The following Op Ed by Ralph J. DeBerardinis, MD, PhD, a Damon Runyon Clinical Investigator, appeared in the Philadelphia Inquirer on April 14, 2017
THE WHITE HOUSE recently proposed slashing support to the National Institutes of Health, the federal agency funding thousands of health-related research projects in the United States. I direct a clinic and research laboratory developing cures for cancer and childhood genetic diseases. My lab runs on NIH funds, and I'm writing to outline why these cuts will be disastrous for our long-term prospects for health.
About 80 percent of the NIH's $32 billion budget supports university-based research across the country. These projects are the largest engine for biomedical discovery in the world, covering every disease that kills us: diabetes, cancer, heart disease, stroke, dementia and many more. These projects will grind to a halt without NIH support, severely limiting progress toward new cures. No other mechanisms can fund biomedical research on the scale of what the NIH provides.
Obtaining NIH funding is difficult. Proposals undergo rigorous peer review, and currently only about one in seven receives funding. That's because funding is already scarce, having declined by 20 percent in inflation-adjusted dollars since 2003. This sustained crunch has forced many talented scientists to close their labs prematurely. Even worse, many young scientists decide against getting into the game at all, lowering the ceiling on our productivity as a whole. The new cuts will make an already challenging situation nearly impossible, bringing the total budget to a 15-year low. The NIH anticipates eliminating all new grants in 2018, putting a full stop on near-term biomedical innovation. That would be a disaster.
You might hear two common misconceptions about NIH funding in the political chatter around these cuts. One has to do with how NIH funds are used. When the NIH funds one of my proposals, most of the money comes directly to my lab, paying for the salaries of my team and supplies for the experiments. The rest goes to my university to cover the overhead - utilities, equipment and other infrastructure - required to maintain research on an institutional level.
Tom Price, the secretary of Health and Human Services, says cutting the NIH budget will force more of the remaining funds to flow directly into research rather than institutional overhead. He might be right that restructuring overhead costs could generate savings, but the proposed cuts are too deep to make the math work unless labs are to operate without electricity or running water. There is no question the cuts will reduce the funds available for research. To suggest otherwise is naïve or intentionally misleading.
Another misconception is that the cuts will be offset by funding from drug companies. Many university laboratories, including mine, do collaborate with drug companies on focused projects such as testing investigational drugs. These partnerships are productive, but, by necessity, companies invest in questions related to their own interests rather than the kind of basic, open-ended research that leads to totally unexpected breakthroughs. Basic research is crucial to scientific progress. Most of the conceptual leaps in our understanding of human biology, including most Nobel Prize-winning discoveries, arise from basic research rather than the goal-directed projects of most industry/university partnerships.
For example, the 2001 Nobel Prize in physiology or medicine went to scientists studying the cell cycle (cell division) in yeast and sea urchins. Why was this work important? Because cancer results from alterations in these same processes, allowing tumors to grow in an uncontrolled fashion. Since 2015, women with breast cancer have been treated with a drug that inhibits the cell cycle and extends disease-free survival - in other words, the processes identified in yeast and urchins are now the basis of a drug giving mothers and grandmothers with cancer more time with their families. Losing our enthusiasm for the most basic aspects of research diminishes our opportunities for innovation and new cures.
Keeping American research at the cutting edge requires investment. The NIH accounts for less than 1 percent of federal expenditures, so these cuts will provide no meaningful economic benefit. But their negative impact on health will be profound and sustained. Slashing NIH funding is only one component of a portfolio of cuts that would also cripple the National Science Foundation, Department of Energy and other agencies that fund research. The plan repudiates the notion that we need to understand the world around us to survive.
I will participate in the March for Science on April 22, and I encourage anyone interested in promoting innovation in research to join me.
Ralph J. DeBerardinis is a native of Delaware County. He earned a bachelor of science in biology from Saint Joseph's and an M.D. and Ph.D. from the University of Pennsylvania. He is a pediatrician, medical geneticist and NIH-funded cancer biology researcher in Dallas. You can learn more about his work at: http://cri.utsw.edu/ralph-deberardinis-laboratory-ralph-j-deberardinis-md-phd/
