NIH budget cuts: A pill too bitter to swallow

ARTHUR LEVINE says budget cuts should not be targeting the vital research work of the National Institutes of Health

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When the Congressional Joint Select Committee on Deficit Reduction, better known as the "super-committee," ended deliberations in November without a proposal, what remained on the table was a bitter pill: $1.2 trillion in mandatory cuts, half from defense and half from domestic programs, including medical research supported by the National Institutes of Health.

Yet investment in NIH-funded biomedical research over the past 60 years has catalyzed many of the advances that are now helping Americans live longer and healthier lives. The death rate for heart disease is more than 60 percent lower, and the death rate for stroke is 70 percent lower than in the World War II era. Cancer death rates have dropped 11.4 percent among women and 19.2 percent among men over the past 15 years because of greater preventive efforts, better and earlier detection, and more effective treatments.

Studies led by the University of Pittsburgh's own Dr. Bernard Fisher contributed to these advances by showing that the drug tamoxifen substantially reduces the risk of breast cancer in high-risk women who have not yet developed the disease.

In more recent research, the anti-retroviral therapies that have turned HIV/AIDS from a fatal to a chronic condition enable people diagnosed with HIV in their 20s to live -- and work -- until a normal retirement age. And a baby born today can look forward to an average life span of nearly 78 years, almost three decades longer than a baby born in 1900. According to NIH director Dr. Francis Collins, the gains in U.S. life expectancy since 1970 are worth some $3.2 trillion annually in enhanced productivity.

In just the past decade at Pitt's School of Medicine, federal funds have supported research demonstrating that an injection of young stem cells makes rapidly aging mice live longer and healthier and that stem cells taken from the fatty tissue of a patient have allowed craniofacial reconstruction in that patient.

It also has allowed the development of brain-computer interface technology that allows users to control prosthetic limbs and computer cursors with their thoughts; the discovery of Merkel cell virus, one of seven known cancer-causing viruses; the invention of desperately needed heart assist devices for babies and small children; and a multitude of other preclinical and clinical advances that promise to deliver better health and well-being for all.

According to the national economic consulting firm Tripp Umbach, federal- and state-funded research conducted in 2009 at the nation's medical schools and teaching hospitals supports nearly 300,000 or one in 500 U.S. jobs and adds nearly $45 billion to the U.S. economy.

Research at medical schools, universities and teaching hospitals supported by NIH funding creates skilled jobs and new products that generate economic growth. The report also showed that the total economic impact of federal- or state-funded research in Pennsylvania was nearly $3 billion in 2009, ranking us fourth in the country.

Voters understand the importance of a long-term national investment in medical research. A new survey conducted for the Association of American Medical Colleges found that the majority of registered voters oppose significant cuts to medical research to trim the nation's budget deficit.

NIH is the largest single funder of basic medical research in the United States; the research it supports provides the foundation of knowledge needed to drive innovation and improve health.

For example, the nation's investment in the Human Genome Project and related initiatives are now beginning to fulfill their anticipated promise of "personalized" medicine, which I predict will be part of routine clinical practice within the next decade.

But that promise will remain unfulfilled if we do not sustain the trajectory of preclinical and clinical research that has brought us to this important juncture. Therapies based on a person's genetic profile are already used routinely for some types of cancer, lung disease, bowel disease and other conditions.

To continually set and achieve a higher standard for understanding health and disease, developing new evidence-based therapies, and saving lives, a long-term, sustained investment in medical research is essential. It's not an enterprise that operates with an on/off switch. Rather, good research teams need a great deal of time and resources to produce the insights and advances that will improve the human condition. Precipitously stopping and starting these efforts will take us backward, not forward, in our quest for a better understanding of health and disease.

Swallowing the super committee's bitter pill will lead to potentially deadly complications for all.

Let's not imperil the next generation of cures, and further compromise the economic health of our communities today, by cutting funding for medical research.

Arthur S. Levine, M.D. , is senior vice chancellor for the health sciences and dean, School of Medicine, University of Pittsburgh.


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