January 3, 2018; STAT News
In 2017, how Americans would be able to access medical care was a highly prominent issue. As 2018 begins, the Affordable Care Act remains the law of the land, but it has been weakened, and successful programs like the Children’s Health Insurance Program (CHIP) remain in limbo. Though it lacks the sound and fury that have marked the debate over health insurance, medical research funding is also under threat.
Overall, funding from all sources for basic medical research has stagnated. Authors of an article recently published in STAT News claims this could mean that we will see fewer medical breakthroughs than we have come to expect: “A healthy life science ecosystem requires investment in basic research, translation of discoveries, and the development of new therapies that enhance and improve human health.” Without adequate, consistent funding, the ecosystem may wither and be unable to produce.
The role played by the National Institutes of Health depends on the outcome of budget battles taking place in Washington. The president’s 2018 proposal calls for cuts in research funding. While the emergent congressional budget spending plan shows an increase for NIH, it is inadequate to keep pace with inflation. As a result, fewer projects, particularly high risk/high reward efforts, are funded, and fewer small labs, which have been shown to be more productive, are supported. Both outcomes, if they continue, will have a long term negative impact on our future health.
In their article, cancer researchers Jeffrey A. Bluestone, David Beier, and Laurie H. Glimcher “urge a concerted effort by industry and philanthropists to grow both the basic and translational research enterprises.” In their vision,
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More aggressive collaboration with the nonprofit sector will drive down costs, as will more openness in sharing data from clinical trial results. The pharmaceutical industry can create consortia to develop precompetitive data and tools for drug development, and set voluntary standards to improve the likelihood of scientific accuracy through appropriate commitments to replicate research results. Industry leaders can also work with the nonprofit and philanthropic communities on tissue sampling, data analytics, and sequencing standards for specific diseases.
Other innovations are emerging from industry-university partnerships, including support for incubators and accelerators underwritten by large companies and sometimes by venture capital firms with an eye to helping university projects survive the so-called valley of death between invention and commercialization.
The authors also advocate new ways to generate basic research funding revenues, especially by reallocating patent revenues to create ongoing financial support.
In the past, patents derived from university research were simply granted to inventors’ institutions. It is becoming increasingly common today for philanthropic organizations to participate in royalty or milestone payments and, in some cases, invention management. These strategies ensure that both the philanthropic organization and the university share in returns that will sustain the engines of innovation and discovery.
No one part of the research ecosystem can turn the funding situation around on its own. The federal government needs to come back to the table and properly fund the work of NIH, work that has stimulated the basic research needed for practical breakthroughs. Private industry needs to continue to invest, but do it in a more collaborative manner that can make its investments offer a broader benefit. Philanthropists, nonprofits, and universities need to be willing to share the spotlight. If all play their parts well, however, this may set the groundwork for further medical breakthroughs, which can both extend and improve thousands—or even millions—of people’s lives.—Martin Levine