Public Health

Op-ed: Cuts in research funding undermine medical innovation

A former US Congressman says US policies are jeopardizing the nation's health and 'research ecosystem'

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[caption id="attachment_26411" align="alignleft" width="201"] John Edward Porter[/caption]

The Author

The Honorable John Edward Porter is chair of Research!America and a former US Congressman, representing Illinois's 10th district as a Republican from 1980 to 2001. During that time, he served on the House Appropriations Committee and as chair of the subcommittee on Labor, Health and Human Services and Education. His subcommittee held jurisdiction over the federal government's health and education programs and agencies, including the National Institutes of Health (NIH) and the Centers for Disease Control (CDC). He is a partner in the international law firm of Hogan Lovells US.

Research!America

Research!America is a nonprofit public education and advocacy alliance that works to make research for health a higher national priority. Based in the Washington, DC metro area, the alliance represents academia, industry, patient advocacy organizations, scientific societies, academic health centers, independent research institutes and foundations. Research!America works to ensure that Congress and the administration sustain the NIH, CDC, Agency for Healthcare Research and Quality (AHRQ), Food and Drug Administration (FDA), and National Science Foundation (NSF) at funding levels that keep pace with scientific discovery. They also advocate for federal funding for global health research and a legislative and regulatory climate that stimulates growth in industry research and development.

Elsevier is an active supporter of Research!America, considering them important advocates for the research community.

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The health of Americans and future generations is at risk. This seems incredulous given our track record in medical discoveries that improved health care and saved lives over the years. But our nation's research ecosystem is now in a precarious state as a result of federal policies and proposals that continue to undermine medical innovation.Sequestration, the across-the-board spending cuts for federal agencies, is a self-inflicted wound on our country and the pain is acutely felt by patients who cannot afford unnecessary delays in the development of new therapies and cures for their illnesses.In short, the entire country is hurting and as much as we would like to believe medical progress will continue unabated, we must accept the inevitable consequence of sequestration and other federal actions that muzzle research and innovation – needless deaths, economic decline and challenges to our global competitiveness.

The current political environment lends itself to ideological battles that ignore national priorities. Those battles are draining the budgets of federal agencies that are critical to the sustainment of basic research and private sector innovation. Medical research, which has received overwhelming bipartisan support on Capitol Hill, is now caught in the crossfire of extreme partisanship and illogical decision-making.

The National Institutes of Health budget has been stagnant for a decade relative to inflation and now has been slashed, along with the budgets of other health and science agencies under sequestration. A House Appropriations Committee proposal would cut health, health research and other discretionary programs 18 percent in fiscal year 2014, inflicting more damage to institutions that conduct basic research that drives commercial applications from innovation to adoption. Basic research is a catalyst for the development of drugs and new therapies that have made diseases that were previously a death sentence into manageable conditions.

How will we ever find cures for Alzheimer's, cancer and other life-threatening illnesses under this scenario? If we continue on this trajectory, patients and their families will bear the brunt of these heavy-handed spending cuts.The baby boomer population is aging, raising the specter of runaway health-care costs and out-of-control deficits in the not-so-distant future. The number of Americans afflicted with dementia, currently 4 million, is expected to double by 2040 along with costs. Dementia's direct costs are $109 billion a year compared to $102 billion for heart disease and $77 billion for cancer.[pullquote align="right"]The cost of treating disease has far outweighed the investments we have made to biomedical and health research. [/pullquote]Consequently, the cost of treating disease has far outweighed the investments we have made to biomedical and health research. As was famously said by Mary Lasker, a champion of medical research, "If you think research is expensive, try disease."

The NIH budget was cut by approximately $1.5 billion in fiscal year 2013 under the sequester. That means 700 fewer competitive research grants awarded this year.More than 80 percent of the NIH's funding is awarded to more than 300,000 researchers at universities, medical schools and other research institutions in every state and around the world. The odds that biomedical researchers will score an NIH grant have fallen below one in five in the past decade, a historical low. With fewer grants available for innovative research that could lead to medical breakthroughs, young scientists will inevitably gravitate to other careers or in some cases to countries that have ramped up their investments in research and development.

Due to our leadership in research and development, many countries are taking a page from our playbook, rapidly increasing their investments and building an infrastructure to lure skilled workers with advanced degrees. China, for example, has identified biotechnology as one of seven "strategic and emerging pillar" industries and has pledged to invest more than $300 billion – or more than 10 times NIH's annual budget – in biotechnology during the next five years.

This is all good news, for China. But we should ask ourselves if we're prepared to cede leadership in science and technology to other countries. All signs point to that conclusion unless we address the flaws in our political and governmental system that lead to partisan rancor and gridlock.

The current system discourages collaboration between the political parties which in turn leads to policies that hamper medical innovation. Many Americans are rightly concerned about the current state of affairs and the implications for their health and economic prosperity.Nearly half (48 percent) don't believe we are making enough progress in medical research in the United States, according to a recent national public opinion poll commissioned by Research!America, a nonprofit advocacy alliance, and a third (32 percent) do not believe the health-care services they receive are based on the best and most recent research available. No wonder America's trust in Congress has dropped to 10 percent, the lowest ever recorded.

This is not the time to allow our nation's research enterprise to falter. We must persuade Congress to put the interests of the people and the welfare of our nation above ideology. Let's insist that both parties tackle tax and entitlement reform and, once again, make investments in science, technology, innovation and research among our nation's highest priorities. It's not too late to change course.

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A version of this op-ed has also appeared in McClatchy-Tribune newspapers, including the Great Falls Tribune, News & Observer, Times Herald Record and Billings Gazette.

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