Oct. 1 of this year will mark the beginning of yet another Breast Cancer Awareness Month, but most people will be unaware that it will also mark another year of funding cuts to breast cancer research. While some lawmakers are calling to defund Obamacare, the slow defunding of the American research enterprise has already begun. If the U.S. Congress can even manage to pass a continuing resolution budget to avoid a government shutdown, this will probably lock in the federal budget at current levels. That level of funding includes the now notorious across-the-board cuts known as “the sequester.”
The sequester was supposed to be so draconian that it would drive politicians to accept some alternative budget compromise. Unfortunately compromise seems to be a dirty word in Washington, and it has become almost dogma for some that any government spending is inherently wrong and should be opposed on principle. But does that really extend to scientific biomedical research that can save lives?
Some types of government spending are crucial and necessary. These investments include not only breast cancer research, but all avenues of basic scientific research funded by agencies such as the National Institutes of Health (NIH), National Science Foundation (NSF) and Centers for Disease Control and Prevention (CDC). Private industry rarely funds very basic research because it needs a return on investment within two to five years at the most. The government is the only entity with enough patience and deep enough pockets to fund long-term basic research. Private foundations are not even in the same league in dollar amounts. The entire research budgets of charities such as Komen for the Cure ($75M) and the American Cancer Society ($160M) combined are less than the 5 percent sequester cut to the $4.8 billion National Cancer Institute budget.
The biggest breakthroughs, the fundamental advances that enable the development of new cancer drugs for leukemia or melanoma or triple-drug cocktails that keep HIV in check, come from scientists working not in private industry, but at universities, nonprofit research institutions and government labs that are funded by these agencies, and ultimately by the American taxpayer.
Admittedly, the federal deficit and national debt are matters of genuine concern for us now, and for future generations. But not all kinds of federal spending are created equal. And not all tax dollars are wasted on frivolous conventions or federal bureaucracies. Government-funded research represents an investment in our future that pays back for itself many fold and actually increases net tax revenue through economic growth.
According to one 2012 study, for every federal dollar invested in biomedical research, there is a corresponding increase of $1.7 to $3.2 in economic activity. That is an economic rate of return of 70 to 220 percent. Thus, increased spending on biomedical research actually can reduce the budget deficit over the long term. Moreover, the social value of the increased 10 years of life expectancy between 1950 and 2009 alone is estimated at $61 trillion, or 3.6 times our total national debt, and 16 times our total Federal budget of $3.8 trillion.
Adjusting for inflation, NIH grant funding in real dollars has steadily decreased by $4 billion since 2004, but the impact of the sequester is nonetheless ominous. Approximately 700 fewer research grants will be funded in 2013 than the previous year (3,100 fewer than at the 2004 peak), and the percentage of applications that are funded has dropped well below 14 percent for the NIH, according to its Director, Dr. Francis Collins. These cuts are also a direct threat to public health. Our ability to respond to emerging infections and potential flu pandemics will be measurably harmed by the slowing of scientific progress on vaccines and new drugs, as funding cuts for the NIH and CDC drag on. We can only hope that it does not take a public health disaster to re-invigorate our commitment as a nation to scientific research.
My own research at Emory University, where I work on changes to the genomes of breast and prostate cancers, has been continuously funded by the NIH for the past twenty years, but that string of success is quite likely about to come to an end.
Unfortunately, I am not alone in facing this prospect; an entire community of scientists is wrestling with the decisions of which highly-trained scientists to lay off next in their ever-shrinking laboratories and which projects should come to a screeching halt. In a recent survey by the American Society for Biochemistry and Molecular Biology (ASBMB), 55 percent of scientists said they have a colleague who has lost their job or expect to soon, and 53 percent have turned away promising young researchers from their labs due to lack of funding. Who is to say that the next breakthrough in breast cancer may not succumb to the budget axe?
The sad irony is that while the science and technology for advancing discoveries in treating cancer and other diseases such as Alzheimer’s, diabetes and heart disease have never been more exciting and hopeful, the future for the careers of my students has never been bleaker. I fear we will soon lose an entire generation of young scientists whose talents and education will not be used to their full potential. Moreover, millions of dollars of investments by the U.S. government in the education and training of young scientists may end up going to waste as they decide to take alternative career paths with more certain futures.
Without support in the Federal budget for basic research, the future pipeline for new technologies, medicines, and industries will eventually dry up. These are the pipelines that drive a knowledge-based economy and keep the United States an economic world leader. This will result if fewer biotech startups and fewer new drugs brought to market. As NIH Director Collins recently mused on the possibility of continuing sequestration, “I think we’ll be no longer the world leader in the production of science, technology and innovation. You can’t look at the curves and say, ‘oh, well, it’ll be fine,’ if we stay on this track.”
It will not be. China is coming up so fast, they are so convinced that this is their pathway toward world leadership; they’re not going to slow down.” If the sequester continues into the next fiscal year, the erosion of our position as a leader in science and technology will accelerate. Scientists will find it next to impossible to find funding for their research, and some will be forced to abandon their work or move overseas. The ASBMB poll indicated that 18 percent of scientists are considering moving abroad, resulting in a looming brain drain for the United States.
Some may argue that NIH’s total $29 billion budget is sufficient for our research endeavor, but that amount is dwarfed by the $651 billion we spend on defense, or the $781 billion we spend on Medicare and Medicaid. The reality is that our research budgets are insufficient and shrinking, and this trend is threatening our health, our economy and our future. As Mary Lasker, philanthropist, founder of the Lasker Foundation and early advocate of publicly funded medical research often said, “If you think research is expensive, try disease.”
Moreno is an NIH-funded scientist, Associate Professor in Pathology and Laboratory Medicine at Emory University, and a Member of the Winship Cancer Institute. He is a an Op Ed Project Public Voices Fellow.