Medical Research Funding

Gregory R. Harriman gregoryh at bcm.tmc.edu
Sat Dec 23 13:09:50 EST 1995


In article
<Pine.SOL.3.91.951222213838.22580C-100000 at mcmail.CIS.McMaster.CA>,
berezin at MCMAIL.CIS.MCMASTER.CA (Alexander Berezin) wrote:

Stuff deleted.

> However, everything is a matter of a proportion. And taking that 
> general or "untargetted" fundamental research can benefit the 
> society "at large", reasonable equity and proportion between the 
> areas have to be maintaned. At this point, biomedical research
> takes disproportionally high share of funds. You may say this
> is because "it is the most important for the public interest".
> I may dispute this: for example, sociological studies for the
> crime prevention are perhaps not less socially important for
> the American society at this point. 

     Reasonable people can disagree about which priorities are more
important and which should receive more funding.  However, your
unsubstantiated statement that "biomedical research takes a
disproportionally (sic) high share of funds" must be challenged.  First,
how did you decide that this funding is disproportionately high?  Based on
what criteria?  How about providing some numbers and evidence.  While I
certainly agree that the U.S. has some serious social problems to deal
with, the inference that biomedical research funding is somehow preventing
the solution of these problems is ludicrous.  The entire proposed NIH
budget for 1996 is a little over $11 billion.  This is out of an entire
federal U.S. budget of roughly $1.5 trillion.  Biomedical research funding
is a tiny fraction of the entire federal budget.  The government could
easily find other areas of the budget (such as defense and entitlements
which are the majority of the budget) from which to could get $10-11
billion to fund other programs if that was felt to be necessary.

     Further, it can be argued that basic biomedical research is one of
the more cost-effective utilizations of tax dollars.  For example,
$billions are being spent (both publicly and privately) every year to
treat the million or so HIV-infected people in the U.S.  In addition,
$billions and $billions are being spent every year on treating people with
various infectious diseases (sexually-transmitted diseases, tuberculosis,
influenza, etc, etc).  If effective vaccines can be developed against even
a few of these diseases, society will save a lot of money in the long
run.  Smallpox used to be a major killer throughout the world and it cost
tremendous amounts of money in terms of morbidity and mortality.  This
virus does not even exist any more, except in two government laboratories
in the U.S. and Russia.  That is the result of successful vaccination
against smallpox.  I'm not even discussing the really big diseases, such
as heart disease and cancer.  Research in these areas has the potential to
be very cost-effective in the long term.

     While one may or may not agree that biomedical research has lived up
to its promise (and I'd be happy to debate that with you), one can't
rationally argue that success in biomedical research would ultimately be
highly cost-effective and beneficial for society.

> And as I have argued earlier, 
> the major source of inefficiency of American medical reseerch is 
> that there is too much money in it rather than too little. This 
> results in all perils of grantsmanship feods, grant-to-grant 
> mentality, 'empire building' and other pathologies we all 
> know about.

Sorry, but I don't agree with this.  See above.  

> 
> I suggest that BASIC research of all kinds (incl. biomedical)
> be supported on equal footing with other areas through the
> single source - National Endowment for Sciences and Arts.
> (after all, medicine was "art" in ancient times). This will
> provide long needed restrain for strengthening and focusing
> of fundamental medical research towards real problems rather 
> than solving numerous gargantuan pseudo-problems. 

     Maybe you live in a part of the world where heart disease, strokes,
breast cancer, lung cancer, AIDS, etc are pseudo-problems.  I'm sure a lot
of people would like to know where that is.

Greg Harriman



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