The completion of the Human Genome Project in 2000 fueled optimism about rapid medical advances, but this promise soon gave way to concerns about a "translational lag"—the slow pace of clinical innovation relative to basic scientific discoveries. This lag became a central theme in US science policy, exemplified by the NIH Roadmap for Medical Research (2003). This roadmap aimed to address "critical scientific gaps" hindering the translation of basic research into clinical applications. The concept of translational medicine emerged, emphasizing a more productive approach to science. This paper explores the translational lag narrative, which diagnoses deficits in the pipeline from "bench to bedside," and how it shapes policy in the US and EU. Public pronouncements about the importance of translation reflect established tropes of therapeutic promise, hoping to restructure political and social spaces. The study compares the US and EU framing of the translational lag, demonstrating that different constructions of this lag cater to distinct sociotechnical imaginaries, visions of desirable futures attainable through science and technology. While similar failures are diagnosed, remedies are framed differently in relation to socio-political goals. Translational efforts thus become drivers of, and are shaped by, broader political and societal imaginaries.

The paper draws on existing literature on science policy, innovation studies, and sociotechnical imaginaries to frame its analysis. It notes that the research-innovation nexus has long been a subject of debate, with scholars questioning the seamless transition from scientific progress to innovation. The NIH Roadmap is presented as a significant event that propelled the concept of clinical translation into a prominent buzzword, albeit one met with some controversy. The authors also reference existing work emphasizing the complexity of clinical improvements, requiring recursive relations between bench and bedside, and the need for more careful distinctions between different phases of translation.

The study employs a qualitative content analysis of 28 policy documents issued between 2000 and 2018 by key policy actors in the US and EU. Documents were purposively sampled from major institutions involved in science policy and funding, including the NIH, NCATS, FDA, NAM (in the US) and the European Commission, European Parliament, Council of the European Union, EMA, IMI, and EATRIS (in the EU). The analysis used an inductive, bottom-up coding approach to identify how obstacles and solutions to translation were framed. The authors analyzed translational discourses as ensembles of ideas, concepts, and categories that give meaning to social phenomena, focusing on how the definition of a political problem relates to its narrative. This involved in-depth analysis of each document to classify impediments and cures into broader categories, recognizing the consistent conceptualization of translation in terms of diagnosed deficits in the bench-to-bedside pipeline.

The analysis reveals distinct sociotechnical imaginaries underpinning translational policies in the US and EU. In the US, four major impediments to translation are identified: 1. **Underdeveloped science of translation:** The lack of a robust scientific understanding of the translation process itself, along with a need for better product development tools and regulatory science to keep pace with biomedical advancements. 2. **Absence of institutional and organizational capacities:** Insufficient collaboration between academia and industry, a lack of institutional formations facilitating such collaboration, and an inadequate supply of appropriately trained personnel (e.g., clinician-scientists). 3. **Regulatory deceleration:** The perceived cumbersome and time-consuming nature of the regulatory pathways for new medical products, creating a bottleneck in getting products to market. 4. **Systemic impediments:** Insufficient engagement with patients, the complexities and costs of the US healthcare system, and global market uncertainties. The US discourse reflects a "technical innovation imaginary," emphasizing the need to facilitate technological innovation primarily driven by private actors, with the state's role in financing research and accommodating industry needs through regulation. In the EU, the analysis identifies four similar, yet differently framed impediments: 1. **The European Paradox:** The contrast between Europe's strength in knowledge production and its weakness in translating this knowledge into innovation and growth. This fuels efforts to bridge the gap between discovery and application, as well as the competitive gap with other innovation leaders. 2. **Fragmentation of the R&I ecosystem:** The fragmented nature of the EU's research and innovation landscape, necessitating infrastructure development and governance models to integrate public and private resources. 3. **Regulatory impediments:** Similar to the US, regulatory issues are highlighted, but with a stronger emphasis on the fragmentation of the regulatory landscape across Member States, requiring regulatory harmonization and streamlining. 4. **Systemic impediments:** Acknowledging the unsustainability of the current healthcare ecosystem, the EU discourse highlights the need for a multidisciplinary, multi-stakeholder approach involving corporations, SMEs, citizens, and patients, underscoring the need for EU-level intervention due to the scale of the challenge. The EU discourse reflects an "innovation-as-statecraft imaginary," linking translational efforts to broader goals of economic growth, political integration, and the construction of a shared European identity within a knowledge-based economy.

The comparative analysis reveals that although similar impediments to clinical translation are identified in both US and EU policy documents, these are framed within different sociotechnical imaginaries. The US approach emphasizes a market-driven model, focusing on removing barriers to the commercialization of biomedical innovations. The EU approach, in contrast, intertwines translational efforts with broader political goals of economic growth, integration, and identity formation. This difference is reflected in the types of institutions involved in shaping policy and the overall framing of the translational challenge. Both approaches reveal tendencies toward reductionist understandings of innovation, with a focus on technological outputs rather than broader social and contextual factors. The study also acknowledges shared trends such as the evolving role of the state, collectivization of risk, and increasing geopolitical competition in science and technology.

The study demonstrates how the translational lag narrative is interwoven with state-specific visions of progress and statecraft. In the US, the focus is on reinstating linearity in the knowledge-to-innovation pipeline, while the EU emphasizes the use of translational efforts to build a cohesive knowledge-based economy and strengthen European identity. The shared trends include the changing role of the state and the increasing focus on commercialization in translational research. Future research could explore the long-term impacts of these different approaches on the organization of biomedical research and its societal implications.

The study focuses on a specific set of policy documents, which may not fully capture the nuances of the translational discourse. Future research could expand the scope of the analysis to include additional types of documents (e.g., industry reports, scientific publications) and perspectives (e.g., stakeholder interviews). The analysis is also limited by the reliance on publicly available documentation which may reflect only certain aspects of policy development and its implementation.