TCS Daily


First, Do No Harm to Basic Research

By Morton Kondracke - November 12, 2003 12:00 AM

Editor's note: This is the first of a two-part series on technology and the nation's health care system.

 

President Bush and the Republican Congress are on the verge of wreaking havoc upon on America's preeminent medical research system, at the same depriving themselves of a glowing political legacy.

 

Republicans have stood firmly for free inquiry and free markets over the decades. Yet, in short order, the Bush administration, for ideological reasons, is squashing the most transformative areas of biomedical research -- stem cell and cloning research -- while, for budgetary reasons, slashing basic research at the prized National Institutes of Health.

 

And with a large number of Republicans in Congress abandoning their free market principles to vote for drug reimportation legislation that would impose foreign price controls on American drug makers, the Grand Old Party seems to have given up its principles.

 

The reversal on NIH funding amounts to a disheartening reversal. Prior to 1999, NIH support had increased by an average of 6 percent per year. Then, a band of visionaries in Congress, including Sens. Mark O. Hatfield (R-Oregon), Connie Mack (R-Florida), Tom Harkin (D-Iowa) and Arlen Specter (R-Pa.) and by Rep. John Porter (R-Ill.), convinced their colleagues to double the NIH budget over five years. President Clinton, to his credit, went along. In 2000, Sen. Mack convinced presidential candidate George W. Bush that, if elected, he should fulfill the promise.

 

From fiscal 1998 through fiscal 2003, the NIH budget rose from $13.6 billion to $26.9 billion. Now, though, just as the nation is beginning to reap the fruits of this investment, the Bush administration and Congress are about to turn the dollar spigot down to a trickle.

 

Bush's budget proposes that NIH funding increases to drop to a bare 2.7 percent this year and 2 percent in the five subsequent years. And to make matters worse, all of the increase will be spent on bioterrorism research.

 

Without question, bioterrorism is a crucial priority, but what about the kind of disease research that has provided awareness of hormone replacement therapy for women; new bone marrow transplantation techniques for otherwise-incurable cancer victims; means for "starving" cancer tumors of their blood supply; intensive diabetes therapies that reduce blindness, amputation and other complications, and AIDS "cocktails" that slashed U.S. deaths by 75% from 60,000 in 1995 to 15,000 in 2001?

 

Now instead of starving tumors, the administration and Congress will starve the very "basic" research that biotech and pharmaceutical companies help convert into vital, life saving -- and financially rewarding -- products.

 

The nexus between the two cannot be overstated. NIH sponsors "basic" research -- mainly at universities -- into genes, molecules, hormones and physiological processes. While it should do more "translational" research to advance development of actual therapies to treat disease, its discoveries have been quickly converted into life saving drugs and therapies by biotech and pharmaceutical companies out of the oldest of motives -- profit.

 

The surge in NIH funding led to a corresponding surge in R&D investment since the late 1990s by member companies of the Pharmaceutical Research and Manufacturers Association and members of the Biotechnology Industry Organization.

 

With the new Bush budgets, this virtuous cycle threatens to spiral into a vicious one. And at the worst possible time, just as the baby boom generation is reaching those years when chronic diseases are most prevalent -- and when medical care will prove most costly to them and taxpayers if better treatments aren't found.

 

Of NIH's visionary sponsors in Congress who foresaw that danger, all but Harkin and Specter have retired. Thus, after the Bush administration proposed its meager increase, dutifully approved by the House of Representatives, the Senate Appropriations Committee approved only a 3.7 percent increase.

 

On the Senate floor on Sept. 2, when Specter and Democrats Harkin and Diane Feinstein offered an amendment calling for a $2.5 billion overall increase, or 9.2 percent -- the minimum reduced growth rate that the scientific community regards as absorbable without causing trauma to the research system -- they could muster only 52 votes, including 35 Democrats and 16 Republicans, short of the three-fifths majority of 60 votes for the amendment to pass.

 

So, under projected budgets, NIH will cut its new research grants by a quarter in fiscal 2005 -- even more after bioterrorism grants are taken into account. As labs are cut, there'll be fewer jobs for post-doctoral scientists, meaning fewer researchers for pharmaceutical and biotech industries in the future.

 

During most of the five "fat" years of NIH increases, the agency lacked a permanent director who could set priorities based on scientific opportunity. After a difficult search, President Bush appointed an imaginative director, Dr. Elias Zerhouni. But now Bush has cut his money off.

 

This represents the GOP's abandonment of a legacy. Whatever diseases were cured in the future, however many lives were prolonged and dollars saved in treatment, Republicans might have said, "We did that." Unfortunately, they never figured out how to claim political credit for the life-saving investments they did made, so now they are about to stop making them.

 

And beyond federal funding of basic biomedical research, President Bush's "pro-life" ideology has led him to sharply restrict federal funding of research using human embryos obtained from in vitro fertilization clinics.

 

Stem cells, the inner core of five-day-old embryos, theoretically could be used to repair damaged organs anywhere in the body, offering the hope of cures for maladies ranging from Parkinson's disease and diabetes to spinal cord injuries and burns.

 

Even though hundreds of thousands of "left-over" embryos sit frozen in storage at fertility clinics -- and are destined for eventual destruction -- Bush has limited federal research to stem cell lines derived from embryos destroyed as of Aug. 9, 2001. In the first nationwide address of his presidency, he announced that day that 60 such lines existed worldwide. But scientists say fewer than a dozen actually exist -- and most of them are contaminated and unavailable for use by humans.

 

Bush also is adamantly against the idea of cloning embryos for research. While a morally difficult area, cloning as a technique would avoid the problem of tissue-rejection when stem cells are introduced into an individual. As matters stand, the research is legal in the United States because it has not been banned -- as Bush would like to do -- but uncertainties have led some top stem cell researchers to leave the United States and establish labs in countries permitting the procedure, such as England and Israel.

 

For unexplained reasons, the administration also has failed to adequately finance research into so-called "adult" stem cells not derived from embryos, but rather from skin, blood or even fat cells.

 

All this represents a massive undoing of a national commitment to medical research, an area in which the United States leads the world. And by Republicans, who have long held free scientific inquiry and basic research as being fundamental to the workings of a free market economy.

 

NEXT: The assault on free enterprise in medicine.

 

Morton Kondracke is executive editor of Roll Call, a Fox News analyst and contributor to TechCentralStation.com

Categories:
|

TCS Daily Archives