The Changing Geography of Medical Research

Medical research remains concentrated in high-income settings, risking misalignment with global health needs. We build a geography-aware knowledge graph linking articles in the 524 leading medical journals to the diseases they study, the countries or territories whose data they analyse, author institutions and funders. We use large-language-model extraction to compare research output with disease burden across 204 countries and 15 major disease groups from 1990 to 2021. Research output has become twice as responsive to domestic disease burden since 1990, yet lower-income regions remain underrepresented in authorship despite serving as frequent research contexts. Maternal-neonatal, nutritional, and many infectious diseases are still under-studied relative to their burden. Philanthropic funders targets neglected burdens, corporations focus on profitable chronic diseases, and governments fall in between. Analyzing WHO disease outbreak news alerts in an event-study design, we show that health shocks trigger rapid, durable increases in both domestic and global research attention, strongest for high-lethality threats. The system is becoming more needs-driven yet remains uneven. Our scalable framework enables near-real-time tracking of convergence.