America's unsure commitment to lifesaving research

April 18, 2007|By E. Albert Reece

Disease is an unrelenting foe. Our nation's commitment to preventing disease and improving health should be equally unrelenting. However, the road to medical discoveries is long. Just as today's discoveries are made using yesterday's investments in medical research, tomorrow's advances depend on the investments we make today.

Dr. Angela Brodie, a professor of pharmacology and experimental therapeutics at the University of Maryland School of Medicine, has won numerous awards for her discovery of the effectiveness of aromatase inhibitors as a first-line treatment for breast cancer. Dr. Brodie's research has been entirely funded by grants from the National Institutes of Health for 30 years.

When Dr. Brodie started her research in 1976, breast cancer was a death sentence. Now, because of aromatase inhibitors and other treatment innovations, 160,000 of the 200,000 women diagnosed with the disease each year survive. How many of them would have died without the groundbreaking treatments discovered with NIH support? Yet Congress, in supporting the redirection of biomedical research funding to other priorities, continues to erode NIH's budget. This "recycling" approach is shortsighted and harmful in the long run to public health.

With continued NIH funding, Dr. Brodie will be able to apply the lessons learned from aromatase inhibitors to her research into androgen inhibitors, which she believes will prove an effective treatment for prostate cancer, the second-leading cause of cancer death in men. Again, thousands of lives could be saved from the results of her work.

Is this redirection of resources in the short term worth the lives that could be saved if adequate funding for NIH were preserved?

NIH is by far the largest federal supporter of basic research, applied research and R&D at colleges and universities, and has a major impact in the biomedical life sciences and related fields at medical schools and teaching hospitals. Many remarkable medical advances are the result of pioneering teamwork between academic health centers and the NIH. For example, death rates from heart disease and stroke fell by 40 percent and 51 percent, respectively, from 1975 to 2000. The five-year survival rate for childhood cancers has risen to nearly 80 percent, and AIDS-related deaths fell by 70 percent from 1995 to 2001.

Fueled by such successes and the promise of new discoveries, the NIH enjoyed double-digit percentage increases from 1998 through 2003. Fiscal year 2004 was the last year the NIH budget exceeded general inflation. Since then, the NIH budget hasn't kept pace with inflation, and this has eroded the research progress we had hoped to see.

Research is an important indicator of a nation's innovative capacity and its prospects for growth and productivity. Basic research builds intellectual capital and lays the groundwork for advances in science and technology. Research is also an economic engine. Sen. Benjamin L. Cardin of Maryland recently called NIH funding "one of the most important parts" of our state's economy.

Several nations have dedicated large, ongoing governmental investments to support research and technology over the past decade, according to a National Science Foundation report. Israel holds the lead, with 4.9 percent of its gross domestic product invested in research, followed by Sweden (4.3 percent), Finland (3.5 percent), Japan (3.1 percent) and Iceland (3.1 percent). In contrast, the United States' investment is only 2.7 percent.

As the scientific contributions from these nations has increased, the United States' trade balance in advanced technology products, historically a strong market segment, has turned negative.

Furthering our investment in biomedical research, as well as other R&D, can ameliorate the potential pain and suffering of the American public while simultaneously advancing our status as leaders and innovators in the global economy. Investment in medical research, a proven formula for progress, shouldn't be eroded or abandoned. A sure way to guarantee this investment is to increase governmental funding for medical research.

Dr. E. Albert Reece is vice president for medical affairs at the University of Maryland and dean of the School of Medicine. His e-mail is deanmed@som.umaryland.edu.

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