Crisis in medical research portends a disease tsunami

The Bermuda Triangle is where aircraft, ships and people disappear.

Another less mysterious triangle swallows good ideas and great science, and leaves people vulnerable. It is the triangle that is formed by the way we conduct medical research in the United States, the role of the pharmaceutical industry in that research and the public’s perception, driven by political ideology, of how it works.

The theory is that the private sector does research, and everything else, better than the government. But the truth is the basic research that has put the United States ahead of the rest of the world – as a laboratory for world-changing science and medicine – has been funded by the government.

It is the government that puts social need ahead of anticipated profit. It is the government that puts money into obscure but important research. And it is the government that will keep the United States in the forefront of discovery in science and medicine.

It is no good for politicians to rant about the importance of children taking more and harder math and science courses. Before they open their mouths, they should look at the indifferent way in which we treat mathematicians and scientists. We treat them as little better than day laborers, called on to do work ordered by government, then laid off as political chiefs change their minds.

A career in research, whether in physical sciences (such as astrophysics) or medical sciences (such as cell biology) is a life of insecurity. Had we put the dollars behind Ebola research years ago (the disease was first identified in 1976), we would not now be watching what may become a wave of death raging across Africa, and possibly the world. Shame.

Any gifted young person going into research nowadays needs career counseling. They will be expected to give their all, with poor pay and long hours, to serve mankind. Then the funding will be cut or the research grant will not be renewed, and they will be on the fast track from idealism to joblessness.

You may have heard of the celebrated virus hunter, Dr. W. Ian Lipkin, director of the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, because he has been called on for expertise in Ebola. What you might not know is that Lipkin is so starved for funding that he has had to use crowd-funding to support his research on Myalgic Encephalomyelitis, the ghastly disease commonly known as Chronic Fatigue Syndrome (CFS).

Nothing is more damaging to research than funding instability. The universities and many research laboratories – including those run by the government – operate like concertinas. They expand and contract according the whim of Congress, not the needs of science, public health or American leadership.

Industry is not the answer to absent government. Pharmaceutical companies spend an astonishing amount – up to $3 billion – to bring a new drug to market. But traditionally agencies of government, particularly the National Institutes of Health, seed research where the social need is apparent or where the discoveries, like an Ebola treatment, are defensive. Big Pharma often comes in later, as the developer of a drug, not the discoverer. Discovery starts with lowly dedication.

Sometimes the cost and risk initially is just too high for private institutions to take a therapy from the laboratory to the doctor’s office. Most drugs, contrary to legend, begin in the research hospitals, the universities and in government laboratories long before drug companies develop manufacturing techniques and shoulder the giant cost of clinical trials.

Developing new drugs has become too expensive for the private sector, according to a recent article in Nature. The magazine says the drug pipeline for new antibiotics, so vital in fighting infectious disease, has collapsed as Big Pharma has withdrawn. The latest to leave is Novartis, which has ceased work on its tuberculosis drug and handed it over to a charity coalition.

Government funding for medical research is now at a critical stage. It has flat-lined since 2000, as medical costs have ballooned. Also, congressional sequestration has hit hard.

Stop-and-start funding breaks careers, destroys institutional knowledge and sets the world back on its scientific heels. That is to say nothing of the sick, like those with Ebola or CFS, who lie in their beds waiting for someone to do something.

Llewellyn King is executive producer and host of “White House Chronicle” on PBS. His e-mail is lking@kingpublishing.com.