The National Institute of Health
Historically, the U.S. has looked to the National Institutes of Health (NIH) to protect us from threats to our health. This long standing and cherished American institution traces its roots to the late 1800s. Over 125 years ago, a Treasury Department employee started collecting 20 cents a month from merchant seamen. These seamen were bringing illness and disease into the country, and often ended up needing medical care. The money collected paid for scientists and doctors who identified the microscopic organisms that caused cholera and other infectious diseases. Today, at NIH headquarters in Baltimore, 1,200 principal investigators and more than 4,000 postdoctoral fellows make the NIH the largest biomedical research institution on the planet.
Everyone wants to live a long, happy, fulfilling life. It’s always tragic when a friend or family member dies unexpectedly, too young, or too early. When death seems unfair, unnatural, even preventable, survivors experience disbelief and confusion, even outrage.
Cancer, lung disease, strokes, Alzheimer’s disease, diabetes, and heart disease Ð these are the top six causes of unnatural death. All of us have brushed up against these killers. As I write this article, the best man at our wedding, in his early 60s, is now on oxygen as a result of a lung disease. My youngest sister has been diagnosed with cancer and told she has only six months to live. My best friend in Denver was just diagnosed with breast cancer. She, too, is in her early 60’s.
Alongside these six causes of unnatural death, epidemics cause loss of life on a magnitude difficult to comprehend. History is scarred by epidemics that have devastated populations from earliest times until today: cholera, influenza, malaria, smallpox, measles, and of course the plague. The current Ebola outbreak in the African nation of Guinea is the worst on record, and is spreading to neighboring countries.
Does the United States have a vaccine for Ebola? The answer is no. Does it have a cure for HIV? No. Alzheimer’s? No. Should it be a priority, as a country, to advance medicine and develop vaccines and cures for these deadly conditions? Of course.
Due to NIH research, a baby born in the United States today can expect to live to age 79 – about three decades longer than one born in 1900. Our quality of life is also improving as a result of their efforts. Over the last twenty-five years, the proportion of older people with chronic disabilities has dropped nearly 33%. The NIH is responsible for many other scientific accomplishments, including the discovery of fluoride, the use of lithium to manage bipolar disorder, and the creation of vaccines against hepatitis, human papillomavirus, the HIB flu, and multiple viruses that lead to a host of heart problems and cancers.
From fiscal year 2000, through fiscal year 2013, the NIH’s budget has grown from $18 billion to $29 billion. Yet surprisingly, the NIH struggles. The funding is inconsistent, and the distribution is through grants to the NIH’s 27 subgroups. Scientists and researchers spend a lot of time and effort writing grant requests instead of searching for cures and new vaccines. Grant requests are often denied, the time spent on them wasted. Just as important, instead of cooperation this grant writing process creates a hypercompetitive environment between biomedical research subgroups. What is needed is a clear strategy to deploy funding that includes government appropriators, physicians and researchers, along with integration into non-profit and for-profit businesses. Funding should include cross-agency teams that put engineers together with researchers.
Recently, members of Congress interviewed 11 individuals representing health researchers, academia, for-profit and non-profit business groups. This impressive group represented a broad spectrum of important stakeholders who will play critical roles in finding new cures. Their message was loud and clear: return to a collaborative and bipartisan approach that rewards investment in research and innovation. Like a governmental agency, non-profit or for-profit business, they want a satisfactory return on the investment. They argued persuasively that they need a predictable and long term funding policy and funding mechanism. They’re begging for a multi-year budget instead of an annual battle for money that grant writers fight over.
They want to see the Food and Drug Administration (FDA), the Centers for Disease Control (CDC) and the National Institute of Health (NIH) work collaboratively and creatively to prioritize national health goals. They want to be able to design and deliver smaller and more effective shared scientific data sets, developed in clinical trials that benefit the largest number of people. They also ask to implement post-market surveillance to measure effectiveness, safety and efficiency. In their testimony, they cited earlier government practices that delivered tremendous innovation when the physicists and engineers at the Department of Energy (DOE), and members of the House Energy and Commerce Committee cooperated with the NIH, the CDC and the FDA.
Colorado’s 1st District Representative Dianne DeGette sits on the House Energy and Commerce Committee. In her comments during the testimony of these 11 individuals, she correctly noted that the “X” of money doesn’t always translate into the “Y” of cures. She called it a nonlinear discussion. Her systemic view of the interaction between government researchers and the public, business and academia presented a picture full of potential. She’s been at the forefront of stem cell research for many years. She talked about how damaged heart tissue can be replaced by healthy new muscle cells through stem cell differentiation, and how the destruction of brain cells in conditions such as Parkinson’s disease and Alzheimer’s disease can potentially be reversed with the replacement of new, healthy and functioning brain cells. Even more promising is the potential to address genetic defects that are present from birth by restoring function and health with the introduction of normal healthy cells that do not have these defects.
The group discussed improvements they’ve seen in reducing bureaucratic barriers and in FDA operations. They also identified ways for further improvement. Where they were all united is in stressing the aggregate risks of the current lack of stable funding, the lack of a strategy for fund deployment, and the general need for more cooperation between business and government.
Aside from our personal responsibility for our own health, the responsibility for the general health and welfare of all Americans rightly belongs with government. Decisions on fund deployment for the greatest good are best made in the halls of government where they are less likely to be driven by marketability and profit. The National Institutes of Health has performed well for more than 125 years, but it can perform better. It deserves to have the strong support of our representatives in government, wise allocation of our tax dollars, and to remain a high priority for us all
Contact your representative and ask them to support the N.I.H. and provide sufficient and predicable funding.