Will support for biomedical research be dead on arrival?

What are we to think when we read that NIH funding for medical research has lost nearly one quarter of its purchasing power in the last decade, as recently in the Journal of the American Medical Association (JAMA)? 

The Ebola crisis exposed this slippage in dramatic and deadly ways.  When the outbreak came, no drugs were approved for treatment and no vaccine was available to prevent the outbreak. 

{mosads}Medical researchers in academia, government and industry have stepped up to try to find answers for Ebola.  But in the meantime, people die.  As pointed out by former Sen. Tom Harkin (D-Iowa), “We must stop chasing diseases after the fact,” and he has called on fellow lawmakers to sustain medical research at a level that would enable the U.S. to cope proactively with future emergencies, a call amplified by the president in his State of the Union address. 

As an infectious disease physician, I know that, statistically speaking, there will be another global outbreak of infectious disease within the next few years.  There are ongoing epidemics already for which we do not have adequate answers–from multi-drug resistant tuberculosis to neglected tropical diseases.

How is it that the United States, which has historically held the global lead in medical innovation was caught flat-footed by Ebola?  The answer lies in those statistics about loss of funding for medical research.  As concluded by the authors of the JAMA report, “it is unlikely that these conventional sources of research investment will be sufficient to meet the challenges of an aging population, the aggregate burden of disease, or the promise of emerging science.”  We are at risk of being unprepared again when the next crisis comes.

For me, Ebola brings back the memories of the early days of the HIV/AIDS epidemic: a mystery new virus, lack of public support for finding a cure, political resistance to dedicating research funds to a disease that happened to “others.” When I established the first clinic to treat patients with HIV at the Minneapolis Veterans Affairs Hospital, there was little we could do other than hold patients’ hands as they died.  The antiviral drugs were still years away.  The research that would produce lifesaving therapies could not be flipped on like a light switch.  It took years to set up laboratories, discern the fundamental biology of the virus, and conduct clinical trials.  And that was during a time when NIH funding was increasing.

As president of the Albert and Mary Lasker Foundation, I have the honor of celebrating great scientists and the medical breakthroughs they developed when we bestow the prestigious Lasker Awards.  The investments that the NIH and other U.S. funders made in the 1990s are paying off today, as evidenced by many of the advances recently recognized by Lasker, from cochlear implants to genetic diagnosis of breast cancer risk to deep brain stimulation for Parkinson’s disease.

But I worry about the future.  If it takes 15-to-25 years for fundamental discoveries to turn into clinical cures, where will the cures come from 15-to-25 years from now? 

Obama has asked Congress to support proposals to increase funding for biomedical research, a move that he argues will usher in a “new era in medicine,” allow the U.S. to maintain its lead as a global innovator, and spur development of promising new technologies such as precision medicine and molecularly targeted drugs.

Will this proposal too be D.O.A.?  Or will legislators see the folly in chasing diseases like AIDS and Ebola from behind and recommit to adequate and predictable funding of the full spectrum of biomedical research?

Pomeroy is president of the Albert and Mary Lasker Foundation, dedicated to advancing medical research.