Sir

While I concur with Ken Dill's call for increased support of research in physics, chemistry, mathematics and computer science, I am troubled by his reasoning1. He conflates biology and medicine into an ill-defined hybrid “biomedicine”, which he believes is reducing “the problems of disease to problems of molecular science”. I believe this belittles both biology and medicine.

The biological sciences are quite distinct from medicine. Obviously they overlap, but so do each of them with the other disciplines that Dill mentions. Further, advances in biology and medicine feed back into and stimulate what he terms the “basic sciences”, and may lead to whole new research paradigms2.

The unidirectional model of “basic” and “applied” research implied by the pyramid in his Fig. 1 derives less from his view of their interactions than from the rapid growth of the budget of the US National Institutes of Health (which supports “biomedicine”) compared with US agencies concerned with the physical sciences.

Many research programmes could influence human health and need new, long-term funding. Among these, I would stress patient-oriented medical research itself3, including human pathophysiology, epidemiology, pharmacology, clinical trials and health-services research. A good case could also be made for behavioural, population and other as yet ‘soft’ sciences. If Dill wishes to present a two-dimensional model for the relationships of the sciences to the curing of disease, I would suggest a circle with radiating spokes for the many disciplines that need increased support.