THE MOST IMPORTANT RESEARCH MAY NOT HAVE AN ROI YET

We have gotten very comfortable asking one question about almost everything: What is the return on investment?

In business, that is usually a reasonable question. In medical research, it can become a limiting one.

Some of the most important scientific work does not begin with a product, a treatment, or a clear path to revenue. It begins with a question about how something works, why a biological process behaves the way it does, or what researchers still do not understand about a disease.

Those questions can sound abstract if you are looking for an immediate payoff. But that is often where the work that eventually changes medicine begins.

BASIC RESEARCH DOES NOT ALWAYS COME WITH A BUSINESS CASE

People understandably want to know what their money is going to accomplish.

If you are funding cancer research, you want to hear about better treatments, earlier detection, improved survival, or better outcomes for patients. So do I.

The challenge is that you cannot always draw a straight line from a research project to one of those outcomes when the work begins. That is especially true in basic research, where the purpose is to understand how something works before we know exactly what we can do with that knowledge.

A project studying how cancer cells communicate may not be able to promise a new therapy in three years. It may not be able to tell you what the commercial value will be. It may not even produce the answer the researchers expected. That does not mean the work failed. It may produce the insight that makes another discovery possible five or ten years later.

That is where traditional ROI thinking can become a problem. We start trying to evaluate discovery science as though we were evaluating a business investment with a defined product, market, and timeline. Science does not always cooperate with that model.

WE LIKE CERTAINTY MORE THAN DISCOVERY DOES

Funding decisions naturally push people toward certainty. What will this project produce? When will it produce it? How many patients will it help? What measurable outcome can we expect?

Those are fair questions, and researchers should absolutely be accountable for how funding is used. But if we require them to know the answer before we are willing to fund the question, we create a system that naturally rewards research that is easier to predict.

That may feel safer, but safer does not necessarily mean more important.

Discovery is messy. A hypothesis can be wrong. An experiment can uncover something completely unexpected.

Researchers may spend years pursuing one idea and discover that the real value of the work is something they never set out to find. That is not an argument for funding anything and hoping for the best. It is an argument for recognizing that uncertainty is built into meaningful scientific research.

If every project has to arrive with a guaranteed outcome, we are no longer really funding discovery. We are funding execution.

PHILANTHROPY CAN TAKE A DIFFERENT KIND OF RISK

This is where private philanthropy has an important role to play.

Philanthropic funders do not always have to operate under the same constraints as government agencies, large institutions, or commercial investors. That gives us the ability to support work earlier, explore questions that may not yet fit neatly into established funding categories, and take a longer view of what progress looks like.

That does not mean being careless with money. In fact, it requires the opposite.

At the JKTG Foundation, the important questions are not simply whether a project sounds exciting or whether a researcher can make a compelling presentation. We want to understand the scientific question, why it matters, what makes the approach different, who is doing the work, and what new possibilities could emerge if the researchers learn something important.

The return may not be a product. It may be knowledge that changes the way a problem is understood.

That still has value.

THE RETURN MAY BE SOMETHING YOU CANNOT MEASURE YET

The return on medical research can take many forms before it ever becomes a treatment. It can be a new model of how cancer behaves, a better understanding of a biological pathway, a discovery about how cells interact, or evidence that allows researchers to stop pursuing an ineffective direction and begin investigating a better one.

None of those things necessarily makes for a dramatic headline. They are also the kinds of advances that later research depends on.

This is one reason I think we should be careful about demanding immediate patient impact from every research dollar.

Of course the ultimate goal is better outcomes for patients. But that outcome is often the end of a very long chain of discoveries.

If we only become interested once a treatment is nearly ready, we are entering the process after much of the important work has already been done.

URGENCY DOES NOT ELIMINATE THE NEED FOR UNDERSTANDING

There is enormous urgency in cancer research, and there should be.

Patients do not have the luxury of waiting indefinitely for science to move forward. That pressure creates a very understandable desire to get treatments developed and into use as quickly as possible.

But urgency cannot replace understanding.

If researchers do not understand the underlying biology well enough, moving quickly can simply mean moving quickly in the wrong direction. Sometimes the fastest path to a better treatment starts with slowing down long enough to understand what is actually happening at the cellular level.

That is not always easy to explain to a donor who understandably wants to know exactly what their contribution will accomplish. It is much easier to talk about a specific drug or treatment than it is to explain why understanding cell communication could matter years from now.

But that communication gap is part of the problem. If researchers and funders cannot connect basic science to the possibilities it creates, important work becomes harder to support.

WE MAY BE ASKING THE WRONG ROI QUESTION

I do not think we should stop asking whether research funding creates value. I think we should become more thoughtful about what value means.

Instead of asking only, “What is the ROI?”, I would ask something closer to: “If we learn the answer to this question, what could become possible that is not possible today?”

That forces us to think beyond the immediate output of a project and consider the knowledge it may create for the broader scientific community. It also allows funders to evaluate research without pretending that every worthwhile discovery can be predicted in advance.

The most important research may not have an obvious ROI yet.

It may be creating the understanding that makes the return possible later.

And in medical research, that may ultimately be the most valuable return of all.