Mar 20 2017

Good News and Bad News

by at 9:54 am under Uncategorized

This was a week notable for good and bad news. Bad news first – the Trump administration released its preliminary “skinny” budget, which, among other things eviscerates the NIH (and by extension the NCI) budget, with a proposed 18% reduction that would reduce funding to levels last seen about 17 years ago. If this actually gets enacted, life-saving biomedical research will be halted in its tracks, along with the careers of countless researchers and the robust commercial enterprises that support this research. Ultimately, the impact on human health and the general human condition will be devastating.

We all know that there is a lag time between breakthrough science and its transformation into life-saving therapies. Consider, for example, the successes of checkpoint antibody therapies for cancer. I have had the privilege of being engaged in fundamental research on the use of monoclonal antibodies since 1986, with federal funding despite widespread skepticism that antibodies could ever be used to treat human disease. Without federal support, the development of commercially viable antibodies would have been delayed or might never have happened.

What’s more, the federally-funded fundamental groundwork, such the discovery of CTLA-4 and of other immune checkpoints such as PD-1 and PD-L,1 all occurred before or at the dawn of the 21st century. Even though the development of drugs based on these discoveries proceeded quite rapidly, we are just now seeing their widespread application in this country. So, the gutting of federally sponsored cancer research will have immediate impacts on our ability to conduct science and to maintain the historic leadership of the United States in biomedical research. More importantly, the impact of this remarkably short-sighted plan will be felt by the generations that follow us – with fewer cures, more suffering and untimely deaths that would not have happened had we been permitted to continue our work without interruption.

As for the argument that the federal government should not be involved in supporting this research, I don’t have enough space in this blog to refute it. Suffice it to note that the genius of the private sector has never extended to basic, life-changing biomedical discovery. The return on investment is too low, because basic science is, by definition, risky.

The support of fundamental and applied biomedical research has been and remains one of the great accomplishments of our federal government. I hope, and we should urge, that Congress respect and support this historic commitment to betterment of the human condition. This is a bipartisan issue, and I believe that the legislative branch will protect this commitment. As a member of the AACR’s government affairs committee, I am doing what I can to advance this argument. I hope all of us can do this, each in our own way.

And, by the way, the CBO estimates that the American Health Care Act will leave millions of Americans without health insurance. They will turn to emergency rooms for their care, creating an unfunded mandate for health care providers. In addition to leaving so many people, especially vulnerable populations, without coverage and thus access to health care – a fundamental human right – the costs incurred will endanger precious surpluses that can be used to support research. This adds an additional layer of uncertainty that needs to be carefully considered. Congress has not yet been heard from on this issue, either, so perhaps reason will prevail. I am by nature an optimist, and believe that we will get past this challenge.

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