The Health Commons. How "health" is defined is essential  We can only address health issues with upmost intelligence with that. "Health" should be defined as pluralistically as possible. We should avoid authoritarian definitions and the health recommendations based on them as much as possible.
- proposal and report by Science Commons
John Wilbanks/Marty Tenenbaum:
"Health Commons is a coalition of parties interested in changing the way basic science is translated into the understanding and improvement of human health. Coalition members agree to share data, knowledge, and services under standardized terms and conditions by committing to a set of common technologies, digital information standards, research materials, contracts, workflows, and software. These commitments ensure that knowledge, data, materials and tools can move seamlessly from partner to partner across the entire drug discovery chain. They enable participants to offer standardized services, ranging from simple molecular assays to complex drug synthesis solutions, that others can discover in directories and integrate into their own processes to expedite development — or assemble like LEGO blocks to create new services.
The Health Commons is too complex for any one organization or company to create. It requires a coalition of partners across the spectrum. It is also too complex for public, private, or non-profit organizations alone - reinventing therapy development for the networked world requires, from the beginning, a commitment to public-private partnership. Only through a public-private partnership can the key infrastructure of the Commons be created: the investments in the public domain of information and materials will only be realized if that public domain is served by a private set of systems integrators and materials, tools and service providers motivated by profit. And in turn, the long-term success of the private sector depends on a growing, robust, and self-replenishing public domain of data, research tools, and open source software." (http://sciencecommons.org/projects/healthcommons)
"Health Commons is a new spinoff of Science Commons, which itself was spawned by Creative Commons in 2005. Health Commons aims to re-imagine and reinvent the ways in which health scientists carry out their work. John Wilbanks, vice president for science at Creative Commons, and Marty Tenenbaum, an Internet commerce pioneer who founded CommerceNet and CollabRx, lay out the case for Health Commons in an excellent paper, “Therapy Development in a Networked World,” You can also watch a six-minute video explaining Health Commons here. The project is a partnership among Science Commons, CommerceNet, CollabRx and Public Library of Science.
A key goal of Health Commons is to establish “a collaborative ecosystem of knowledge and research services that can be rapidly assembled to develop new therapies with unprecedented efficiencies and economies of scale.” Although Tenenbaum and Wilbanks do not allude to Wikipedia, free/open source software and social networking websites, Health Commons clearly has in mind exploiting the same kinds of “value-creation” that occur on open platforms. This would be a stark contrast to, and huge advance over, the stodgy, conventional ways that scientists tend to work.
Participants in Health Commons would agree to standardized legal contracts and pre-negotiated licenses that will make it easier to access and share data, knowledge and physical materials. They would adapt their research to a “uniform platform architecture” so that scientists could readily share their private information and resources – “initially to one’s lab, then to collaborators, and ultimately to the greater research community.” Scientists would agree to use common digital information standards so that different databases, for example, could share datasets.
Over time, Tenenbaum and Wilbanks hope to change the very business models for developing new therapies. Instead of everyone working on their own, on in short-term, ad hoc partnerships, collaboration would be the rule until it became clear that there was something of potential value to commercialize. At that point, participants could negotiate their proprietary interests." (http://onthecommons.org/content.php?id=2018)
"If there is one problem that I have with the Health Commons, it is its unexamined assumption of health as an object of technological solutions – pills, treatments, expert-driven interventions. We surely need these approaches; they can do a world of good. But it would be a shame if the Health Commons’ vision of health as something that is delivered through scientists and drug companies were to eclipse the social dimensions of health and well-being. Besides better, faster, cheaper research, we also need a health commons that reintegrates human beings into communities of meaning and support. It hardly needs adding that we could also use a “health insurance commons” that can socialize the risks of disease and injury, much as Social Security socializes the risks of old age and disability. I’d be happier if the new project were called the “Health Research Commons.”
This is a quibble. The Health Commons is attempting something extraordinarily significant and transformative. It will be fascinating to watch the evolution of this ambitious project in the coming months and years." (http://onthecommons.org/content.php?id=2018)
Report: Health Commons: Therapy Development in a Networked World - an introduction and overview, by John Wilbanks and Marty Tenenbaum.
From a commentary by David Weinberger:
Marty Tenenbaum and John Wilbanks write:
"We are no longer asking whether a gene or a molecule is critical to a particular biological process; rather, we are discovering whole networks of molecular and cellular interactions that contribute to disease. And soon, we will have such information about individuals, rather than the population as a whole. Biomedical knowledge is exploding, and yet the system to capture that knowledge and translate it into saving human lives still relies on an antiquated and risky strategy of focusing the vast resources of a few pharmaceutical companies on just a handful of disease targets.
After citing more problems with the current system, the authors propose a Health Commons:
Imagine a virtual marketplace or ecosystem where participants share data, knowledge, materials and services to accelerate research. The components might include databases on the results of chemical assays, toxicity screens, and clinical trials; libraries of drugs and chemical compounds; repositories of biological materials (tissue samples, cell lines, molecules), computational models predicting drug efﬁcacies or side effects, and contract services for high- throughput genomics and proteomics, combinatorial drug screening, animal testing, biostatistics, and more. The resources offered through the Commons might not necessarily be free, though many could be. However, all would be available under standard pre-negotiated terms and conditions and with standardized data formats that eliminate the debilitating delays, legal wrangling and technical incompatibilities that frustrate scientiﬁc collaboration today.
The paper emphasizes the need for metadata standards: “Providing such standards, Heath Commons improves and extends the public domain by integrating hundreds of public databases into a single framework…” The Commons also provides the needed “social and legal infrastructure,” and a portal that provides the right set of services.
They hope that by lowering research costs, some of the 5,000 tropical diseases currently “uneconomical to address,” for example, will become the target of pharmaceutical R&D. “Health Commons makes it cost effective for small groups of researchers to conduct industrial scale R&D on rare diseases by exploiting the economies of scale afforded by an ecosystem of shared knowledge…”
The authors see the benefits going beyond the Commons’ value to non-profits. “Every pharmaceutical company sits on a wealth of promising targets and leads that they won’t develop themselves.”
The Health Commons could be a huge step forward. But it will take some work. “To realize the full potential, existing companies need to rethink their business models to leverage the commons.” As an example, the paper points out that “Only six out of the 1800 biotechnology companies funded since 1980 have made more money than was cumulatively invested in them.” Rather than counting striking it rich with proprietary drugs discovered via proprietary R&D platforms, perhaps companies could profit by opening up their platforms and taking a cut of any drugs discovered with them.
Finally, Health Commons will provide a way to continuously publish research, along with comments, to supplement the traditional publishing model.
Health Commons can and should be a big deal. It requires lots of pieces coming together over time, but its acknowledgment of the role of profit is encouraging, and it is in the hands of serious, committed, and wickedly smart people." (http://www.everythingismiscellaneous.com/2008/05/21/health-commons-making-pharmaceutical-knowledge-miscellaneous/)