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Money and Methods in Cancer Research
The National Cancer Institute funds a lot of important research aimed at treating cancer, but some experts would characterize very little of it as transformative work. Gina Kolata’s article in the Sunday New York Times describes a system geared towards incrementalism rather than high-risk, high-return science.
But a dearth of transformative work isn’t the only thing missing from the biomedical system in the United States. As Merrill Goozner reported here on Science Progress, there’s a lack of data-driven clinical trials that compare what works with what doesn’t.
Of course, the question of how to develop better cancer treatment’s isn’t either-or. We need both more transformative research and more evidence-based medicine. But as funding for the National Institutes of Health increases, a re-think of the grant review process will be necessary to get resources to promising but untried ideas and to the younger generation of scientists.
Comments on this article
It’s easy to pick on government-funded scientists getting R01 grants. Wisconsin Senator William Proxmire did it for years with his “Golden Fleece” awards. But the idea that much basic science research would be misdirected was fully anticipated when Vannevar Bush, President Roosevelt’s science adviser, released “Science, The Endless Frontier” in 1946 and set the stage for NIH and the National Science Foundation as we now know them. He knew that among the chaff would be foundation kernels of basic science insights that would lead to social and commercial progress, and he had the confidence to assume that the private would sector would be able to engage in that sorting process. His core wisdom was in understanding that it took a lot of fodder (i.e., government money) to create that seed corn and that the private sector would never fund it on its own.
So Gina Kolata’s story was, unlike the grantees she picked on, entirely misdirected. A good story would have looked at why the government has largely abandoned its directed research programs, especially at the National Cancer Institute. Fifty of the first 59 anti-cancer drugs, the earliest anti-AIDS drugs, methods of mass producing penicillin – government-funded targeted research programs have a very positive story to tell. Alas, it has largely been lost to a younger generation that has grown up with the idea that only the private sector can innovate in the health care sector. The irony, of course, is that over the past two decades — the era of private sector supremacy in searching for medical cures — innovation, at least as measured by significant new products emerging from the FDA, has vacillated between stagnant and decline. Indeed, the FDA has launched a Critical Path Initiative to explore the reasons and look for solutions to that decline. But sophisticated reporting on complex subjects is not what Gina Kolata was interested in. How much easier it was to pick on young researchers scrambling to get their first or second R01 basic research grants, from which some will build careers of significance as Vannevar Bush fully anticipated.
June 30th, 2009 at 12:50 pm