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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