January 1, 1970 (Vol. , No. )

Taralyn Tan Ph.D. Curriculum Fellow Harvard Medical

For anybody who runs a laboratory, it is the stuff of nightmares. It is the enormous hamster wheel on which scientists find themselves interminably scrambling. Yes, it’s the one topic that can make any researcher cringe. I’m sure that by now you’ve figured out that we’re talking about: research funding. Yes, it’s a cold hard fact that even the most brilliant mind can’t run his/her laboratory without money, just as the most beautiful, expensive car cannot run without fuel. The debate regarding how to divide funds among different research areas and laboratories has existed, no doubt, ever since there first was money to divide. However in today’s economic climate, money finds itself lingering in people’s minds more and more often, and as we gaze around the research landscape, some areas of investigation are clearly more privileged than others. Is it perhaps time for a bailout or stimulus package to help the little guys in research?

The problem and solution begins and ends with that simple, little question: how to divide up the money? Well, one approach is the currently employed “bigger wound, larger bandage” philosophy, in which the greatest medical threats to society are given more money. This has a certain amount of intuitiveness to it, and since a large percentage of research funding comes from the government, shouldn’t the most money be spent on projects that will benefit the most people in the population? Two clear heavy hitters in the funding arena are cancer and HIV/AIDS. According to the NIH’s Research Portfolio Online Reporting Tool (RePORT), just over 5.5 billion NIH dollars were spent on cancer research in 2008, and just under 3 billion NIH dollars were dedicated to HIV/AIDS research. (Keep in mind that these are just numbers from the NIH – there are also numerous other sources that contribute money to cancer and HIV/AIDS research.) By comparison, many other serious medical maladies facing this country received far less money from the NIH. For instance, Alzheimer’s, ALS, and Parkinson’s combined received approximately 600 million dollars. And of course, one must also consider the research areas at the other end of the “more people afflicted equals more money” spectrum; namely, diseases with fewer cases each year, and substantially less money. Take, for example, the approximately 7,000 diseases lumped into the category of “rare diseases,” defined as having a prevalence of fewer than 200,000 people in this country. NIH total funding for all rare diseases was only 9.4 million dollars in 2007.

Clearly, a financial hierarchy exists. And yes, are cancer and HIV/AIDS enormous problems in society today? Of course they are! Should we be dedicating substantial resources to research in these areas? Of course we should! Yet, as we find ourselves in an era of economic stimulus packages and incentives to jumpstart our economy, perhaps some similar initiatives to benefit other areas of investigation should be explored as future funds are allocated. I would hope that young researchers would lend their minds to a variety of research areas, as there are still many unanswered questions in regards to Alzheimer’s, rare disorders, infertility, organ transplants, etc., etc., in addition to the obvious societal burdens of cancer and HIV/AIDS. However, young researchers surely also have a survival instinct that is telling them to follow the money – why voluntarily go into a research area that is continually under funded? Where is the motivation to compete for a small slice of the 9.4 million dollar rare disorders pie, when individual HIV laboratories may have a 9 million dollar annual budget for themselves? I fear that unless additional financial incentives are provided, the currently skewed distribution of funding may result in funneling future scientists into very narrow areas of investigation.

While I certainly argue that we should be working hard to cure cancer, I would also disagree with the notion that every scientist in the country should be focusing his/her efforts of that solitary goal. So let’s encourage diversity of thought – let’s financially stimulate research areas that aren’t normally the top contenders in the battle for NIH funding. Perhaps the NIH could institute its own “cash for clunkers” program, wherein run-down, dead-end research projects that are currently guzzling funding are abandoned in favor of new thoughts and new directions. Maybe we can jumpstart scientific inquiry by funding the research of smaller, but easier-to-solve, medical problems. For instance, if we were able to determine the cause of and eradicate a few thousand of the rare disorders, that would be a great leap forward. Sure, it might not be the elusive HIV vaccine, but it would be progress nonetheless.

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