Funding Our Brightest
By PAM BERNS
According to Dr. Jyoti Patel— an oncologist at Northwestern
University’s .School of Medicine in the Journal of Clinical Oncology—we
will be spending up to $160 billon on cancer costs in 10 years. Imagine
how much lower our costs would be if we had cures for cancer, not just
treatments. But, of course, we have been trimming funding for the
National Institutes of Health—640 fewer grants were funded last year
because of sequestration, so even though $1 billion more has been passed
by Congress this year, it is still less than it was before
sequestration.
According to a conversation in The Atlantic
between writer James Fallows and professor at MIT and Harvard Medical
School’s Eric S. Lander, “We may soon convert many forms of cancer from
being fatal illnesses to manageable chronic diseases. But that good news
may be tempered by our financial situation.” According to Lander, “It
is incredibly limiting right now. Young scientists who need to look at
100.000 cancer samples, or do functional tests inhibiting all the genes
in the genome, or explore the use of chemicals in ways they never could
before—they need an NIH that is able to place bets. With sequestration,
and the NIH budget falling by about 25 percent in real terms over the
past decade, the people reviewing grants naturally become more
conservative. When there’s less money, reviewers don’t want to run the
risk of wasting money on something that doesn’t work....I’ve got to tell
you, if you aren’t prepared to waste money on things that might not
work, you can’t possibly do things that are transformative.” Lander
continued, “In a very objective sense, this is a unique moment to be
investing....We’ve got an amazing cadre of young people coming into the
field, and they have this cognitive dissonance right now. On the one
hand they see unbelieveable opportunities, and on the other hand, for
the first time they see the nation decreasing funding for biomedical
research.”
In 1998, Congress committed itself to doubling
the budget of the NIH for the following five years. In 2009, the NIH
received some stimulus funding. But then Congress let some of its
investment in research go down the drain.
In 2011, the
sequester trimmed the budget five percent. Younger researchers have had
to spend increasing amounts of time writing and re-writing grants.
Psychologically, this is very difficult for younger researchers who want
to enter a field where their funding may be yanked from beneath them.
Scientists no longer have the ability to plan their research into the
future. Because biomedical research may take up to a decade, trimming
budgets can waste the valuable inroads it has already accomplished. The
scientific community has been working on a budget that is on par with
1998 funding. The National Cancer Institute which is funded by the NIH,
cut grants by 6 percent for existing research programs including cancer
centers. After adjusting for inflation, the NIH budget has been
virtually working with a decline by more than 22 percent—6.1
billion—over the last decade, according to NBC News.
In the
past year, despite the trimmed budget, there has been progress on drug
developments and improvements in speeding new treatments for
patients—over existing ones—mostly extending remissions. Despite the
cuts in funding, nine cancer drugs have come out this past
year—including targeted therapies—for prostate cancer, melanoma,
multiple myeloma, breast cancer and thyroid cancer. According to NBC
News, the research progress just this year with so many cancers is proof
that targeted, precision medicine is now a reality for an increasing
number of patients, reported Dr. Clifford Hudis, President of the
American Society of Clinical Oncology.
According
to NIH Director Francis Collins in an article in The Atlantic, “Across
the board, we need to turn this around. You look at what a country
invests in research and development as part of GDP [which is] an
indicator of the health of the [nation’s seriousness]. Right now we are
at 2.6 percent. Many other countries are at 3 percent or above—they’re
basically out to eat our lunch.”
Collins said that China
is planning on increasing research spending by 15 to 20 percent per
year. Collins said the rate of grant applications to the NIH for
scientific research has plunged to about 15 percent this year, down from
30 percent a decade ago. The Washington Post reports that 90 percent of
basic biomedical research in our country is funded by the NIH. There
are many more applicants submitting grants today. Advances in imaging
technologies and genomics hold the promise of understanding how diseases
develop and how they can be treated and cured.
Biomedical
research is a career-generating investment that results in lives saved
and protection from devastating illnesses all over the world. To not
fund promising young scientists is to put our nation behind others who
value their enormous potential. It’s not as though private industry can
pay for this research. We are a nation of innovators. Do we want to lose
our status as the leader in advancing medical knowledge, attracting the
best, talented and brightest investigators or do we want to try to
explain to future generations why we dropped the ball on solving the
most important biomedical mysteries of science while treating patients
with life-threatening diseases throughout the world?
Questions that need explaining are how cancers hide from the immune
system and how most drugs become resistant to preventing cancer growth.
For organizations and people invested in advancing cancer research,
funding only a small fraction of qualified grants is devastating for the
future of medical science. We should be increasing funding, not merely
ending the sequester cuts. When we figure in inflation, we have lost too
much. Our senior scientists are deeply worried about losing more of the
next generation of investigators to countries in Asia and Europe where
their economies value the career tracks of biomedical researchers. These
researchers need stability in their funding to pursue their studies
here at home. This greatly increases the likelihood that scientific
discoveries made in America will lead to cures.
Published: February 22, 2014
Issue: Winter 2014 Issue