Even with the introduction of the replacement, reduction, refinement (the three Rs) approach and promising technological developments in animal-testing-free alternatives over the past two decades, a significant number of animal tests are still performed in medical science today. This article analyses which factors could accelerate the transition to animal-free medical science, applying the multi-level perspective (MLP) framework. The analysis was based on qualitative research, including a desk study (literature review and document analysis), lectures from experts, and nine online focus group sessions with experts on 26 July 2021. These were undertaken as part of an honours project between May and September 2021 to identify barriers, levers, and opportunities for accelerating this transition. The MLP framework identifies required changes at three levels: innovations and new practices (niche level), the current (bio)medical research system (regime level), and larger societal forces (landscape level). All three levels interact in a non-linear fashion. The model enabled us to identify many relevant factors influencing the transition to animal-testing-free medical science and enabled priority setting. Our findings supported the formulation of six "focus areas" to which stakeholders could devote efforts in order to accelerate the transition to animal-testing-free medical science: (1) thorough and translatable new approach methods (NAMs) for human-relevant medical research; (2) open science and sharing data; (3) targeted funding for NAMs; (4) implementing and modernising legislation for NAMs; (5) interdisciplinary education on animal-testing-free medical science; and (6) facilitating a shift in societal views, as this would be of benefit to both animals and humans. It is proposed that these focus areas should be implemented in parallel.
Keywords: NAM; animal ethics; animal research; animal-free innovations; medical research; new approach methods; transition analysis; translation science.