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Published online 22 June 2009 | Nature | doi:10.1038/news.2009.589
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Has NIH funding improved public health?
Increased funding for biomedical research boosts health and economy, researchers claim.
An analysis of more than 50 years of research funding from the US National Institutes of Health (NIH) suggests that it has helped to avert up to 1.35 million deaths per year from four chronic diseases: cardiovascular disease, stroke, cancer and diabetes.
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Yes, of course, progress in medical research is helped by funding. As set out in my book - Tomorrow's Cures Today? - that the medical research train is moving towards its destination at 20 miles per hour sounds great, unless you know that trains are capable of much greater speeds! The key issue is not the fact of funding, but how our peer-review system mis-allocates that funding.
I would be interested to read an elaboration of the previous statement from Dr. Forsdyke. How is funding misallocated in his point of view?
One way is through poor enthusiasm, peer review, and support for clinical trials.
I can't speak for Forsdyke, but I also believe that research funds are misallocated under the current system. While there are many thousands of scientists receiving grants for their research, there are actually only very few scientists that actually advance scientific knowledge in meaningful ways. Our current system allows slightly underachieving scientists equal access to funds if they are willing to jump through the right hoops and/or gain the right political/social connections. Unfortunately, slightly underachieving can mean completely useless when it comes to advancing the frontiers of knowledge. I've witnessed entire laboratories that do nothing more than repeat experiments already done by others, but they do them with proteins from a slightly different organism. E.g. someone does groundbreaking work on an enzyme from E. coli, so some slightly less talented, but no less ambitious scientist, afraid they won't get anything to work, repeats the experiment with yeast protein. Most of these experiments add nothing to our understanding. Sometimes they do, but mostly not. If you don't believe me, consider, what fraction of papers in your own field do you consider worth actually reading? Actually very few. I think there is actually quite a strong argument to reduce NIH funding so that these scientists are forced out into the real world where they can use their highly trained minds to do something worthwhile for society, such as teach or run a successful business. Let the real geniuses control more of the money and see what happens.
What a shame that the debate seems to have taken off concerning the demerits of peer review rather than the merits of increased biomedical research funding. Peer review works great when I get funded and poorly when I don't. Most of us probably feel the same way, but haven't come up with workable alternatives. So what's the answer? We need more money in the system. The Manton article is probably a gross underestimate of progress acheived by NIH research, since it deals with mortality rather than improved quality of life, with commensurate increases in productivity. So...more funding for science equals both increased federal revenue and more proposals funded. More proposals funded increases both the number of innovative and confirmatory projects, and all of these contribute to scientific progress and to the health and welfare of humankind.
I don't think anyone would question that increased research has led to a decrease in deaths and a better quality of life for the aging population. That said, it is not clear if the NIH funding had been at half the level whether the same progress would have been made or if the level was doubled, whether faster progress would have been made. But the peer-review system not only works, but works well. Like anything else, it could be better, but it works. What many fail to understand is that many scientific breakthroughs are the result of careful observations of unexpected results, results that obviously could not be predicted. In order to have the opportunity to see these results, one needs to fund the research. Almost as a probability function, the more research you fund the better your chances, the less research you fund, the more restricted your chances. The very difficult question is where is the best balance point where one is getting the most for their dollar and not throwing money away? The current funding crunch (stimulus packages not included) would indicate that too little funding for research is occurring and that too many good ideas are not being funded. Additionally, the loss of good ideas, and good ideas from younger scientists, may result in a loss of a decade's worth of scientists. Finally, although not commonly recognized, basic research is "translational research". It is like, if you didn't have the acorn, where would the giant oak come from?