Funding: to Harriman

Keith Robison robison at
Wed Dec 27 09:03:51 EST 1995

Alexander Berezin (berezin at MCMAIL.CIS.MCMASTER.CA) wrote:

: (to make easier: single summarily reply)
: Dear Gregory,

: Reading word-by-word what you are saying, I can 
: see a point in almost everything you say. Yes,
: there are 'good' and 'productive' big labs.
: (question still 'good' and 'productive' for
: what ?). Yes, not all go there 'for money' (although 
: I do know quite few young fellows, both genders, who 
: recently dropped half-way their biomedical PhDs 
: to go to, etc.

: But being 'insider' of the biomedical research 
: you may (slightly or strongly - I don't know)
: overestimate what people outside of it think about 
: the importance of it for the real progress and
: improvement of medicine. You may be very enthusiastic
: about how much molecular biology and genetic engineering
: can do for cancer, Alzheimer, AIDS, or whatever. 

: But people 'out there' not necessary see it this way.
: What people see is that there is NO real progress on
: cancer despite all the billions spend on it (try to argue 
: overwise to a mother whose child just died of leukemia). 

: What people see ON THE GROUND are largely broken promises. 
: And yes, that's why people go (often in desparation) 
: to 'faith healers' and other likes. And paradoxically,
: more and more people see the MAINSTREAM medicine as a 
: just a form of highly sophisticated quackery which really 
: can't do too much. In short, its geting more and more
: clear (like in my earlier example with undelivered 
: thero-nucler fusion) that Big Biomedical Establishement 
: simply does not delievr. I personally, very sorry to say you
: this, but it seems to me rather unlikely that BBE can 
: continue on the same gears for too much longer on the 
: basis of promises.   

I always find this sort of argument equally maddening & amusing.
Yes, the biomedical community got overconfident after some
early successes (polio, smallpox, etc) and made unrealistic
promises on cancer, etc.  The "War on Cancer" is every 
ax-grinder's favorite example of lots of money spent with
little visible progress on cancer.  That is the perception,
and it is of course perception that drives the ilk of Berezin.

Reality is far more complex.  While the funding poured into 
the War on Cancer has not made a huge impact on cancer overall,
it has had some small victories.  It is ironic that Berezin
uses childhood leukemia as an example, as that is now largely
a treatable disease (which does not mean 100% treatable --
clinicians will always be cursed with explaining to bereaved
families why their loved ones were in the unfortunate minority).
In addition, spin-offs of the War on Cancer have had important
impacts.  The rapid progress on detecting AIDS was almost a
direct result of the work on oncoviruses sponsored by the War
on Cancer, and this progress allowed the blood supply to be
made safe.

I think that any _rational_ observer who closely studies the facts will
find that the current system is working about how it always has --
slow, methodical progress against complex diseases.  It's worth noting
that much of the interest in this country has shifted from fighting
bacterial infections (completely foreign) to cancer and viral infections
(both fights against largely non-foreign targets) and degenerative diseases
(arthritis, Alzheimer's).  These are inherently a tougher nut to crack.

Keith Robison
Harvard University
Department of Cellular and Developmental Biology
Department of Genetics / HHMI

robison at 

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