Hurting the nation's health: Sequestration cuts in biomedical and behavioral research will rob Americans of economic gains and better lives

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Everyone understands that it's necessary to take a hard look at your budget and cut costs to eliminate debt. That's true for household budgets, small business budgets and the federal budget. But I doubt that any of us would choose the current approach called sequestration in any situation. If your business were forced to cut 5 percent of its expenses, would you do so across the board for every category of spending, or would you carefully select the areas that could sustain cuts while maintaining critical investments that will more than pay for themselves in the long run?

One of my roles at the University of Pittsburgh is to advocate for one particular entity in the federal budget -- investment in biomedical and behavioral research through the National Institutes of Health, which administers grants to scientists around the country, including hundreds at the University of Pittsburgh.

About 80 percent of all funding for medical research in American universities comes from the NIH. One quarter of NIH funding is for research that leads directly and quickly to improved health care and is aimed at answering important questions like whether hormone replacement therapy is safe and effective for all post-menopausal women. Another 55 to 60 percent is for basic science research to understand biology at the cellular and molecular levels, research that, while often taking years to bear fruit, time and again yields unexpected discoveries -- especially ones that lead to drugs and vaccines -- with profound implications for human health.

To consider NIH-funded research only as an expense is to completely misunderstand its purpose. The federal government has long supported biomedical and behavioral research because it's a wise investment that pays great dividends for all Americans. In addition to improving health and the quality of life, scientific advances spur the economy as private enterprise takes on the commercialization and implementation of our discoveries.

"The discoveries that are helping patients today are the things that emerged from the research arena years ago," says my colleague Jeremy Berg, our associate vice chancellor for science strategy and planning. "Without those discoveries, there's nothing to translate to patient care five to 10 years from now. We may save $1.5 billion now, but it will cost the economy many times that in future years because of the economic potential of these discoveries and, of course, the billions of dollars gained by having a healthy work force."

At the University of Pittsburgh, we don't yet fully know how sequestration will affect our NIH-supported programs, but we know that it would be unprecedented. A proportional cut could reduce substantially the number of staff working directly on ongoing research projects, as well as the jobs supported indirectly in our community, such as sales and construction related to research. Such a cut would make it prohibitively difficult for even the brightest young scientists to launch their research careers. When the question of whether you can pursue your chosen career comes down to a crap shoot, those who have other options will exercise them.

What do NIH-funded scientists at Pitt study? A partial list includes some of the most pernicious health problems Americans face: asthma, depression, traumatic brain injury (TBI), Alzheimer's disease, diabetes and cancer, for example. In the area of TBI, multiple projects are providing answers for athletes with sports concussions and military veterans struggling with blast injury. In pediatrics, Pitt scientists are evaluating drug candidates that could save the lives of thousands of premature babies annually.

Investing in such studies isn't just humane. It's smart. A report by the nonpartisan Information Technology and Innovation Foundation recently estimated that sequestration cuts to science would reduce the GDP by $200 billion over the next few years.

Sequestration was designed to be a nonsolution -- a fate so objectionable and threatening to both political parties that it would force compromise. Sadly, it will likely do what it was designed to do -- have devastating and crippling effects on our nation for years to come.

Though compromise is still possible, time is short. Unless the president and Congress achieve a mutually agreeable solution that alleviates the worst of these effects in the coming days and weeks, Americans will be robbed of the very significant economic gains and the better and longer lives that result from the nation's investment in biomedical research.


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


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