D. Miller, M.D.
Academic medical centers have gone to work in our
nation’s capital this spring—and Johns
Hopkins has joined their crusade. We are marching on
Washington to educate members of Congress on our big
common concern: government funding for biomedical research.
After years of hefty increases, the National Institutes
of Health, this nation’s primary research engine,
faces the prospect of an overall funding freeze and
a $233 million cut in research grants.
I fear such a move. A cut in research funding, if
approved by Congress, could have long-lasting consequences
for America’s competitiveness in moving medicine
forward. The astonishing advances we’ve witnessed
in recent years in understanding complex diseases could,
in fact, be slowed dramatically. What’s more,
denied federal grants, many of our bright young investigators
might well opt to follow other career opportunities.
Because Hopkins leads all universities in NIH financial
support, our research labs will feel the impact of
this cut in support more than others. Our level of
government funding is, of course, a grand compliment
to the string of medical discovery success stories
that have sprung from this institution. But it’s
also because we’ve come to count on this funding
that we’re taking such an active role in convincing
Congress to expand federal backing for medical science.
President Bush’s budgetary restraint on research—for
the fourth year in a row—is no doubt the result
of shifting priorities in Washington. But let’s
take a look at what resulted when the opposite held true—when
research was the priority. In 1998, President Clinton
and the Republican Congress agreed to double the NIH
research budget over a five-year span, and with that
huge bipartisan investment came such amazing discoveries
as biomarkers for cancers. Very quickly, that five-year
investment started to pay off. With the ability to
test for these new biomarkers, physicians began diagnosing
cancer earlier, and researchers discovered more effective
therapies. And with those advances cancer deaths in
the United States began to drop for the first time
since the nation started keeping such statistics 75
I am convinced that we are on the verge of a dramatic
transformation of health science discovery. I believe
that this is the worst possible moment to change course
in supporting this kind of research. If Congress wants
to ensure that its earlier commitment brings home the
biggest bang for the buck, it needs to support more,
not less, funding for laboratory investigations.
Here’s why I think larger appropriations are
critical to our nation’s future:
- We don’t want to lose one of our last
strategic advantages—leadership in scientific
research and health care. The United States undoubtedly
has lost ground in areas like automobile and other
kinds of manufacturing, but we remain the clear leader
in biomedicine. That won’t last without reinvigorated
- Investing in improved human health has to
remain a national economic imperative. The best way
to curb dangerously ballooning Medicare and Medicaid
costs is by federal support of research. As that funding
reaps more effective treatments, earlier interventions
and even cures, medical insurance expenses go down.
(Lost productivity and other negative effects of disease,
according to NIH, cost the nation’s economy
$136 billion a year.)
- We can’t afford to lose a generation
of enthusiastic, inquisitive and creative young researchers
who, without a doubt, will become discouraged as
NIH grants become scarce and out of reach for most
One final word: It’s ironic that while biomedical
research is targeted for budget cuts, the president
has earmarked mathematics and the physical sciences
for a large boost to help improve America’s competitiveness.
Yet the two branches of science cannot be separated.
If the United States wants to remain the world leader
in the sciences, all forms of investigation must be
amply supported. To borrow a phrase from another White
House program, no science should be left behind.
Interestingly, historic dividing lines between the
sciences are now disappearing. Computational science
has become an integral part of biomedical research.
Interdisciplinary teams are mining data, hunting
genes, modeling molecular networks, identifying biomarkers
of disease at early stages and finding new treatments.
The physical and biological sciences go hand in hand.
Both merit increased federal backing.
exciting time in medicine. That’s
what we must convey to our friends in Congress. Early
in this decade, academic medical centers got complacent.
Thanks to the continuing flow of huge sums of federal
dollars to our research labs, we felt we didn’t
have to raise our voices in the hallways of power. We
were wrong. We learned that it’s our job to deliver
the message that biomedical investigators are on the
brink of tremendous scientific advances that will make
life better for millions of Americans. But this can happen
only if there are sufficient funds to stimulate basic
and translational research.