OF ALL the hardships imposed by the federal shutdown, none may be more tragic than its impact on a field that had already sustained devastating budget cuts: biomedical research. That is an impact measured in human terms. The National Institutes of Health, for example, is turning away patients seeking to enroll in clinical trials. The impact will ripple outward from them to other patients who might have benefited from what researchers would have learned from those studies.
They are not alone. Even as 35 million new patients stand to be enrolled in health exchanges created under the Affordable Care Act, policy makers have been unwittingly but systematically undermining the quality of the next generation of care that awaits them by gutting biomedical research.
Consider one example: The Framingham Heart Study, a 65-year, multigenerational study of the residents of one Massachusetts town, revolutionized medical science’s understanding of cardiovascular illness by establishing links between cholesterol, obesity, and heart disease. These important findings have extended and even saved lives worldwide. Now, armed with the genetic data of 15,000 patients in the study’s third generation, researchers are hot on the trail of the causes of Alzheimer’s disease, diabetes, and other maladies, but the promise of breakthroughs in these areas is in serious jeopardy.
Instead of flooring the accelerator to unlock the mysteries of these debilitating diseases, policy makers are slamming on the brakes. Sequestration is forcing the National Institutes of Health to slash a staggering 40 percent from the Framingham Heart Study’s resources, potentially crippling it and certainly preventing any expansion into new frontiers of medical science.
The impact of sequestration on one of the most successful and important studies in the history of medicine is just one example of a crisis that is bringing some of the nation’s most promising biomedical research nearly to a halt.
Even before sequestration was enacted, the federal research and development budget had declined 10 percent in constant dollars since 2010. The onset of sequestration forced the NIH to slash its budget by $1.7 billion. If Congress chooses the path of a continuing resolution this year, then under the Budget Control Act, 2013 research funding levels — deemed the “darkest ever” by NIH Director Francis Collins — will be cut even more.
In the Psychiatry and Neuroimaging Laboratory at Brigham and Women’s Hospital, where important work is being done to understand cognitive impairments in aging, funding from the NIH has been reduced to one-third of the original amount, which may result in this study being abandoned.
The impact of sequestration on biomedical research is not only medically devastating; it is also fiscally and economically shortsighted. Boston is home to a thriving life-sciences sector that creates jobs and wealth, saves and improves lives, and reaps returns on taxpayer investments. Yet the slash-and-burn approach to budget-cutting means the United States now stands at risk of ceding its longstanding preeminence in biomedical research.
In the meantime, we understand that research dollars are limited, so here at the Brigham we are seeking to create new and innovative funding mechanisms to sustain our commitment to life-giving breakthroughs. We have sent a loud and strong message to industry and to the venture capital community that the Brigham is open to new ways of partnering. We are creating new collaborations with companies for sponsored research as well as licensing with biotechnology, pharmaceutical, and health care technology companies. We are also actively exploring “impact investment” models that combine philanthropy with venture capital investment. If successful, the Brigham, in partnership with Partners Healthcare, will be the first academic medical center to create a venture capital fund that both private and public foundations can contribute to as required to maintain their federal nonprofit tax status.
These new vehicles are indeed promising, but government support remains an essential mainstay to enable us to conduct research on the scale necessary to confront the major challenges of Alzheimer’s, cancer, and heart disease.
Medical research is at an important crossroad. This ought to — and still can — be a thrilling era for medical research in the United States. Cures for diseases that have devastated families for generations are within our reach, and researchers are in hot pursuit. This is no time to turn our backs on patients and on the potential for life-giving breakthroughs.
Dr. Betsy Nabel is president of Brigham and Women’s Hospital.