D4.4b - Report on collaborations between Europe and China at the policy level on healthcare initiatives (M24)

Since the late nineties, the relation between university and industry (and the related technology transfer involved) has gained attention in the policy and scientific debate worldwide (see for example the debate on the Triple Helix started by Leydesdorff and Etzkowitz, 1996). Such relation involves different principles of action that are patronised by the two parties. On the one hand, private actors are aimed at fostering profit-maximising strategies through the collaboration with academic institutions; on the other, public institutions must be careful in enhancing, also through this cooperation, those policies and activities that are crucial to the success of the academic first and second missions.
Rather than being one-directional, the technology transfer process involves a two-way mechanism: while the basic interpretation of this process explains it as a flow of knowledge and information from public to private actors, in many innovative experiences the relation is mutual and is based on a co-production of knowledge between academics and private partners. Indeed, particularly when such relation goes beyond national boundaries and becomes international – better said, transnational – the subjects participating to the collaboration are usually more than two, and so the relationship becomes an "n-ways" one, with various actors with different knowhow, capabilities and contexts of origin, that dynamically work together.
In the case of the health industry (see par. 4), for example, the co-producers are providers of health knowledge that can be both clustered in geographical proximity and embedded in national and international networks.
It is nowadays clear that such collaboration involves not only private firms and academicians. Rather, it broadens to a list of additional players, among which other public actors have a major role. Such networks include in facts hospitals, universities, laboratories, clinics, research centres, associations, foundations, spin-off companies, small and medium-sized enterprises, large firms and multinationals. Each of these single actors is likely to be both a producer and a consumer of health knowledge; all of these actors may promote joint and collaborative actions to co-produce health knowledge, and they may all exploit and produce spillovers and positive externalities. However, as the relation becomes participated by multiple, different partners, particularly in the transnational dimension, the complexity of the network increases, and the success of the collaboration is under higher risk of failure due to the fragilities that complexity brings with itself (Messner 1997, 2000). Such fragilities are for instance due to the different interests that the partners involved in the network might represent. Not only gains for private actors might differ from those of collective actors, but also in transnational networks the different actors represent - and are accountable to - different communities, corresponding to rules, norms, value judgement and societal objectives that can vary largely.
The ability to elaborate new ways of managing the potential costs connected with complexity, to lower the level of fragility and to impede the failure of transnational networks in the field of health knowledge production are major challenges for national and international, public and private actors. Such challenges must be tackled properly in order to keep the network relation mutually advantageous for all the partners involved.
This report aims at exploring the various sources of complexity and potential fragilities that can affect networks relation between academic, and more generally public, and private actors when cooperating in the field of co-production of knowledge in the health sector, mainly in the transnational framework. We first do so by analysing the general case of co-production of knowledge (section 2): in this framework, we describe in a critical way the universities and companies' roles, motivations and internal policies and the mechanisms able to foster the collaboration in a knowledge-transfer oriented network. In the following section (3), we tackle directly the issues of complexity of networking, specifically on the transnational level, and we highlight the fragilities and asymmetries that call for new ways of managing networks and new policies for transnational co-production of knowledge. Then (section 4) we specifically focus on the heath sector, by investigating the university-industry collaboration, the role of public institutions and the specificities of the co-production of knowledge in the sector. In the last section (5), we analyse the status of the cooperation between China and Europe in the health co-production of knowledge, by exploring the characteristics in terms of number, variety and transnationality of actors participating in European project networks.

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