Competition Between Superpowers

The Russian invasion of Ukraine took place against a backdrop of increasingly fraught geopolitical relations between world superpowers such as the US, European Union, and China.16

“Part of the general ebb and flow of cancer research is whether it is competitive or cooperative,” Dr Sullivan said. “Right now, we are seeing geopolitical competitions breaking out, especially in biopharmaceuticals, which is a major strategic area.” 

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In particular, China has made major investments in its medical research, biotechnology and pharmaceutical industries, including both infrastructure and expertise.17 Chinese academics are increasingly choosing to return home after studying and honing their skills at some of the world’s best universities abroad.18

“China’s rise in the cancer research space is absolutely stratospheric,” Dr Sullivan said. “We’ve never seen any country moving at this speed. It will overtake the US in the next 5 years in terms of their overall cancer research outputs, particularly in oncology biopharmaceuticals.”

Dr Sullivan noted that China is putting a lot of resources into immuno-oncology, seeing the potential to undercut the market with biosimilars of high-grossing immunotherapy drugs such as nivolumab and pembrolizumab.

“China saw an opportunity over the last 10-15 years in the targeted therapy area, to really push forward with innovation and work in this space, and they’ve done it masterfully,” Dr Sullivan said. “Whether that gets translated into a competitive advantage with other countries remains to be seen.” 

Impact of Brexit

In 2016, the UK voted to leave the European Union (EU).19 A couple of years later, it formally completed the “Brexit” process. Even in 2016, there were concerns about the effect of Brexit on cancer research, and some of the predictions have come to fruition.20,21

“Brexit has diminished our power in Europe because we are not at the table anymore,” Dr Sullivan said. “Many of our major organizations like the Medical Research Council and Cancer Research UK are just non-existent on the European circuit. Overall, it’s seen as a substantial own goal [act of self-sabotage], particularly when it comes to policy and influence.” 

A key issue has been the UK’s association with Horizon Europe, the EU’s funding program for research and innovation that has a budget of €95.5 billion.22 The European Commission has barred the UK from Horizon because of a disagreement over the Northern Ireland Protocol, a part of the UK-EU post-Brexit deal.

Science and medical organizations have called for the UK to rejoin Horizon, but talks between the EU and the UK stalled. The UK government recently announced an alternative plan, Pioneer, that could serve as a backup to Horizon, but scientific societies have voiced their preference for Horizon.23-25 

Yet another concern has been that Brexit would cause foreign scientists to leave the UK. Although some scientists from other parts of Europe decided to leave the UK post-Brexit, many have stayed.26,27 

“We predicted that Brexit would have a significant impact on recruitment of expertise to the UK, and it has, to a point, but there are also other countries in Europe with worse conditions than the UK, so the ability to recruit expertise is still relatively high,” Dr Sullivan said. “However, there is no doubt that we are missing some very good people because of Brexit.” 

Disclosures: Dr Sullivan and Dr Coussens reported having no relevant conflicts of interest. 


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