Medical Research Recession: Funding Flatlined for Diabetes, Cancer, Alzheimer's

The housing market wasn't the only bubble to get pricked of late. Consider the budget for the National Institutes of Health, the primary source of funding for U.S. biomedical researchers. It, too, has recently had the rug pulled out from under it. And while the negative impacts may not be as obvious or immediate as the fallout from the housing, credit and stock market crises, the repercussions of this pound-foolish parsimony promise to be massive.

Recall that between 1998 and 2003 the NIH budget underwent a long-overdue expansion. In a remarkable act of bipartisan solidarity -- and reflecting a broad appreciation that biomedical research is both an economic pump-primer and the best first step to conquering diseases -- Congress doubled the agency's budget over those five fiscal years.

Even more important than bolstering the work of hotshot scientists across the country, the move opened the doors to a new generation of young researchers with fresh ideas and enthusiasm. Laboratories grew. Scientists launched ambitious projects. And American leadership in the biomedical sciences seemed assured well into the future.

Then, immediately following that enlightened surge, something strange happened. It all stopped. The money dried up. Through the fiscal 2004, 2005, 2006, and 2007 budgets -- and again this year in 2008 -- the NIH was flat-funded. And despite a rising tide of concern, it looks like the same fate will recur in 2009.

A higher and higher percentage of grant proposals -- more than 80 percent at last count -- now go unfunded.

In fact, Congress last week passed a continuing resolution to keep the Department of Health and Human Services (of which NIH is part) operating for the first five months of fiscal 2009, which began October 1. Within that legislation is an NIH research budget that, once again, is flat-out flat.

But it is worse than that. Because as everyone who has tried to keep up with rising food prices knows, flat is not flat at all. Modest increases would be needed simply to keep up with inflation. And the inflation rate for research is higher than it is for the general economy. So for all its so-called flatness, the NIH research budget has actually now dipped to an inflation-adjusted level about 13 percent less than it was five years ago, according to the American Association for the Advancement of Science.

The impact has been insidious. For one thing, a higher and higher percentage of grant proposals -- more than 80 percent at last count -- now go unfunded. This in turn has a perverse effect not only on the research pipeline but also on the careers of countless scientists who, during those halcyon millennial years, were wooed into the fraternity of experimentation and discovery.

Like cars hitting their brake lights on the Washington beltway as they come upon a rush-hour traffic jam, scientists who have just gotten up to speed on projects taking aim at humankind's greatest causes of suffering -- diabetes, Alzheimer's, cancer, and infectious diseases -- have had to stop what they were doing, scramble for temporary funding from their universities or research institutes, and in many cases start looking for other work. For those who stick with it, as postdocs or other underlings laboring in the low-paid laboratorial labyrinth, the years tick by with little in the way of rewards.

The average scientist today does not win a first federal research grant until he or she is nearly 42 years old. In 1970, that age was 34. The implications of this recession go deeper yet. Think about which grants are most likely to be funded in such a situation: The ones that are most likely to pay off. Meaning, the ones that are in many cases the least imaginative, and the most derivative.

"People don't take as many risks," says Jerry Chi-Ping Yin, a researcher at the University of Wisconsin-Madison, one of many scientists to decry the current situation in a report from earlier this year, "Within Our Grasp -- Or Slipping Away?" compiled by a group of universities and research institutions. "You can't afford to swing the bat and miss too many times."

Meanwhile, that report notes, other countries are increasing their investment in science. Singapore recently announced it was doubling its national biomedical research budget, and has taken explicit aim at hiring U.S. scientists away.

The corridors of scientific institutions are rife with anecdotes of promising young researchers changing tracks and moving on to other careers. "She's decided to go to law school!" is the common refrain, in semi-mock horror. But the downstream effects are no joke.

"You can lose a generation of researchers pretty fast -- in five or ten years," Joshua Boger, founder and chief executive of Vertex Pharmaceuticals and chairman of the Biotechnology Industry Organization, says in another report, also released earlier this year: "A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk."

"You create such a discouraging atmosphere," Boger says, "they just go somewhere else instead of academic research. We don't have to lose 50,000 researchers, just 50 really good ones. Once it happens, we won't get those people back."

And of course, just as it is homeowners who will ultimately pay the price for the housing bubble, it will be the everyday owners of bodies -- each and every one of us and our children -- who will pay the price of the NIH funding deflation. Take it from Nancy Andrews, Dean of the Duke University Medical School, in the Pipeline report:

"People who have diseases that five or ten years from now should be curable are going to have to wait a lot longer," Andrews says. "The knowledge is there, and we have the people who know exactly what to do to study the things that turn into cures. But they don't have the funding to do it."

Congress just promised up to $700 billion for Wall Street. The entire NIH budget is (and for years has been) less than $30 billion. As our intrepid legislators scatter for their home states, perhaps some janitorial broom-jockey, sweeping up the Capitol building's marble floors, will find a scattered two or three billion dollars on the floor and send it on to Bethesda, to buy the American people, and the world, a healthier future.