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Updated: Sep 23, 2026

Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
Published on: June 13, 2025
ESIC Series: Paper 9 Estimating initial costs of Evidence Synthesis Infrastructure Collaborative solutions:
Subhash Pokhrel1, Stephen Hanney1
1Health Economics Research Group, Department of Health Sciences, Brunel University of London, Uxbridge, UB8 3PH, UK.
Aim:
To estimate the initial costs of implementing the Evidence Synthesis Infrastructure Collaborative (ESIC) solutions and therefore provide funders with a costed menu of options for strengthening global evidence synthesis systems.
Background:
ESIC was established to enhance the timeliness, relevance, and affordability of evidence synthesis worldwide. Five Working Groups and a Governance Planning Group were tasked with identifying priority solutions to address systemic gaps in infrastructure, capacity, and governance. We were tasked with costing these solutions from a funder's perspective to inform strategic investment decisions.
Methods:
We followed a structured approach with planning of the costing occurring concurrently with the solutions being identified by the groups. We identified resource requirements, measured quantities, and applied unit costs. Inputs included personnel, tools, and system requirements, with indirect costs set at 20% of direct costs and an additional 5% for monitoring, evaluation, and learning. Data were gathered through resource-use questionnaires, literature reviews, and consultations with ESIC groups. Salary costs were estimated using a 3×3 matrix of seniority and geographic bands (Global North; Global South-high/upper-middle income; Global South-low/lower-middle income). Sensitivity analyses addressed uncertainties, particularly in salary assumptions. A separate costing exercise was conducted for a Vanguard Suite, a prioritised collection of 100 living evidence syntheses.
Results:
The total estimated cost for all 40 solutions identified by the groups was US$278.3 million (range: US$257.2-299 million). Employment costs accounted for the largest share, with 80% of staff time and 78% of senior roles allocated to the Global South, reflecting ESIC's equity goals. Individual group costs ranged from US$9.1 million (Governance) to US$70.5 million (Data solutions). The suite of living evidence syntheses was costed at US$19.2 million.
Conclusion:
This costing exercise provides transparent, equity-focused information to assist funders when selecting scalable solutions aligned with ESIC's mission. While estimates involve assumptions, they offer a pragmatic basis for investment planning and demonstrate ESIC's commitment to affordability, inclusivity, and global impact.
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