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A Word From the President: State of Our Research Is Linked to the State of Our Union

AAMC Reporter: February 2014

In President Obama’s State of the Union address last month, he urged Congress to “unleash the next great American discovery” by undoing “damage done by last year’s cuts to basic research” at the National Institutes of Health (NIH)—refreshing words given otherwise discouraging trends related to U.S. research funding over the last several years. The president’s call came on the heels of some positive news in January when Congress agreed to restore $1 billion to the NIH for fiscal 2014. While we welcome these renewed demonstrations of support for medical research, it is more important than ever that our national leaders recognize the need to undertake a more sustainable approach to medical research funding over the long term that avoids the “boom and bust” cycles of recent years.

In the early days of my career at the NIH, I truly grasped the promise research holds to uncover new therapies, prevent illness, and connect great minds to improve the quality of our lives. The vital scientific work that can lead to cures often is painstaking, time consuming, and in need of substantial and predictable funding. By the time I left the NIH in 1994, researchers were on track to tackle some of our most pressing national health concerns. Over the next decade, the NIH’s spending power doubled, and along with it, my confidence grew. I believed that this support would help our most creative researchers develop new means of preventing, treating, and managing diseases, from cancer to diabetes to my own area of interest, schizophrenia. But the federal budget constraints of recent years have diminished that confidence.

Since 2003, the NIH has lost nearly one-quarter of its purchasing power. Funding cuts combined with last year’s sequestration have stifled progress in basic and clinical research, patient-centered outcomes studies, community health, evaluation of new delivery models, and comparative effectiveness research. Without grant support, once-promising research has been scrapped, delayed, or scaled down. Academic faculty members are being drawn to well-endowed labs overseas. Limited funds have forced other researchers to eliminate control groups, rely on inferior equipment, or use smaller samples, all of which can compromise results. Looking at a breakdown of U.S. health care spending in last month’s Modern Healthcare, I noted sadly that support of noncommercial research—namely the research that agencies like the NIH undertake—had actually decreased, while all other areas of medical spending increased. But we can reverse such trends by reinstating sustained NIH funding.

As health professionals, we understand that medical research requires years of trial and error before it yields fruit. In the past, even when we experienced brief periods of slowed funding, we held a belief—validated by experience—that the nation was committed to its standing as a world leader in research and would sustain its support of scientists.

Today, as the population ages, we are increasingly called upon to cope with the staggering costs of chronic illness and disability. A commitment to research means investing in people, infrastructure, and equipment to foster discovery. In fact, sustained growth in NIH funding is essential for continued national well-being. While restoring some of the sequestration cuts to NIH will boost its ability to support promising research and cultivate the next generation of researchers, more needs to be done. Given that research and the serendipity of discovery cannot be turned off and on like a spigot, our national leaders must make a strong commitment to sustained growth in NIH funding over the long term. As AAMC Chief Scientific Officer Ann Bonham, Ph.D., says, “Serendipity takes planning.” And there can be no serendipity without scientists, grants, and laboratories. With the current scramble for limited research funding, the scientific environment has become risk averse and more competitive—not collaborative—which takes its own toll.

In addition, the best scientific minds coming out of our medical schools today need to feel assured there will be a place for them to pursue medical research if they want to follow that path—that funding will not run out arbitrarily. At the NIH, I was fortunate to have a mentor who introduced me to the excitement of basic and clinical research, and convinced me of the real career opportunities that lay ahead in research for both physicians and basic scientists. Our newest young scientists deserve the same.

As leaders in academic medicine, we understand the serious implications of funding cuts to our labs in a way that government policymakers and the public may not. That makes it our obligation to protect the nation’s investment in medical research. We must raise our concerns and our voices now to make research a national priority once again.

We can start by joining together to urge Congress to take the next step by providing the NIH at least $32 billion for research for fiscal 2015. The NIH is the world’s greatest research program, and I am still honored to say I had the privilege of doing work funded by that program. I have hopes that the state of our research can be bright again.

As a nation, we now have a choice either to preserve our status as the world’s research leader or yield it. Making the right decision can be the difference between a future in which we inspire the next generation of scientists or relinquish them to other fields. It can mean living in a country where we seize scientific opportunities, rather than ceding them. This year, I would like us and those we elect to represent us to hew to the message in this year’s State of the Union address and work to restore a vibrant climate in the state of our research, where potential is unleashed and discoveries benefit all who are awaiting tomorrow’s cures.