The Fiscal Cliff Is Forcing a Biomedical Day of Reckoning

12/31/12Follow @xconomy

Sarah Palin, the onetime candidate for the second-highest elected office in the U.S., once delivered a rant on the campaign trail about waste she perceived in federal support of fruit fly research.

Scientists everywhere were appalled. Regardless of whether Palin knew about the historic importance of the drosophila to genetics, they were furious that a national figure would launch an all-out attack on biomedical research funding in this country. Didn’t she understand that the National Institutes of Health has been the envy of the world for decades? Didn’t she understand the NIH made the U.S. the undisputed leader in biomedical research? Didn’t she understand that basic research, in all its messy glory, is the foundation for progress in patient care?

That story played out in 2008. Palin lost, and went on to a dubious career as a reality TV star, author, and political commentator. But while the public rants against biomedical research faded, the budget battles ever since have taken a toll on the U.S. biomedical research enterprise. The days of abundant NIH funding for bright ideas in America’s labs are over. Even in a golden era of biomedical research—think genomics, stem cells, RNA interference, and more—fewer and fewer competitive grant proposals are getting supported. Young scientists in their 20s and 30s are finding it extremely difficult to get their first break. If lawmakers can’t settle their differences over this latest “fiscal cliff,” then the world’s premier biomedical funding agency could suffer its worst body blow yet—an 8 percent budget cut that would whack 2,300 worthy NIH grant-winning projects.

It would be foolish to go over the cliff, and I doubt elected officials will allow it in the end. But no matter how the “fiscal cliff” conflict gets resolved, scientists have gotten the message that the age of abundance in biomedicine is over. The grand bargain between President Clinton and Newt Gingrich to double the NIH budget from 1997 to 2002 is ancient history. Scientists at America’s top institutions have been forced to think more seriously than ever about finding other sources of support. They are increasingly looking to disease-focused foundations and drug companies. And when those groups bring their different agendas to the table, it will change the complexion of biomedical research.

Thong Le, managing director of WRF Capital

Thong Le, a managing director with WRF Capital in Seattle, says he can see a shift occurring in the mindset of researchers he meets at one of the nation’s biggest recipients of NIH grants—the University of Washington.

“It’s no longer a question of, ‘How does the zebrafish swim?’ It’s now, ‘Gee, we already know something, like the zebrafish produces a specific protein in its mouth that appears to be involved in coagulation. Can we synthesize that compound and see if it could be the next warfarin?’” Le says.

This development, to my mind, is a mixed bag. If the nation’s scientific brainpower is channeled properly by a leaner NIH, by foundations, and by drug companies, then we could see a real payoff in the form of new drugs, devices, and diagnostics over the next five to 10 years. The NIH has been beating the drum for more “translational” research for years now, trying to protect itself from budget hawks who love to ridicule research it holds dear, like that of the fruit fly. I personally want to see basic and applied research going on all at once—everything from the fruit fly through the next warfarin. It’s absolutely within our rights as citizens to demand that more valuable medical products come from all this investment in basic research.

The problem with shifting the focus toward “translational” research is that if we tip the balance too far in that direction, we could miss out on a whole series of bigger breakthroughs that can come only from asking basic, open-ended research questions about how genes, cells, and lower organisms work. Franklin Roosevelt’s science advisor, Vannevar Bush, famously wrote about “Science: The Endless Frontier” in a memo to the president that’s just as valid today as it was when he wrote it in 1945. This investment in basic research can really only come from the government. Foundations don’t have enough money. Shareholder-supported biotech and pharma companies will always have to be more focused on projects that carry lower risk, and that offer near-term rewards.

Ideally, government-funded academic researchers would work in collaboration with their counterparts in industry, but that’s rarely how it really works. It’s a fundamental flaw in our current biomedical R&D model that scientists can win grants for basic questions like how zebrafish muscles contract, but they lose interest and funding dries up when it comes time for the next series of experiments that could create a new drug for, say, kids with Duchenne Muscular Dystrophy.

Those next steps are supposed to be … Next Page »

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  • @ConsanoCMO

    Luke, you are quite correct — the current system for funding research needs improvement. In a time when research dollars are finite, and ideas for new projects are infinite, researchers should be encouraged to collaborate through sharing of data and ideas to better utilize each research dollar. The NIH tends to fund less risky projects, but many novel therapies can be discovered through less conventional means. It can be difficult to weed out the “less worthy” research projects from those that hold the most promise in advancing medical science, thus making the allocation of the NIH budget very challenging. Moreover, many disease categories are underfunded, such as pediatric cancers, which receive just 4% of the total NIH budget. As the Chief Medical Officer for Consano, a nonprofit crowd funding platform for medical research, we envision the public making their voice heard through their donation. At Consano.org, the public can browse a list of vetted medical research projects from a variety of academic institutions, decide which projects resonate with them, and donate directly to that specific project. While our platform may not compete on the same financial plane as the NIH budget, perhaps the public nature of Consano will encourage greater sharing of data and ideas, create new connections between donors and researchers, and place the focus of medical research funding directly on making patient care advances.