Pay attention to the crisis in biomedical research

Professional associations that represent the field of cancer research or clinical oncology such as the American Cancer Society, AACR, ASCO, FASEB as well as numerous other private foundations have for many years championed this cause. Impressively they and other special interest groups have often banded together to speak with one voice on Capitol Hill. But why have concerted efforts over the last decade not brought more results? I believe it is because biomedical research and the researchers who dedicate their lives to doing it have not been on the national radar screen and the whole enterprise has been taken for granted. It has been business as usual as real and ongoing damage has been going on at medical schools and research institutions across the country. Politicians have continued to be elected and to thrive and have not been challenged enough to fix this problem.

I think the biomedical research infrastructure and the talented hard-working researchers have been taken for granted for many years. People who dedicate their lives to helping others by going into biomedical research careers do not do this to make money. Most spend many years in training, make numerous sacrifices often at the expense of their families simply to help other people they will never meet. In the last decade the dream of most biomedical scientists has been shattered. Instead of spending their time and keeping their talents and efforts focused on making and translating discoveries for the public good, scientists lives have turned into a real nightmare. Imagine that you spend five to ten years after college in training to get your first real faculty job and then realize that you need to secure funding not just for the research you want to do but also for your own salary and the salary of all the researchers who choose to work with you. Now imagine that to succeed in getting the funds to do the research you must compete against others with the same goals and dreams but that less than one in ten will actually get the money for a given research proposal. Imagine that after a grant is funded that the budget gets an across the board cut and that you have to constantly be writing reports to the funding agencies (in addition to doing the research and publishing your work for all to see) and planning for and writing new grants. Imagine that to support a critical mass of 10-20 lab-based scientists you need at least 3-5 major grants and other smaller grants just to keep a research program going. Do the math. How many proposals must you submit when one in ten to one in twenty is successful to have a lab of 10-20 scientists? How does a laboratory of 10-20 scientists in the United States in 2012 operate or continue to make discoveries and advances to find the next cures and get them to patients?

Efforts to support basic research must not be held to the standards of a business model. The history of biomedical research advances has many many examples of serendipitous discoveries that ultimately led to treatments of various maladies including cancer. It takes many years to build a successful research laboratory infrastructure and culture, but it takes much less to destroy it. I think in many if not most medical campuses across the nation this has either been forgotten, is being ignored, or it has not been possible to address it. Of course in many cases it is well established there is a return on investment with new jobs and a very positive impact on the economy. But this must never be a requirement for supporting basic or translational research.

Arguments that we must end useless wars to support research are flawed. The resources are already there and there is no need to compromise on any national priority to support research. What is needed is for the public to be aware and to make biomedical research a higher national priority. As a society we must once again put a great value on research and we need to find a way to rescue the present generation of young people who have been turning to other careers because biomedical research within academia has become much less viable in the last decade.

I was amazed to learn recently that China spends 500 billion dollars a year on biomedical research, and Singapore spends 40 billion. The annual U.S. NIH budget is 30.7 billion.

The system in the U.S. established by the NIH for reviewing and funding the best and most promising science is not perfect but it is the best in the world and has been modeled in many other countries. Although not perfect, it is worth preserving and improving in order for the advances and cures to continue to be made in the U.S. The public cannot afford to wake up one day in five or ten years and realize that investing in biomedical research over the last 15 - 20 years should have been a high priority. It is a decade too late already. 

Wafik S. El-Deiry, M.D., Ph.D., F.A.C.P.