Why the Biomedical 'Crisis' Really Isn't
The nation's biomedical research enterprise is in a serious crisis, says a new report from America's top universities. Because of shortfalls in funding from the National Institutes of Health (NIH), only 20% of the projects submitted for funding are being supported. Researchers are spending more time writing grants than doing science. Brilliant young investigators are leaving science in frustration. And the historic U.S. lead in biotech is threatened, said Dr. Edward Miller, chief executive officer of Johns Hopkins Medicine and dean of the university's School of Medicine, at a Mar. 19 Senate briefing on the new report. "It is a disaster," he says.
The problem—and the pain—are real. "Very, very productive scientists are doing no research. They are spending all of their time trying to get their labs funded again," says Dr. Robert Siliciano, professor at Hopkins' School of Medicine.
But the truth is that the wound is largely self-inflicted, a classic case of good intentions gone awry. And the whole tale raises difficult questions about the relative importance of federally funded biomedical research compared to all the other demands on the taxpayers' purse.
To understand why, flash back 10 years. Science had begun to uncover some of the deepest mysteries of biology, understanding how genes work and how diseases arose as glitches in the molecular machinery. Biotech and pharmaceutical companies, from Amgen (AMGN) and Novartis (NVS) to Genentech (DNA), were turning these discoveries into new treatments and cures. Boost federal funding for research, argued scientists, patient groups, and supporters in Congress such as Senator Tom Harkin (D-Iowa), and the result would be an unprecedented flowering of science and medicine.
The Dollars Roll In
The powerful biomedical lobby got its wish. Between 1998 and 2003, Congress doubled the NIH budget, upping it from $13 billion to a staggering $26 billion. Since then, it has risen even further, to $28 billion. "The last 10 years saw a tremendous buildup in scientific capacity," says Dr. Eric Kandel, Nobel Laureate at Columbia University.
So what's the problem? It's not the actual size of the NIH budget. Rather, it has been the sudden shift from the five-year doubling, between 1998 and 2003, to the four years since of barely keeping pace with inflation. What happened during the boom times is that universities built scores of gleaming new labs, anticipating that double-digit increases would never end. Those labs needed ever more dollars to keep running. Meanwhile, the NIH funded thousands of long-term projects. Now that the budget has flattened, the scientific enterprise has a voracious appetite for funding that can't be satisfied. And with a lot of this year's money already tied up in grants, there is little for new projects. "The doubling built the momentum. Then the momentum came crashing to a halt," says Ira Mellman, of the Yale University School of Medicine.
Scientists, who fear that new knowledge and treatments are being delayed, feel betrayed by the federal government. "NIH had a compact with us," says Hopkins' Miller. "They said, 'If you build facilities, we will support them.'" Now, with flat funding, "this contract we had with NIH is broken," Miller complains. Put simply, even though NIH is spending $28 billion a year, there are too many scientists chasing those dollars. "The doubling brought in a cohort of research 'baby boomers,'" explains Dr. Lee Riley of the University of California, Berkeley. "These new investigators suddenly have to compete heavily against each other and against senior investigators for grants. Many of them are leaving. This is a crisis for the research community."
But it's a crisis that didn't have to happen. The big problem, says Kevin Casey, senior director of federal and state relations at Harvard University, is that instead of gradual increases in funding, there was a boom, then a relative bust. Instead of the five-year doubling followed by flat funding, "there are people who hold that a steady 10% growth would have been better," admits Hopkins' Miller. That way, universities wouldn't have rushed so much to cash in on the unprecedented largesse, and wouldn't have overbuilt their research capacity for today's dollars.
The larger question, though, is what the levels of funding should be. For scientists, who truly believe they are on the cusp of astonishing medical advances, almost nothing is too great. "How much does it take?" asks Joan Brugge, chair of the department of cell biology at Harvard Medical School. "It takes as much as we can give it."
With an unlimited federal budget, scientists might get their wish. The fact is that biomedical research has been singled out for unprecedented boosts in funding. The physical sciences and other promising areas have had essentially flat funding for a decade, while biomedical funding more than doubled. So instead of complaining about a crisis that is largely of its own making, the biomedical research establishment might try to make better use of the money it does have, eliminating redundancies and pruning more of the less productive research.