain diseases only account for 15% of direct healthcare costs in Europe. Contrary, the costs of cancer of heart diseases are primarily direct costs, and the conspicuous directs costs may have impact on the allocation of public grants for research. Stroke and dementia are high-ranking on the list of the most burdensome diseases in Europe, but like many other neurological disorders they primary affect older people, and these groups of frail patients do not have strong advocates to plead their cause. In general, patients with cancer and heart diseases are younger and have more powerful patient organizations and relatives to promote their interests. What can be done to increase the investment in brain research? New drugs have been introduced for the treatment of stroke and even for neurodegenerative disorders like Alzheimer’s disease and multiple sclerosis that a few decades ago were thought to be untreatable. These drugs have had significant impact on the quality of life for thousands of patients. In order to stimulate phar- maceutical industry research and development in Eur- ope, European neurology has to expose its great scientific resources and to exploit the cost advantage in undertaking clinical trials in Europe. Realising that many brain diseases have important features in common, patient advocacy groups need to understand the importance of collaboration in order to attract increased public awareness to brain disorders in general instead of competing for attention to single diseases. For the neurological society, it will be an extremely important task to explain decision makers in Europe that increased public investment in brain research is likely to be highly cost-effective. As the burden of brain diseases will grow in parallel with the ageing of the population, Europe cannot afford not to invest in brain research. Per Soelberg Sørensen Department of Neurology, Copenhagen University Hospital Rigshospitalet – Danish Multiple Sclerosis Research Center, 9, Blegdamsvej Copenhagen DK-2100, Denmark (tel.: +45 3545 2080; fax: +45 3545 2626; e-mail: pss@rh.dk). References 1. Olesen J, Baker MG, Freund T, et al. Consensus document on European brain research. Journal of Neurology, Neurosurgery, and Psychiatry 2006; 77(Suppl. 1): i1–i49. 2. Olesen J, Leonardi M. The burden of brain diseases in Europe. European Journal of Neurology 2003; 10: 471–477. 3. Sobocki P, Lekander I, Berwick S, Olesen J, Jonsson B. Resource allocation to brain research in Europe (RABRE). The European Journal of Neuroscience 2006; 24: 2691–2693. Ó 2007 EFNS 597 European Journal of Neurology 2007, 14: 597 doi:10.1111/j.1468-1331.2007.01813.x