Research!America Leads Campaign for Biomedical Research Funding

pp.13 Date: May 30,1994 Editor's Note: Following is the text of Research!America's consensus statement on biomedical research support (see story on page 1). The document, signed by 156 academic, scientific, and corporate supporters, was delivered to members of Congress on May 3. Research!America Forum Consensus Statement Too many Americans are suffering and dying needlessly because, as a nation, we don't invest enough in [basic and all other forms of] medical research. Just one discovery can save millions of lives and billions of dollars. As the United States endeavors to reform its health-care delivery system by seeking to improve quality, increase availability, emphasize prevention, and control costs, we must rededicate ourselves to the principle that better health and cost- effective health care require a larger societal investment in medical research. The United States has a medical research enterprise that is the unquestioned world leader--envied by many nations but equaled by none. This enterprise, comprising a unique collaboration among government, academia, industry, voluntary health agencies, and private philanthropy, is preeminent in: the leadership that American scientists have provided in such frontier fields as cell and molecular biology, genetics, immunology, and neuroscience; the application of knowledge gained in these and other fields to the development of vaccines, pharmaceuticals, and technologies for the prevention, diagnosis, treatment, or cure of scores of diseases including AIDS, Alzheimer's dementia, birth defects, cancer, dental caries, coronary artery disease, diabetes, meningitis, mental illness, polio, stroke, and tuberculosis; the training of the next generation of medical researchers. Remarkably, all of this achievement has come at a relatively low cost. In 1993, the United States spent less than 3 percent of its total health-care bill on research. Put another way, we spent less on medical research in the entire year than we did on health care in 10 days. Beyond the value that medical research contributes to the health of the public, the enterprise is also a major contributor to the economy through research and development dollars spent by both the private industry and the taxpayer-supported public sector. Medical research provides high-quality, long-term employment for more than a million people--administrators, behavioral scientists, doctoral-level scientists, epidemiologists, maintenance personnel, nurses, technicians, and other employees in universities, small and large businesses, hospitals, government laboratories, and independent research institutions. In the period 1985 to 1992, private-sector investment in the pharmaceutical/biotechnology industry alone created more than 200,000 new jobs. But our treasured medical research enterprise is much more than a source of quality care, national pride, and economic strength. Its promise for the future vastly exceeds its progress to date. We are: within reach of decoding the entire human genome and, by so doing, identifying thousands of genes that, when defective, cause or contribute to diseases; poised to use biotechnology products and pharmaceutical therapies to address a host of unmet medical needs; moving closer to promoting health and preventing illness by employing more widely the knowledge generated by fields such as nutrition, environmental sciences, and epidemiology; understanding more about the importance of psychological and social factors in preventing or modulating the course of disease and the effectiveness of treatment; expanding the horizons of research to consider the cost- effectiveness and impact on quality of life of pharmaceuticals, medical devices, and technologies hitherto tested only for safety and efficacy; committed to the principle that participation in, and reward from, medical research must be shared equally by people of all ages, races, and ethnicities. Despite all this progress and promise, the research partnership and citizens throughout the U.S. share deep concerns for the insufficient attention that has been paid to the central importance of medical research in improving health and lowering health-care costs. Research, the driving force behind the unmatched quality of America's health care, has been largely ignored as the nation grapples with formidable issues--economic, social, and political--raised by the debate over how to reform the health-care system. Reform proposals that threaten any research entity--be it academic, industrial, governmental, or voluntary--in turn threaten the future value and quality of health care available to all Americans. The most formidable challenges to medical research are economic, and they include: constrained federal support for the National Institutes of Health, the National Science Foundation, the Veterans Administration (VA), the Centers for Disease Control and Prevention (CDC), and the Agency for Health Care Policy and Research (AHCPR)--the major sponsors of medical research in academia; inadequate public and private support for renovation of aging research facilities; decelerating investment in medical research and development in the pharmaceutical/biotechnology industry due to a shrinking capital base, reduced earnings prospects resulting from increasing competition, managed care-driven business climate, and fear of more intrusive governmental regulatory policies; downward pressures on revenues from clinical services in academic health centers because of the shift from fee-for- service medicine to managed care--clinical revenues currently contribute substantially to the support of medical research and its infrastructure in these institutions; the inherent complexity of modern technology and the need to comply with state and federal regulations, both of which have increased the costs of conducting medical research. Other challenges concern the work force needed to conduct quality medical research as well as communication among that work force, the general public, and policymakers. They include: reduced incentives for the best and brightest people of all races and ethnicities to enter careers in medical research--including the increased cost of research training, uncertainty about prospects for employment, and inadequate stipends for predoctoral and postdoctoral fellows; inadequate incentives for physicians to pursue training for clinical research and insufficient support of physician and nurse trainees to conduct health-services research; persistent lack of understanding among the general public, health-care providers, and policymakers of the interconnectedness of medical research and quality health care; insufficient attention to complex ethical issues and anti- science biases. Public opinion polls clearly indicate that a majority of Americans want the nation to invest more heavily in medical research. Over 90 percent believe this country should spend more on medical research to better diagnose, prevent, and treat disease and disability. Over 70 percent are even willing to pay more for an increased investment. To fulfill this public mandate, health-care reform must promote an environment conducive to medical research. Now, more than ever, the medical research enterprise must be encouraged to realize its humane promise in the public interest. To accomplish this goal, the organizations [signing this document] make the following recommendations to our nation's public policymakers: Incorporate the promotion of medical research as an integral element of health-care reform. Increase the capacity of NIH, NSF, VA, CDC, and AHCPR to support medical research. Ensure that our health-delivery system makes the fruits of medical research available and accessible to all patients in need. Promote the integration of patients, their families, and their caregivers more meaningfully into the medical-research process to focus on quality-of-life considerations. Include support for the education of medical scientists as a vital part of health-care reform. Encourage, do not obstruct, the discovery and development of innovative and effective pharmaceuticals, devices, and reagents by private industry. Provide adequate resources and mechanisms to accelerate the translation of fundamental research from the laboratory to clinical care via development in the private sector. Ensure stable revenue streams to academic health centers for medical research and education of medical scientists. Provide these centers with incentives for heightened interaction with industry, voluntary health agencies, and other private-sector sources of medical-research support. Strengthen the medical-research work force by provision of increased support for the recruitment, training, and retention of medical scientists as well as provision of special incentives to attract underrepresented populations such as women and minorities to careers in medical research. The [signers of this document]--academic institutions, health-delivery organizations, private companies, professional societies, philanthropic organizations, and voluntary health organizations--which represent a combined work force and membership of more than 1.5 million Americans, plus a volunteer base of more than 5 million, assert that medical research can help our nation's people live longer, healthier, and more productive lives while reducing the costs of doing so.

Research!America Leads Campaign for Biomedical Research Funding

The Scientist Staff

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