Many in the scientific community lament that the purchasing power of the National Institutes for Health has decreased 23% over the past decade. Despite its economic (not to mention lifesaving) benefits, and despite the President’s call for investment in precision medicine, funds to battle antibiotic resistance and tax incentives to stoke research development, investment in future medical research continues to lag. The waning of funding (private and public) is a startling example of political and societal myopia—valuing short-term savings over long-term commitment and an investment in greatness.
When we compare the cost of treatment and care with the cost of prevention and cure, research investment is a no-brainer. The cost of treating dementia alone will likely top $20 trillion over forty years; while budget allocations for research into a cure is $1.3 billion. As Newt Gingrich, a champion for NIH funding, has complained, political myopia “should trouble every fiscal conservative.” I would add that it should trouble every American, as all lives depend upon wise investment of our tax dollars.
Consider the economic and humanitarian impact of medical breakthroughs: In 1976, a 34-year-old Alfred Sommer (a Lasker Laureate) conducted research in Indonesia that was supported by USAID, NIH and others. He discovered that children with deficiencies in vitamin A suffered increased risks of blindness and susceptibility to fatal infectious diseases. Sommer devised a simple treatment approach and achieved staggering results. Two cents' worth of vitamin reduced childhood mortality in these developing countries by a third. UNICEF estimates that since its launch in the 1990s, the vitamin A supplement campaign has saved 10 million children from blindness and death. The World Bank estimates that every dollar invested in supplementation yields more than $100 in economic return.
Sommer’s life-saving discovery was produced at a time when support for biomedical research was robust. In the 1980s, a dedicated young scientist could conduct global research and then find the training and support to turn passion and curiosity into a viable career path. Unlike today when researchers struggle to identify sustained research funding for their labs, this was a time of opportunity and the pay-offs to humankind were enormous.
Would an ambitious researcher like Sommer have succeeded in leading a research team today? Unlikely. NPR reports that of the 40,000 postdoctoral fellows working in science labs, only 15% will secure tenure-track professorships. Too often they don’t receive the experiential training or encouragement they need to find jobs in industry, science education, policy or administration. Today, scientists face the worst funding environment in 50 years. Those under age 36 receive half as many grants as those over age 65. In 1980, most biomedical researchers received their first grants from the NIH at age 38. By 2013, that average had risen to age 45.
As Francis Collins, director of the NIH, said, “I worry desperately this means we will lose a generation of young scientists.” Of young researchers who watch their senior research mentors struggle for funding, he said, “They wonder, 'Do we really want to sign up for that?' Many of them, regrettably, are making the decision to walk away.”And since each generation trains the next, losing a generation means future generations won’t be trained—leading to debilitating long-term impacts.
We are at a time of immense potential for developing new treatments and therapies for cancer, Alzheimer’s and other diseases that could mark a watershed moment in medical research. But this will happen only if labs stay open and the work of our best and brightest scientists is funded.
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As Congress comes to a budget resolution for the fiscal year beginning October 1, it should go beyond the rhetoric of support to enact legislation that will adequately fund our powerhouses of biomedical innovation, including the NIH, NSF, AHRQ and CDC. Legislators should heed the voices of advocates calling for a 5-10% increase in the NIH budget to offset the recent budget erosion. And we should encourage the work of the bipartisan Senate NIH Caucus created by Senators
Support from the private sector—pharmaceutical firms, medical device and biotechnology companies, and foundations, charities and other private funds—is equally critical. Unfortunately, research support from industry is also being curtailed. In a recent interview, Francis Collins has pointed out that “the success of biomedical research in the U.S.…has been a healthy ecosystem: public support through NIH, private support through companies, biotech and pharma.” But he points to a worrisome trend over the last five years in which pharmaceutical companies have begun to scale back their internal research budgets: “If you see the government support for research dropping, which it has been for twelve years, and then the private sector cutting back, then this is the perfect storm…”
Enacting a permanent and enhanced research and development tax credit to create certainty and stability for businesses engaged in medical research is key to reversing this trend.
But even more, activist investors with short-term goals for returns must consider their myopia when blindly recommending across-the-board cuts to R&D budgets at public companies. Investment in basic research is a long game. The average drug for the central nervous system, for example, takes 15 years and more than $1.5 billion to develop. Analysts need to appreciate that laboratories that produce these “miracle therapies” do so because of a highly sophisticated scientific workforce that has been developed over decades, and whose members labor over many years to produce breakthrough drugs, devices and procedures.
If funding for biomedical research continues to decline—the U.S. will lose its global leadership role to Asia and Europe, future researchers and their medical advances will be lost—and the nation will suffer our myopia. Government, private enterprise and philanthropic investment in biomedical research that is sustained and predictable is critical if we hope to benefit from future life-saving breakthroughs.
