With the sequester now affecting programs from Head Start to the U.S. Marine Corps, I believe that Americans should also care about its impact on medical research. Research sponsored by the National Institutes of Health (NIH) has accounted for the vast majority of advances in health over the past 50 years, from preventing heart attacks and type 2 diabetes to customizing treatment for leukemia in children and breast cancer in women to extending the lives of people with devastating infections such as HIV and influenza. But the NIH’s budget, too, has come under the sequester ax. Not only does that reduce research grants by 6 to 10 percent in 2013, but if it remains in place year after year, it will reduce NIH dollars even further.
Every day, we read about people, patients, scientists and projects that are hurt by the sequester. Every day, I see our own investigators, students and physicians struggle to keep their research going. I hesitated to write this blog because it seemed that all the horror stories are well known, and since we’ve all seen this movie, what could possibly be added to the conversation? Plus, some may think “What’s all the fuss about the sequester, since it’s cutting research funding by only a few percentage points?”
Then it hit me as a physician-scientist: the key to explaining the problem is to talk about this from a translational research perspective. At its core, this new paradigm in medical research says that we can advance human health by interconnecting research scientists, physicians, information experts, care providers and patients. Translational research allows us to exchange knowledge quickly within teams of scientists, so that the right drugs are designed with the patient in mind; testing of treatments takes into account all the factors that affect the wide range of children and adults; and treatments are designed to work safely in actual medical practice and in specific populations.
What all this means is that today’s scientific research is collaborative and interdependent—sort of like the parts of a car. Think about what would happen if you eliminated only one wheel of a car. Or just one spark plug. By itself, each of these items seems to be only a small part of the overall machine, but without it you can’t drive—at least not well or safely. That’s what translational medical research is all about, and the absence of one (seemingly small) part of the whole can delay and potentially kill progress. That’s what an across-the-board cut in research funding has done. No part of the research engine is capable of working the way it was intended, and researchers have little choice but to eliminate whole programs so that some portions of others can survive.
Oh, and that second question—what’s the fuss about only a 6 percent cut? We need to remember that the sequester cut is coming at the worst possible time. We have just seen a decade of no real growth in the NIH budget (which is actually $5 billion less in real dollars today than it was 10 years ago), combined with an era of unprecedented growth in new scientific knowledge. So: the opportunities for healthcare advances have never been better, the biomedical research engine is all fueled up and ready to go, but we’re not moving ahead because of missing a spark plug!