By Alyssa Picchini Schaffer
Remember the panic about the sequester in early 2013? All of the doomsday predictions about how detrimental the automatic, across-the-board budget cuts would be to all facets of American life? Since National Institutes of Health (NIH) Director Francis Collin’s call to Tweet about how the sequester is affecting biomedical research, many scientists have been weighing in about its future impact:
Despite the apocalyptic hyperbole, the sequester’s overall impact on the US economy has been relatively small and diffuse since the cuts began on March 1, 2013. However, we haven’t seen the worst of it; the biggest cuts took effect just last week. As an experimental scientist by training, I worry – often in the wee hours – about how these cuts will affect biomedical research. Because as this next phase of austerity nears, the future of biomedical research funding looks bleaker than it has in decades. This bleakness is not just about the amount of funding available, but also about how the funds are distributed across the biomedical research spectrum.
According to the American Association for the Advancement of Science (AAAS), government-wide funding for research and development will decrease by a net $9.3 billon thanks to the sequestration. Some $1.5 billion of that will be slashed from the annual NIH budget, which has already declined by 22% in constant dollars since 2003. This means that this coming year the NIH will fund approximately 700 fewer biomedical research grants, admit 750 fewer patients to its clinical center in Bethesda, MD, and decrease funding already promised to current grantees by about 10%.
Additionally, $227 million will be taken from the already miniscule budget of the National Science Foundation (NSF), our nation’s major funder of basic biological research. I think very few will disagree that these budget cuts will delay progress in biomedical research.
But by how much?
I doubt anyone knows. However, a trend that is already occurring in funding of biomedical research is likely to be intensified due to further restriction of funds – a focus on directly clinically-related research at the expense of basic science. Meaning that projects with a direct connection to a disease are more likely to be funded than projects that focus on understanding basic biological processes.
Scientists, policy makers, tax payers, and grant providers are all looking for the same things – cures, breakthroughs, big jumps forward in our understanding and treatment of disease that will improve life quality and decrease suffering. But focusing research dollars solely on clinically focused research will only delay advancement further rather than expedite it.
Here’s why: The solution to clinical problems is built on the knowledge and insight collected through basic research. Sure, basic research most often moves forward in small steps. Yet these incremental advances lead to an essential accumulation of knowledge. True cures – cessation and/or reversal of disease processes, not just management of symptoms — can only come after thorough and full understanding of the biological processes underlying a disease. If we don’t first understand what ‘goes right’ when someone is healthy, how can we correct things that go wrong during disease?
Furthermore, serendipitous discoveries in basic research have lead to some of the biggest clinical breakthroughs in history. For example, the discovery of the first antibiotic, penicillin, came directly out of an accident of basic research. In 1928, Sir Alexander Fleming was investigating properties of the bacteria Staphylococcus aureus and noticed that a fungus that killed the bacteria in close proximity contaminated one of his cultures. This fungus, Penicillium notatum, was found to secrete the antibiotic compound penicillian, which kills bacteria by breaking down their cell walls as they grow and divide.
Another example: Researchers funded to understand the basic process of how the brain interprets smells discovered a technique, designed only to further their research, that enabled the entire biotechnology industry. In the late 1970’s, Richard Axel and his colleagues figured out a technique to modify genes, and then stably transfer those genes and express them in live cells. This process, called transfection, has propelled countless cures and treatments.
These are just two of the many discoveries made in the course of basic scientific research that drastically changed clinical treatment. We need multidisciplinary thinking, collaboration – and funding – to succeed in any endeavor, especially when it comes to tackling our biggest questions in science and medicine. All research has a part to play in advancing our health.
Alyssa Picchini Schaffer, PhD, who handles research that informs the editorial process at TEDMED, has studied the biological basis of psychiatric disease. Follow her @AlyssaPSchaffer.