Tuesday, February 26, 2013

Robbing Peter to Pay Paul-How the Federal Sequester will damage our National Role as Medical Innovator

by: Nicole Aiello, Penn Biomedical Graduate Student

The United States federal government is poised to impose arbitrary cuts on the National Institutes of Health (NIH) budget, as a part of a series of global budget reductions termed “sequestration.” These cuts will stifle medical progress, kill research jobs, and fail to reduce the national deficit in a meaningful way. Sequestration will trickle down to negatively impact thousands of research facilities across the country that rely heavily on federally funded grants to address the fundamental scientific questions that drive medical breakthroughs. Although the University of Pennsylvania is a private institution, biomedical research labs here operate almost exclusively on grants awarded by the NIH, which is poised to endure a $1.6 billion reduction in funding on March 1st if Congress fails to act on the looming sequestration.

The NIH distributes more than 80% of its funding to researchers at universities and other institutions all over the country to support biomedical research. Its budget has been flat for the last ten years, and as inflation continues to climb each year the NIH can do less and less with its money. If the sequestration is allowed to occur, the NIH will lose 5.1% of its already stagnant budget, which means that significantly fewer scientific projects will be funded. These are projects that address fundamental questions about how diseases like cancer, Alzheimer’s and diabetes arise and how they might be targeted for treatment.  Importantly, these proposals often would not go forward without federal funding, because profit-driven private sector companies do not consider them a cost-effective investment.

The competition surrounding NIH funds is already at an all-time high and will only become more cut-throat if the sequestration is allowed to occur. Labs in academia, even though they operate within a university, rely almost entirely on grants. The loss of financial support would force some labs to shut their doors, halt critical biomedical research, and deter young scientists from pursuing careers in academia. Job prospects for science PhD holders have been grim in recent years, with a steady flow of incoming graduate students and dwindling opportunities for traditional academic positions, and the situation will become even more dire if the NIH budget is cut. As a graduate student waiting to hear back about a federal grant application, I can attest to the uncertainty surrounding the current funding situation. Because Congress has pushed the decision on sequestration to March 1st, my application exists in a state of limbo until the NIH receives its budget for 2013. There are tens of thousands of researchers in the same position all over the country, many of whom desperately need these grants to carry on with, or even begin, their research projects.

Cuts to the NIH budget will have an obvious negative impact on the scientific community, but they will also indirectly hurt the economy, especially here in Philadelphia. Federal investment in research is a large source of support for academic universities, which rank among the top employers in the Philadelphia region. For instance the University of Pennsylvania, which received $472 million in NIH awards in 2011, is the 2nd largest employer in the region, with Temple and Drexel also falling in the top 50. These universities drive the local economy, and they all directly benefit from publicly funded research. This means that the less support the NIH can give to our universities, the less support they can give to the Philadelphia community.

Unfortunately, deep cuts to the NIH budget will not only hinder medical progress but will only amount to a mere 0.04% in savings on the national budget. To put that into perspective, it’s like saving a nickel on a $100 purchase. Politicians have been throwing around the buzzwords of “shared sacrifice,” but we as a people should not have to forfeit the future of medical research in a desperate attempt to balance the budget. Indiscriminately slashing research funding is a bad short-term solution for reducing the national deficit, with even worse long-term repercussions for the economy and the health of our nation.

Time to politicize Science Research?

By: Alana Sharp, Penn Biomedical Graduate Student

There has perhaps always been a bizarre disconnect between scientific research, the general public, and politics.  The story of measles is a fitting example.  A highly contagious viral infection first described as early as 68 AD, measles was once “as inevitable as death and taxes” (Babbott Am J Med Sci 1954).  In the 1971, Merck & Co. began marketing Maurice Hilleman’s combined vaccine for measles, mumps, and rubella; today, MMRV is a CDC-recommended vaccination, and measles is no longer considered endemic in the United States.  However, due to the reverberations of a now-retracted study linking childhood vaccinations with developmental disorders, an obstinate anti-vaccination movement persists in the United States.  In the past twenty years, enclaves of children unvaccinated due to parental refusal have permitted sporadic outbreaks of the disease.  Such outbreaks have been thus far contained by surrounding vaccination-compliant communities; however, the growth of this anti-vaccination movement bodes ill for the future eradication of measles.  In this way, one of our greatest medical advances has thus been sullied and distorted, to the detriment of both childhood health and the reputation of the scientific community.

Another illustration of the divide between science and politics is that of anthropomorphic climate change.  The now renowned assessment by the Intergovernmental Panel on Climate Change (IPCC) in 2007 predicted significant changes to global temperatures, weather patterns, sea levels and acidification, and losses to biodiversity.  This report has repeatedly been shown to be overly conservative, as new data suggest faster Arctic ice melting and temperature rises, and reveal broader detrimental impacts to ecosystems, food safety, and political stability.  In the realm of American politics, these warnings are generally unheeded.  With the exception of occasional head nods by Barack Obama and the political left, the impetus to shift toward renewable energy sources and green infrastructure has been weak and unsustained.  Indeed, a significant contingent of our political system and mainstream media maintains that global climate change is a hoax, and an untold network of unreported funding continues to nurture anti-science organizations and promulgate propaganda and misinformation.

The risks in politicizing science are significant.  To the researcher, they may be personal and severe, as demonstrated by the ‘Climategate’ attacks of 2009 and the firing of the NWS scientist last month.  Some believe that the politicizing of scientific discovery will tarnish the reputation of scientists as unbiased purveyors of truth.  Furthermore, bringing research to the general public is a time-consuming pursuit, made worse by an educational climate in which politicians threaten to ban critical thinking and wherein sensitive scientific topics are altogether ignored.  In contrast, it is much easier to research tissue engineering without delving into the controversies over human embryonic stem cell research.  It may seem nobler to publish on the therapeutic benefits of entheogenic compounds without delving into drug policy reform.  The scientist may feel better trained to produce data on climate change, or to develop cancer treatments, than to contribute a voice to the politics of carbon taxes and Medicare reform.  I argue, however, that this reluctance by scientists to address the political ramifications of their research, and confront those that would usurp and pervert it, is at best an act of self-preservation and at worst an act of cowardice.  

This issue will come to a head March 1, when Congress must cut $85 billion in federal spending.  This spending ‘sequestration’ will produce lasting effects to federal funding of scientific research, with cuts of 5.0-8.2% to funding agencies including the NSF, NIH, FDA, NWS, DOE, NASA, and more.  Superimposed on a largely stagnant funding climate, these cuts will produce significant changes to research funding.  The NSF is expecting to award fewer new grants, and the NIH will reduce the size of existing research grants; furthermore, the funding of large projects may be rejected in favor of safer, incremental proposals.  We can expect the career trajectory of young scientists to suffer and for graduating PhD students to struggle to find employment.  Academic institutions with meager endowments will suffer, and the United States will continue to drop in international rankings of education and scientific productivity.  

If there was ever a time for the scientific community to speak up, the time is now.  Congress will not make our case for us.  The public will not make our case for us.  It is for us to contribute to the dialogue and remind the country that science is valuable and inextricably linked to American progress.  We must explain that many of our great intellectual steps forward were initially preliminary projects nurtured by federal grants, most of which were deemed too risky to fund by private corporations.  We must explain the relationship between the scientist in the lab and treatments for cancer, diabetes, and heart disease; we must demonstrate the link between the technologies of our future and the funding that will make them realities; and we must elucidate the economic, intellectual, medical, political, and security payoffs of research.  In the days to come, we must make our voices heard.

The Sequester and its impact on Medical Breakthroughs

I believe that we are entering a new era of hope in medical research.  Seemingly every day we hear about new and exotic therapies that read more like science fiction than scientific reporting: immune cells are removed from our bodies and re-engineered to destroy cancer; patients are cured of AIDS by receiving bone marrow transplants; children are given vaccinations to prevent the development of cancers when they become adults; and massive genetic analyses are providing insight into the causes of disease and directions for developing the therapies of the future. 
It is therefore deeply concerning that in the midst of such promise and growth, we stand at the edge of a deep precipice of cuts to research funding.  The United State’s federal debt has ballooned into a number that is increasingly difficult to look at, and en lieu of rational fiscal policies and bipartisan compromise, Congress has instead backed itself into a corner called “sequestration.” 
Beginning in 1917, as part of a rarely discussed operational formality, federal budgets were limited by a pseudo-arbitrary debt ceiling.  Without much discussion, this limit has every year since been reached and subsequently raised.  In 2011, however, an impasse was reached wherein the national debt was suddenly decried as a threat to the nation’s future.  At the hand of overzealous small government advocates and divisive partisanship, the Budget Control Act was enacted, resulting in immediate federal budget cuts totaling $900 billion.  In conjunction, a “super committee” of congressional representatives was assembled and assigned the task of cutting $1.2 trillion from the national budget.  This exercise ended in failure.   
In the wake of this disappointment, the task of making the $1.2 trillion spending cuts has fallen to Congress.  In what has been termed the ‘nuclear option,’ failure to institute these cuts will result in sequestration, wherein draconian across-the-board cuts will be instituted automatically.  Sequestration is currently slated to go into effect March 1.
The primary medical research funding agency, the National Institutes of Health (NIH), risks disproportionate funding cuts if sequestration is permitted to occur.  The NIH’s budget has been neither adjusted for inflation nor increased in the last decade, an oversight unseemly in light of the increasing prevalence of preventable disease, the emergence of novel infectious disease, and the need for improved therapeutics for undertreated disorders.  To compound this flat-lined funding with budget cuts is shortsighted and reprehensible.  Furthermore, it is inefficient: the proposed 8% cut in NIH funding constitutes an inconsequential 0.08% of the federal budget.  The NIH funds our medical institutions, pays for our medical research, and supports graduate education for the future leaders in basic and clinical sciences.  To decry the failings of our educational system and urge for a larger, more competitive scientific workforce, while simultaneously gutting the NIH’s funding, is simply senseless.
Furthermore, the economic payoff from investment in scientific funding is disproportionately high.  Investment in biomedical research pays off in many ways: in many states, research facilities are a significant employer, which is invaluable in periods of high unemployment.  Development of new and improved medical therapies generates savings in the providing of medical care, a worthwhile aim when healthcare costs threaten many families’ savings.  Many pharmaceutical and private medical corporations, economic drivers and major employers themselves, received public funding in their nascent development.  The preparation of vaccines and treatments for emerging diseases is essential for guarding our national security against bioterrorism.  And, really, who wants to lose a loved one because the medication that could have treated them was halted mid-development due to lack of funding?
I urge everyone in America to stand up and demand that medical research not be subjected to these budget cuts.  To allow sequestration to proceed would be a thoughtless step backward, but it is within our power to demand of our elected officials that these cuts not be made.  Perhaps Barack Obama said it best, in 2009: “At such a difficult moment, there are those who say we cannot afford to invest in science, that support for research is somehow a luxury at moments defined by necessities.  I fundamentally disagree.  Science is more essential for our prosperity, our security, our health, our environment, and our quality of life than it has ever been before.” 

by: Alana Sharp, Penn Biomedical Graduate Student

Save the NIH from the Sequester!
On March 1st, sequestration will eliminate $1.6 billion from the National Institutes of Health (NIH) budget. The deadline is fast approaching, and Congress has failed to put forth any alternative plans for avoiding the drastic cuts sequestration would entail. As a biomedical graduate student, whose research and training are supported by the federally funded NIH, these cuts deeply concern me. Although many argue that spending cuts are necessary in an era when the country has amassed trillions of dollars in debt, austerity does not translate well to medical research nor to the well being of the general public. The amount cut from the NIH would save the federal government 0.042% of the national budget, but would have devastating effects on the economy, medical research, and the training of a new generation of scientists and medical doctors. Is the paltry amount of money saved really worth all that will be lost?
It is impossible to estimate how a loss of $1.6 billion would affect our lifespan, health, or quality of living. This money funds research that develops treatments for cancer, diabetes, and countless other diseases. Since 1962, NIH-funded research has played a role in the development of 153 FDA-approved drugs, vaccines, and new indications for currently approved medication. Furthermore, without the NIH, basic scientific discoveries that fuel new treatments will not happen. The basic research funded by the NIH is essential to designing the best drug treatments and therapies, but because they are long-term investments and do not guarantee a high profit margin, private industry is wary of investing its time and money in these projects. Thus, sequestration would both harm the NIH’s ability to promote new areas of discovery-based research and indirectly impact the NIH-dependent pharmaceutical industry.
Under sequestration, the NIH is slated to lose 5.1% of its annual $31 billion budget, a sum of $1.6 billion. This loss would have a devastating impact on the nation’s economy, as the NIH is a major source of employment and expenditures, and essentially acts as the base for the U.S. medical innovation sector. In 2011, the NIH contributed $61 billion to the U.S. economy, and supported over 432,000 jobs. In spite of the fact that government funding for health research and development has been stagnant over the past decade, the NIH has proven that the returns it generates are well worth the investment.
If the sequester takes effect, a substantial number of important research projects will be rejected simply due to lack of funding. Only the top 18% of research projects in the country acquire coveted NIH funds, which means that many worthwhile projects are already being cast aside. Under sequestration, the grant success rate would drop to 14%, at least 20,000 jobs would be lost, and 3 billion fewer dollars would be funneled into the economy. To put the $1.6 billion figure into even sharper perspective, this is double the amount currently invested in training grants and fellowships. Consequentially, many of our most talented young scientists will take their skills to other fields, or leave the country altogether, creating a lost generation of trained biomedical researchers and doctors.
Congress seems inclined to let the sequester pass, as a means to score political points for each party. Congress needs to be reminded that biomedical research is largely a non-partisan issue, and historically has been supported by both Republicans and Democrats. Both parties understand how biomedical research can reduce the cost of healthcare, and representatives from each political party have indicated that the NIH plays a crucial role in such endeavors. House Majority Leader Eric Cantor (R-VA) has said, “Doing what we can to facilitate medical breakthroughs . . . should be a priority. We can and must do better.” If Congress truly believes that federally funded advances in medical research are worthwhile, they should act quickly to ensure that the NIH is spared the results of sequestration. 
Spending cuts for federally funded medical research affect everyone to some extent, as most individuals have experience with a family member that has a chronic disease or illness. The most recent statistics collected by Research!America found that nearly 50% of Americans think the government isn’t investing enough resources in medical research, and 54% would be willing to pay slightly more in taxes provided their money went directly to medical research. I urge you to take this same passion and contact your congressmen about sequestration. The future of the NIH, the healthcare driven economy, and medical research in the U.S. depends on your support.

 By Ellen Elliot, Penn Biomedical Graduate Student

Friday, February 15, 2013

Check out our first op-ed piece! (Originally published at the Daily Pennsylvanian http://goo.gl/cZpwk)


Two weeks is all that remains before the largest automatic federal budget cuts take place, which could have devastating affects for the Penn Community. If these automatic budgets cuts occur, expect Penn’s ability as a science innovator to be hampered as the sequester would slash billions from the National Institutes of Health (NIH), the National Science Foundation (NSF) and Graduate Medical Education (GME) programs-all programs that fund science research at Penn.

How could Congress and the President allow this to occur? The sequester was born out of two years of political fights over the national debt and federal spending habits. These automatic cuts were constructed as a nuclear option to force both parties into negotiations over federal spending, by having severe financial consequences if it was ever triggered. However the sequester mechanism was triggered in the fall of the 2011, as a bipartisan budget committee failed to compromise on how to rein in federal spending.

These automatic cuts call for equal across the board cuts to military and non-military agencies. With the recent Taxpayer Relief Act of 2012, the automatic sequester was delayed till March 1st, 2013, with the hope that a polarized Congress could figure out a solution.  At this point in time, non-military agencies are slated to lose $42.5 billion in funding, or roughly 5-6% of their budgets this year. Additional reports are now suggesting that Congress is also content to let sequester occur, which could have dire circumstances at Penn.

Penn biomedical research labs depend on funding from the NIH, which is slated to lose at least $1.6 billion this year-a savings of less than 1% of the federal budget! This would severely hamper the discovery of advances in basic and clinical science. Penn is a leader for cancer immunotherapies, thanks, in part, to Dr. Carl June’s Phase I clinical trial (NIH funded) that resulted in amazing regression of lymphoma in pediatric patients. Without the initial NIH investment, this trial would have been nearly impossible to conduct, as pharma companies deemed it too risky to invest in.  Breakthrough vaccine development has also occurred at Penn, as exemplified by Dr. Paul Offit’s pediatric vaccine to rotavirus, another example of research that would not have been possible without NIH funds. Thanks to the sequester, reduced NIH funding will have a chilling effect on new therapeutic development at Penn and possibly drive away talented individuals from scientific careers.

Reduction in NIH funding would severely impact the training of the next generation of biomedical scientists and could impact the U.S.’s position as a leader in innovation in the coming decades. In addition, Graduate Medical Education, or residency training, would also be hampered due to a 2% cut in Medicare and thus is a real concern for Penn Medical Students and Residents. This would also undercut the mission of the nation’s #1 Children’s Hospital. The National Science Foundation (NSF), which funds researchers in the Engineering Program and the School of Arts and Sciences, would also lose $300-500 million (5-6%) this year.   Collectively, these cuts have the potential to create a lost generation of newly trained scientists, engineers and clinicians.

In light of this information, the Penn community needs to tell Congress and President Obama how important this funding is to the viability of this institution and to Pennsylvania as a whole. Pennsylvania is one of the top 5 recipients of federal research dollars. The biomedical industry alone creates millions of dollars of revenue in the state and more than 350,000 jobs including those due to the ripple effect. Continued support of research is good for the university and it is a smart investment for the economy.  Obviously the sequester will be a job killer in this struggling economy.

We need you to act, in order to avoid the full severity of these automatic budget cuts. You can e-mail your Congressperson through this link- http://goo.gl/to9Pv

We also welcome to you to join the newly formed Penn Science Policy Group, to learn more about this issue.  This coalition of science graduate students and post-docs are contacting our Congressional leaders to promote the necessity of continuing to invest in American innovation. To learn about this group, email at penn.science.policy-at-gmail.com.