At the University of Oklahoma Health Sciences Center, we shudder at the thought of congressional budget cuts to the National Institutes of Health. Funding reductions for biomedical research could radically stunt discoveries that would mean a vastly improved quality of life for all of us.
The kicker in this situation is that, in making our case to Washington lawmakers, it's impossible to say what cures or breakthroughs won't be discovered if the NIH runs out of money.
In a recent journal article, Dr. Samuel O. Thier, president of Massachusetts General Hospital in Boston, recalled that in the 1970s he deemed the establishment of the National Cancer Institute to be an enormous waste of resources.
"What actually happened was that scientists were drawn into cancer research and began to ask questions that were at least remotely related to cancer," he wrote. "If one looks at what has been learned since then about oncogenic viruses, about oncogenes, about the regulation of cell growth and its importance in abnormal cell growth, one can see that the whole paradigm of the control of cancer has shifted dramatically within 15-20 years."
Squandering of resources? To the vast number of cancer patients who are staying healthier longer and enjoying prolonged lives, I don't think so.
Thier refers to the "feedback loop" of biomedical research. For example, the success of vaccines led to the development of the science of immunology. Studies in that field led to better vaccines, which led to better control over viruses through mechanisms we were able to pinpoint.
Many of you have read about the exciting possibilities of gene therapy, where a defective gene in an individual that codes for a disease can be replaced with a healthy gene. As Thier points out, freeing a patient from a devastating illness is a thrill in itself. But he predicts that "when we begin somatic cell gene therapy by placing the gene into the cell, and the gene replaces the missing or damaged product, numerous other unexpected effects will occur."
Without the clinical investigator who is supported by research grants, "who will be there to observe these events and recognize their enormous importance for biology. . .the relevant questions that feed back into the biomedical system will not be asked," Thier wrote.
Forget the unimagined possibilities for the moment. According to NIH Director Harold Varmus, a Nobel laureate in his own right, during the past year there have been breakthrough discoveries in identifying genetic predispositions for breast and colon cancer. Researchers discovered that the drug zidovudine (AZT) can prevent the transmission of human immunodeficiency virus (HIV) between a pregnant mother and her child. A new treatment was discovered for sickle cell disease, and new information emerged regarding the potential of protease inhibitors to vastly improve treatment for HIV victims.
Scientists also found evidence that a naturally occurring peptide could scotch the metastatic growth of cancerous tumor cells.
Because it is impossible to quantify in advance the outcomes of biomedical research, it sometimes is hard on Capitol Hill to defend the expenditures. As Dr. Herbert Pardes of Columbia University wrote last year, "the United States leads the world in biomedical research, biotechnology and psychopharmaceutical development. . .(while) the nation has handed over leadership in many industries, including the automobile industry, the steel industry, the consumer electronics industry and others." It would be a real shame to also lose our excellence in this realm.
Threats to slash NIH funding, and health care reform activity in general, already are having profound effects. According to the Jan. 28 issue of the journal Lancet, the NIH has shed about 2,000 positions in its in-house research program since 1993, and further reductions are planned. …