Effect Measure

Pandemics and research funding

I’ll soon be at the end of my career, funding-wise, although I plan to continue as an active scientist for as long as my neurons will process information in a logical order. I mention this so you won’t take this as special pleading. I’m not going to benefit from it. But if we want to continue to make advances in science and health (as well as other things), we’re going to have to invest more heavily in basic research. And when we do, we’ll have to do it smarter than we’ve done it before. Notice I didn’t say anything about competing economically as a nation, although any nation that fails to invest in science will fall behind. Science doesn’t care about national borders and neither do I. I’m talking about learning enough about how the world works that we can deal with major threats like influenza pandemics — to take an example not at all at random.

Many readers here are surprised (and some shocked) at how little we know about basic influenza science — like why it is seasonal, what are the major modes of transmission, what makes one strain more virulent than another and much more. The community of flu scientists is surprisingly small and research on the virus now requires a wide range of expertise it didn’t in the past. Bioinformatics and biophysics have revolutionized virology, but it takes time for knowledge and skill to build up in any specialty. Right now there are far too many questions being chased by far too few scientists. And if history is any gauge, we are about to see a currently bad situation in research funding get even worse.

It’s not because there isn’t sufficient money, at least at the moment. It’s the consequences of how the money is being spent. Here’s a story from my days in medical training. I spent a rotation in the impossibly busy downtown emergency room in a hospital in the largest city in the country. My home base was another hospital in midtown. To get from one to the other you had to go down a large drive that was three lanes in each direction. We usually hitched a ride in an ambulance. Depending on the time of day, traffic moved faster or slower — but usually it moved. Until, that is, they decided they would do some road work and widened the drive from three lanes to five lanes — but only for a couple of hundred yards. Cars immediately spread out to occupy the full width but within a minute had to squeeze back down to three lanes. Like the turbulence caused by an aneurysm, the result was a terrible traffic jam.

We saw the analogous thing happen with research funding when Congress doubled the NIH budget in 1998 but then dropped it back to the previous level and then below, in real terms. New labs, post docs, graduate students and young faculty came on board, started active and vigorous research programs and suddenly found funding lines drop from 21% of NIH grant proposals to 8% or less. The ensuing crisis and loss of talent in basic biomedical sciences is having a lasting effect. Now a sudden infusion of stimulus money into NIH, to be spent in two years, is threatening to do this again in a system still reeling from the budget doubling fiasco. Researchers are already worrying about what’s going to happen:

NIH?s $10.4 billion windfall in stimulus funding runs out in 2011. Today, the Federation of American Societies for Experimental Biology (FASEB) issued a report claiming that the number of competing grants?essentially new awards?will plunge about 40%, from 16,564 to 9850, if NIH’s base budget stays at the $31 billion requested by President Barack Obama for 2010. That would put many scientists out of work, FASEB suggests. “We’re going to slow progress; we’re going to end careers; we’re going to be terribly discouraging to young scientists,” incoming FASEB President Mark Lively told reporters at a press breakfast this morning. (Jocelyn Kaiser, ScienceInsider)

It’s not about me. I’m very well funded and I’ll be fine. But as I look at my students, post docs and younger colleagues I wonder how many of them will be active scientists in ten years if we don’t face up to the fact that while finding out important things pays off handsomely, it costs money. Modern science is powerful, but it is also expensive. FASEB functions like a trade group for scientists, so you could see its warning as just another special interest lobbying effort. It is a lobbying effort by a special interest, all right, but it’s not just another special interest.

FASEB’s analysis suggests that NIH will need a 10% boost in 2011 and then another 3% above inflation in subsequent years (i.e., 6 – 7% each year). That may be a hard sell for politicians (and Obama is as guilty as any) whose tendency is to pander to voters by throwing money at dread diseases like cancer. But we never know where the new insight will come from that unlocks some other health problem. Research on fruitflies and yeast is central to much of what we know about cancer and Alzheimer’s Disease — and influenza. Research that targets diseases may sound efficient, but it doesn’t pay off as much as across-board-investments in basic research does.

Late yesterday afternoon word came that the Obama administration will finally nominate geneticist Francis Collins as Director of NIH. Collins is somewhat controversial among scientists for his religious views — he has some — but he knows research, has a track record as a capable science administrator, and with any luck he’ll be able to represent basic biomedical research in a way that will prevent terrible damage to our scientific infrastructure.

Comments

  1. #1 S. Lakshmi
    July 9, 2009

    Your point about the importance of fruitflies in medical research brought to mind Sarah Palin’s comment: “Where does a lot of that earmark money end up anyway? [...] You’ve heard about some of these pet projects they really don’t make a whole lot of sense and sometimes these dollars go to projects that have little or nothing to do with the public good. Things like fruit fly research in Paris, France. I kid you not.”

    Could you imagine the state of funding for science under her administration? At least we dodged that bullet!

  2. #2 sherrie p
    July 9, 2009

    Reveres, please- your thoughts on this:(Even though I’m sure this is ‘old hat’ for you & many of EF’s readership.)
    from http://www.WantToKnow.info/health/vaccines_swine_flu_
    mandatory

    “Department of Homeland Security officials are declaring that any disease outbreak is a matter of homeland security. Department of Defense officials are defining public demonstrations as ‘low level terrorism.’ In some states … doctors have persuaded legislators to quickly pass pandemic influenza legislation that will allow state officials to enter homes and businesses without the approval of occupants; to investigate and quarantine individuals without their consent; to require licensed health care providers to give citizens vaccines and to ban the free assembly of citizens in the state.”*
    — Barbara L.Fisher,Pres., Nat’l Vaccine Information Center < http://www.nvic.org>, 6/18/09
    And– (believe me, I’m condensing here!!)the issue of B. Pharma/Gov:
    http://www.wanttoknow.info/truthaboutdrugcompanies
    All of which only scratches the unscrupulous,dirty surface.

    Thanks- sherrie

  3. #3 revere
    July 9, 2009

    sherrie: Sounds to me like anti-vaxer bullshit.

  4. #4 Magpie
    July 9, 2009

    Awesome. This agrees with the system I’ve been working on to model research in the space strategy game I’m (perpetually) making, which uses something of a momentum-like approach, and in which a balance between broad-based basic research and focused outcomes-directed research gives the best long term bang for buck.

    (Don’t worry – it’ll be a lot simpler and more fun in the game than it sounds. That is, if I ever finish it).

    I love it when my unscientific hand waving approximates reality.

  5. #5 Magpie
    July 9, 2009

    Well I can comment on the demonstrations part of that, Sherrie: The low level terrorism thing relates to the legal definitions of terrorism. Don’t know the US law, but for most places it boils down to something like “politically, ideologically, or religiously motivated violence”.

    Hence a demonstration for political or ideological purposes, that turns violent, can be defined in law as terrorism. It usually isn’t treated as such by law enforcement or the legal system, though – hence the strange description of “low-level terrorism”.

    It’s a problem, of course, to define precisely what you mean by terrorism, without letting some terrorists off the hook, but at the same time keeping people in innocent circumstances out of the picture. Generally the judiciary seems able to sensibly keep the issues apart, at least as far as I’ve seen.

    Not optimal, and I’m sure terrorism law is more complicated than I can talk about (I’ve got reason for expertise, other than some vague interest), but that’s life. Complicated.

    Other stuff, again from a position of almost-complete ignorance, but I suspect someone is taking the most hysterical possible spin on what could be perfectly innocent situations:

    Department of Homeland Security officials are declaring that any disease outbreak is a matter of homeland security.

    Given that bioweapons, even DIY bioweapons like intentional spread of normal diseases, are a likely tactic for terrorism to come, I’d be horrified if they didn’t think that a disease outbreak warranted at least a look. I wish there were more resources in this area, since better analysis of spread would help to understand natural pandemic spread, too.

    In some states … doctors have persuaded legislators to quickly pass pandemic influenza legislation that will allow state officials to enter homes and businesses without the approval of occupants

    Like going in to a home where you suspect the occupants are unconscious? What’s wrong with that?

    to investigate and quarantine individuals without their consent

    Shouldn’t there be a legal provision for intentional spread of disease? not only from the terrorism point of view above, but I know people have been successfully prosecuted for intentionally or even just recklessly spreading HIV.

    to require licensed health care providers to give citizens vaccines

    That doesn’t say the citizens have to accept the vaccines, just that providers have to give them. Which seems pretty weird and pointless, since it’s a vanishingly small minority who refuse.

    …and to ban the free assembly of citizens in the state.

    It might not be terribly effective, it might be very effective, I don’t know. But in the case of a major pandemic, I don’t think something like a curfew would be terribly sinister. Such provisions already exist in most countries for civil disturbances, why not for medical emergencies too?

    So maybe all of that is actually based in more frightening facts, but perfectly reasonable explanations seem to exist for all of those claims.

  6. #6 Magpie
    July 9, 2009

    Um, I meant to say that I’ve got NO reason for expertise in terrorism-related law. Silly typo.

    To sum up: nothing I’ve said should carry any weight of authority. I type entirely with my arse.

  7. #7 BostonERDoc
    July 9, 2009

    I know I am changing the subject somewhat but what is up with the NEJM republishing a commentary that first appeared in May in today’s issue? It reads almost word for word unchanged. Are they getting desperate for pandemic manuscripts? I guess I better get writing and fast.

    I would like to see more research done by clinicians who are in the pits seeing individuals stricken with flu, cMRSA, etc.–it would bring a real life perspective in addition to the ivy tower perspective and maybe we would get some answers to the fundamental question : Does flu spread by airborne or by large droplet?

  8. #8 Noumenon
    July 10, 2009

    I badly misread your first sentence as saying you were losing your funding and your job…

  9. #9 revere
    July 10, 2009

    Noumenon: No, thankfully I’m in pretty good shape in that regard. My funding and job are both secure at the moment. But I am still under pressure because many others depend on my funding, now and the future. So it never ends. Well it sends sometime, and that sometime isn’t that far off for me as I will retire as overall PI at some point soon. I’ll be glad not to have the responsibility.

  10. #10 miso
    July 10, 2009

    revere,
    congratulations on being “soon to be at the end of your career, funding-wise”.

    I hope you’ll stay on posting at Effect Measure. The end of funding will set you free.

    Since the invention of swine flu and the return of faith that Tamiflu resistance was a aberration rather than an obvious structural flaw, I’ve been at the “end of my wits, sanity-wise”, so I hope you’ll share the burden and mention Relenza occasionally.

    (if everyone can remember Relenza’s not a pill, why is it so hard to remember it doesn’t suffer resistance in any strain of Influenza A. Period.

    And if someone had paid more attention to i.v. zanamivir, or GSK’s LANI the famous gap in defence caused by inhaling Relenza daily could have made influenza A impenetrable.(I’m sorry if all your concentrating on is my truthful display of “end of wits, sanity-wise”, instead of my truthful information)).

  11. #11 miso
    July 10, 2009

    “My funding and job are both secure ”

    Revere,
    I notice this was posted while I was composing my post.

    Congratulations, your funding and job are secure, and to stay that way, leave it to me to mention Relenza, I don’t need anyone’s funding.

  12. #12 raven
    July 10, 2009

    Reportedly, bulk swine flu vaccine will be ready in July. This month.

    It needs to be tested.

    The latest timelines say it could be ready in mid-September but they also talk about giving immunizations in mid-October so that might be too optimistic.

    So far this summer flu looks like a herald wave. The main pandemic should hit during the normal flu season.

    My best guess is that the main wave will be early. This flu isn’t dying out during the summer as usual, in the UK is doesn’t even seem to be slowing down.

    Will the vaccine make a difference? Who knows, wait and see.

  13. #13 miso
    July 12, 2009

    Revere,
    All it takes is a “Google News” search of the latest articles to see how much of the information has filtered through “funding and job security” to result in lies and misinformation.

    I wonder if readers at Effect Measure can find the seam between science and public relations or is it only the viri prepared to expose the truth and interfere with the plans of big business by ridiculing their products and their PR?

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