Government funded basic research gives birth to new industries and jobs. Shortchanging it is akin to not eating while you are pregnant to save money for the baby’s future. Nevertheless, our nation’s growing (and repeated) budget crisis is short changing research and its long term economic cost is perhaps nowhere so clear as is it in research advancing health.
The Atlantic Meets The Pacific, an annual event of The Atlantic Magazine and University of California San Diego (UCSD), gave testimony to the high return to innovation and the urgent need for more of the same. Sadly, many speakers coupled their comments about discoveries with growing fear that the lack of reliable funding will harm our ability to push the boundaries of medicine forward.
One medical frontier is cancer, a disease that will afflict one in four of us and poses a demographic time bomb as the baby boom ages. Sequencing of the human genome has opened the door to treatments based on the genetic structure of each person and her cancer cells. Further advances in this area could reduce the enormous cost of delivering cancer therapies by greatly improving their effectiveness.
Another frontier is the brain; an area we know very little about relative to other parts of the body. An innovative decades-long UCSC project to map and archive human brains – The Brain Observatory – is creating a vital research tool that will deepen our understanding of mental illness as well as dementia and Alzheimer’s, each so costly to individuals and society.
Yet another frontier is our gut: 90% of our body is composed of trillions of microbes, each impacted by what we eat, how we sleep, the air we breath and the exercise we get; and they in turn impact how our body works or fails to work, as with the onset of Crones and other auto-immune diseases. Discoveries in this area will create threats and opportunities for the handful of companies that control the vast majority of the US’ food supply.
The findings in each area go beyond changing treatment. They are leading to a dramatic shift in the locus of control from individual doctors to a team of healthcare providers, including a much stronger role for the individual in collecting personal health-related data and deciding on therapies.
These changes present a cultural shift for physicians – away from a largely paternalistic system. As a result, the next ten years will, speakers predicted, be very messy as institutions and physicians adjust to precision (a.k.a. personalized) medicine, big-data based insights and pressure for affordability. UCSD Eric Topol, MD, Director of Scripps Translational Science Institute and Professor of Genomics, astutely calls physicians unwilling to make the shift the “high priests before the introduction of the printing press.”
The challenges and frontiers do not only affect the medical provider and patient communities. Researchers also face cultural change, with collaboration across disciplines becoming essential to notable discovery. Corporate speakers talked about their growing interdependency with academic research, a point reinforced by my tour of UCSD sound labs, which gave me a window into new solutions for the hearing impaired, another demographic time bomb. I saw the start of a TV sound system that would enable each listener in a room to listen at his desired volume level – without headsets.
Both academic and corporate speakers discussed their fear that our government’s inability to set long term budget priorities – or indeed to even fund government as is happening today– has created an increasingly fragile ecosystem for research. “Science is a continuous conversation. If it breaks it ceases and forgets. You cannot put research on hold,” said Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies: A Biography of Cancer.
We need more grant money and more unrestricted research grants, in particular, as break-through discoveries cannot be directed, according to Nicholas Spitzer, MD, UCSD Distinguished Professor of Neurology and Co-Director of the Kavli Institute for Brain and Mind at UCSD. Funding research that creates more tools is also important as new tools drive new breakthroughs.
The shortage of funds is producing an incremental “safe” approach by many researchers that is causing us to lose the war against cancer, according to journalist Clifton Leaf, author of Truth in Small Doses: Why We’re Losing the War on Cancer. Equally sad, the shortage of funds is likely leading young talent away from the Academy where tomorrow’s breakthrough solutions are waiting to be discovered.
A fragile research ecosystem produces a fragile economy, as any corporate leader who has shortchanged R&D understands.