Embedding patient- and public health-oriented research in a national health service: the GISSI experience

In their book Good Pharma: the public-health model of the Mario Negri Institute, Donald Light and Antonio Maturo documented the ethos, origins and development of the Istituto Farmacologiche ‘Mario Negri.’. One reviewer commented that the book combines ‘a devastating critique of the pervasive harms of patent-driven medical research by the pharmaceutical industry with a compelling account of an alternative patient-driven, no-patent research’. In his Foreword in Good Pharma, Iain Chalmers notes that the mission of the Mario Negri Institute since its inception in the 1960s has been ‘to do research of international quality to improve people’s health, based on independent, transparent science, openly used to educate doctors and patients about how best to address their health needs’. The Mario Negri Institute has used a variety of strategies to promote its mission. One of these is to embed clinical research within publicly orientated healthcare. This requires collaboration with the doctors providing and the patients receiving care. The philosophy underlying this element of the Institute’s mission has been elaborated as follows: