If you cut my budget, I'll drop this box.

You Can't Cure Ebola With Money

Megan McArdle is a Bloomberg View columnist. She wrote for the Daily Beast, Newsweek, the Atlantic and the Economist and founded the blog Asymmetrical Information. She is the author of "“The Up Side of Down: Why Failing Well Is the Key to Success.”
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Last week, when I was somewhat disparaging about the claim by Francis Collins, head of the National Institutes of Health, that if only his agency budget hadn't been slashed, we would have a vaccine for Ebola, a number of people responded with outraged indignation that I, a libertarian journalist, could malign a lovely, brilliant, noble government scientist.

Well, fair enough. But Michael Eisen, a biologist at Berkeley and investigator at the the Howard Hughes Medical Institute, says basically the same thing, at greater length:

I read this testimony at the time, and was taken aback by this statement, but I was a bit reluctant to undermine efforts to increase NIH funding, no matter how cynical they might be. It was, after all, Congressional testimony, and one can forgive a bit of exaggeration in pursuit of remedying the horrible financial situation the NIH (and, thus its grantees and would be grantees).

But now Collins has gone public with this claim, in an article in the Huffington Post, and so it's time to call this for what it is: complete [Expletive Deleted].

First, let's deal with the most immediate assertion - that if there had been more funds there would be an Ebola vaccine today. Collins argues we'd be a few years ahead of where they are today, and that, instead of preparing to enter phase 1 trials today, they'd have done this two years ago. But last time I checked, there was a reason we do clinical trials, which is to determine if therapies are safe and effective. And, crucially, many of these fail (how many times have we heard about HIV vaccines that were effective in animals). Thus, even if you believe the only thing holding up development of the Ebola vaccine was funds, it's still false to argue that with more money we'd have an Ebola vaccine. Vaccine and drug development just simply doesn't work this way. There are long lists of projects, in both the public and private sector that have been very well-funded, and still failed.

It is a gross overtrivialization of even the directed scientific process involved in developing vaccines to suggest that simply by spending more money on something you are guaranteed a product. And, if I were in Congress, frankly I'd be sick of hearing this kind of baloney, and would respond with a long list of things I'd been promised by previous NIH Directors if only we'd spend more money on them.

Second, let's assume Collins is right. That the only reason we don't have an Ebola vaccine today was that the project wasn't properly funded. If this is true, than one should rightly ask why this wasn't given a higher priority. The potential for a serious Ebola outbreak has been there for a long time. And while money is tight at the NIH, they still manage to find funds to do a lot of stuff I would not have prioritized over an Ebola research program if it was really on the crux of delivering a vaccine. So there is an element of choice here too that Collins is downplaying.

Derek Lowe adds that the NIH budget hasn't exactly been slashed to the bone.

I support government spending on basic research. But I really do not support the wrongheaded idea that medical research is like ordering groceries from Peapod: Just dial up what you want, and if you're willing to pay the cost, you can have the goodies. In fact, it's more like a lottery: if you don't play, you can't win, but at best, you still lose an awful lot. An Ebola vaccine is entering trials right now, and if it succeeds, that will be incredible news. But it could fail in many ways, and acting as if it's a guarantee is grossly irresponsible.

Francis Collins is smarter than I am, and he has dedicated his life to furthering the advancement of human knowledge, one of the noblest causes there is. He's also a Washington bureaucrat, and while he's wearing that hat, his job is to get more money for his agency. I suspect he let his good judgment get a bit carried away in the zealous pursuit of that mission. Raising unreasonable expectations very likely to be dashed is bad for public policy, and ultimately, bad for the scientific research that Collins has done so much to promote.

This column does not necessarily reflect the opinion of Bloomberg View's editorial board or Bloomberg LP, its owners and investors.

To contact the author on this story:
Megan McArdle at mmcardle3@bloomberg.net

To contact the editor on this story:
James Gibney at jgibney5@bloomberg.net