Varmus on Funding for Disease-Specific Research

The Scientist this month features an excerpt from Nobelist and former National Institutes of Health director Harold Varmus’s forthcoming book, The Art and Politics of Science. In it he describes some of the subtly to accounting for research money applied to the study of specific diseases:

Advocacy narrowly focused on a single disease is often problematic for leaders of the NIH, because such advocacy is likely to be inconsistent with the ways science works best. Furthermore, the goals of such advocacy are often spending levels that are difficult to measure accurately. For example, research on a specific neurological disease, like ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), should, in principle, include basic studies of nerve cells and mechanisms of cell death, in addition to clinical trials in ALS patients, which are readily classified. The basic work may be impossible to classify by disease category, since it could help to understand many neurological diseases or others. This is where the concept of scientific opportunity comes into play: Spending funds to seize a chance to understand a fundamental principle in biology is often a more effective approach to disease than mandating funds for research on a specific disease. Furthermore, efforts to understand another disease, even one that does not affect neurons, might prove to be a more valuable means to understand ALS than work on ALS itself.

He goes on to explain examples with which he is personally familiar, including studies of breast cancer leading to a breakthrough in colon cancer research, and brain tumor research improving the understanding of breast cancer.

In context, Varmus is talking about the budgetary difficulties of balancing requests from advocacy groups, Congress, and the White House. But this is also a useful example of why support for basic research in biological sciences is important: the eventual applications of that work is not always predictable, but it is sometimes serendipidous. And that benefits everyone.

Posted by Andrew Plemmons Pratt | January 13, 2009 | Share This |

Tags: funding, NIH

Comments on this article

You can skip to the end and leave a response. Pinging is currently not allowed.

2 Responses to “Varmus on Funding for Disease-Specific Research”

Marilyn Walker says:
This is on target with the reasoning behind Research!America’s work – we advocate for all types of research to improve health rather than disease-specific.
January 13th, 2009 at 6:50 pm
Malcolm Getz says:
Dr Varmus focuses on science, not medicine. Our biggest opportunity to improve medical care is vigorous study of which of the available treatment strategies for each illness is most cost effective. Appendectomy is an effective treatment for appendicitis, not because basic science understands the biology of the appendix but because physicians tried it and found that it works. A recent study of treating certain kinds of knee pain with surgery showed that surgery had no effect in reducing pain. It would take billions of dollars and a good bit of luck for basic science to be able to explain why the surgery doesn’t work. Knowing the basic science is a very expensive way to learn not to do pointless surgery. Fortunately, for much of medicine, we are better off investigating what works well relative to its cost and doing more of that and doing less of expensive things that don’t work very well. Currently, Federal dollars spent on research in clinical medicine is about one percent of that spent on basic science. Dr Varmus speaks eloquently for science but his point of view is too narrow.
January 18th, 2009 at 12:18 pm