The return on investment is guaranteed — medical research saves lives, creates jobs, spurs innovation, reduces healthcare expenditures, advances competitiveness and improves the nation’s health and economic wellbeing. Yet the troubling reality is the U.S. is at risk of dangerously underinvesting in medical research — the National Institutes of Health’s initial FY2013 budget was $530 million lower than FY2010 and sequestration erased an additional $1.55 billion, plunging it to FY2007 levels.
NIH’s FY2014 outlook is bleak. The Senate Appropriations Committee approved $30.95 billion, about the same as FY2011 levels, and estimates the House of Representatives will propose $8 billion less, the lowest amount since FY2001 and more than NIH spends on cancer and cardiovascular research combined. NIH’s website states it is “the leading supporter of biomedical research in the world.” Many in Congress appear to disagree with this goal. The U.S. is losing its ability to create a healthier world and its innovation beacon is dimming. The country must come together to advocate for stopping this downward spiral in national greatness.
Medical breakthroughs are not budget line items
A poll found that 83 percent of Americans believe medical research is important for reducing healthcare costs, nearly half feel 1.5 percent of government spending currently allocated for biomedical and health research is insufficient and more than half would pay $1 per week more in taxes for additional medical research. The message is clear, yet America’s voices are not being heard in the budget deficit reduction debate.
Finding treatments and cures for new and existing diseases is a decades-long process that cannot be turned on and off. Halting, reducing or delaying research funds is similar to dropping the sail on a sailboat while at sea. The vessel floats, yet loses momentum and direction. It is unable to take you where you need or want to go. When the sail rises, progress is deferred until the boat returns to where it was prior to giving up ground.
Investing in medical research anchors the government’s obligation and ability to provide health and economic security. Failing to adequately fund research as a national priority is a crisis of conscience for the nation’s moral compass and cultural identity.
Inadequate funding sets adrift next generation researchers
New investigators rely on NIH grants to help launch careers and engage passion for discovery. NIH counts on them to develop new fields of research, contribute innovative ideas and integrate technologies into the nation’s medical research enterprise. I recently spoke to young clinical translational scientists — the game changers who will help define world health in the decades ahead. Instead of enthusiastically describing their research, they focused on career threats from low NIH budgets and sequestration.
Next generation innovators are discouraged that NIH can now fund only one in six applications and 700 fewer than FY2012. Reducing support for new researchers exacerbates the concern that by 2020 almost 70 percent of NIH-funded principal investigators will be 41 or older and less than 10 percent will be 40 or younger. The unpromising future forces upcoming researchers to consider changing careers or working in other countries. The U.S. medical research corps shrink with every dollar that disappears from NIH budgets.
HIV/AIDS epidemic catalyzed medical research advocacy
As an HIV physician, I know that the HIV/AIDS drug development timeline records the human tragedy from late and under-funded medical research as well as the transformational impact of subsequent investment. While celebrating breakthroughs, we must remember the unconscionable start of the nation’s AIDS research program. Congress waited two years after the first deaths to pass the first AIDS research bill and it provided only $12 million. Two years later Congress allocated $70 million — the National Academy of Sciences called for $2 billion and social anger launched the AIDS Coalition to Unleash Power (ACT UP).
ACT UP’s high-profile demonstrations interrupted the New York Stock Exchange, closed the Food & Drug Administration headquarters building and disrupted scientific conferences. Thousands were arrested. ACT UP was instrumental in increasing multisector awareness, instilling national urgency and changing attitudes in Congress that led to more funds and new drug approval regulations. AIDS cases and deaths finally began to decline 15 years after Congress passed the first AIDS bill.
That was then. This is now.
The end was successful and ACT UP and other courageous leaders’ impact reminds us of the importance of research advocacy — only by raising our voices together will we obtain appropriate research funds for effectively addressing a national health crisis. Now is not the time for complacency or passivity.
Today, we the people can do better in issuing collective calls to support publicly funded medical research. We the government can do more in honoring the principles of health equity and social responsibility. We the nation can do the right thing for humanity. As Presidential Medal of Freedom and Congressional Gold Medal awardee Mary Lasker said, we have a simple choice — “If you think research is expensive, try disease.”
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