“Yesterday’s triumphs may pale beside the promise of tomorrow’s breakthroughs — if pressures on research funding don’t threaten the future of biomedical research,” said researchers Jeffrey A. Bluestone, David Beier and Laurie H. Glimcher in an article called “The NIH is in danger of losing its edge in creating biomedical innovations” in STAT.
While the US has led the world in biomedical research innovation, it appears to be losing its dominance in discovery to other countries, having a potentially negative impact on the development of new therapies and the health of “an industry that supports more than 300,000 jobs.” Because the levels of federal funding for biomedical research are dwindling and they are not efficiently allocated by the National Institutes of Health (NIH), there is less innovation. States are also cutting funding to universities and nonprofit research institutes. While private donors and disease-specific foundations have provided some funding for biomedical research, those amounts are not enough to make up the difference in federal and state allocations.
The authors believe that “the 21st century can become the century of biology and medicine by turning more disease interventions into cures and accelerating the pace of basic research necessary to increase health outcomes and life expectancy.” However, some hurdles need to be overcome by renewing the commitment to federal funding for biomedical research, strengthening the NIH, integrating public and private research and bringing together the current biomedical research establishment and philanthropists.
While just 22 percent of applied biomedical R&D funding comes from the federal government, 64 percent comes from within the industry. While almost all breakthroughs come from federal research funding of academic-based basic and translational research, federal support for biomedical research is less than a fourth of federal R&D efforts.
The 2018 budget for the NIH should come out at between $34 and $36 billion, but “the funding trajectory over the last 25 years has been downward,” the researchers said. If adjusted for inflation, the NIH budget is actually 19.2 percent less than it was in 2003. Meanwhile, other countries are increasing funding for biomedical research.
Declining federal funding for biomedical research has led to two major problems, according to the researchers. With less grant applications funded, discovery rates decrease. Highly intelligent people decide not to engage in careers in basic biomedical research.
The authors advocated predictable federal funding – “a longer-term budget for the NIH backed by Congress’s enduring commitment to research” – along with “a concerted effort by industry and philanthropists to grow both the basic and translational research enterprises.” They want to see a royalty or industry fee paid to the NIH and allocated to the NIH Common Fund or a revenue-generating strategy to help NIH.
They added, “To revitalize its intramural program, the NIH must foster a philosophy that embraces risk and failure and gives the program the freedom to perform high-risk, innovative research, free from grant writing and the vagaries of unstable financial support. Raising the quality of NIH intramural research can also be accomplished by dedicating funds to grand scientific challenges in biology with interactions and joint projects between the intramural and extramural research communities, including developing new research models.”
While the pharmaceutical industry should support basic biomedical research, it should collaborate with the nonprofit sector to reduce costs and share data. Many philanthropic donors -- the Parker Institute for Cancer Immunotherapy, the Howard Hughes Medical Institute, the Bill and Melinda Gates Foundation and the Chan Zuckerberg Initiative -- are creating business models to sustain investments in research. These new models have to seek a return on philanthropic investment and apply new methodologies to research design and execution.
In conclusion, the researchers recommend increasing direct federal budget spending for the NIH “in a stable and predictable manner,” requiring the private biomedical sector “to add to NIH coffers,” making public and private institutions share data and collaborate “in the pre-competitive industry space,” developing “new business models” to expedite the process of going from basic research to new therapeutic products and enticing private foundations to “advance more collaborative research models by breaking down the existing barriers that inhibit research collaborations and by supporting grand scientific challenges.” The results will return the US to its leadership status in biomedical research.