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NIH Director Francis Collins: Budget fight a tragedy for life sciences

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NIH Director Francis Collins says the result of the budget crisis on life science means that breakthroughs that might have changed people's lives will not happen.

It's safe to say it's been a pretty rough year for science agencies like the National Institutes of Health (NIH). First, squestration cut 5 percent of their budget since March, and now, with the federal government shutdown, the agency has gone into "sleep mode" -- halting granting activity, furloughing 73 percent of its staff and turning away 200 patients, 30 of them children, seeking experimental treatments at the agency's hospital, NIH Clinical Center. How will all of this impact research? In the weeks leading up to the start of the new fiscal year (October 1), NIH Director Francis Collins reached out through social media to take the pluse of scientists feeling the budget squeeze. His Twitter thread, #NIHSequesterImpact, garnered worldwide media attention and helped to raise awareness of the plight of those working in the life sciences.

Before the shutdown, AAAS MemberCentral talked with Collins about the budget situation facing the NIH and what the future may look like if congressional dysfunction continues in Washington.

AAAS MemberCentral: Why did you start the Twitter feed #NIHSequesterImpact?
NIH Director Francis Collins:
I wanted a better sense about what was really happening out there at our nation's finest universities and medical centers, which is where almost all of our money goes. To get a quick response, since I have about 20,000 Twitter followers and a lot of them are involved in research, I figured I would ask, 'Okay, tell me your story, what's happening, what's the consequence been already to your research just in the first month or two of this really negative development?' I got more than 2,000 responses, some of which were quite troubling.

AAAS MC: What has struck you most about the responses you've received?
Collins:
Many of them are from young scientists and those are the people I'm most worried about. Graduate students, postdocs, junior faculty — all talking about dreams that they are going to have to scale back. Students that were prepared to do an experiment that was really going to nail down the direction of their research are now being told by their principal investigator they couldn't afford to do that experiment. A particularly poignant story, an individual who was finishing a Ph.D. and getting ready to go into a postdoc position who'd already been offered a slot, was now getting a note from their lab saying 'Sorry, we have to rescind the offer because with the sequester our grant is probably not going to get funded after all and we can't afford to bring you on.' Here's a talented young scientist left high and dry at the last minute.

AAAS MC: What words of encouragement can you offer these young scientists?
Collins:
Winston Churchill once said, 'You can always count on the Americans to do the right thing — after they exhaust all the other options.' When it comes to the support of biomedical research, we are running out of the wrong options and it's about time we try the right one — which is to put funding back on a steady trajectory. The encouraging thing is, the case for support of biomedical research is so compelling that anybody who looks at the evidence will come to the conclusion we should get back on a steady path — at least flat budgets relative to inflation, or better yet, growth.

Look at what biomedical research has done for both our nation's health and its economic well-being. Thanks in large part to NIH-funded research, Americans are living nearly 30 years longer than they did in 1900.  Not only have these gains in longevity enriched many lives, they have added an estimated $3.2 trillion annually to the U.S. economy since 1970. Let's consider just two of the many examples of how research is helping to fuel these economic gains: cancer and preterm birth. Because of research-driven advances in early detection and treatment, U.S. cancer death rates are now falling about 1 percent each year, with each 1 percent decline translating into an annual savings of about $500 billion. Meanwhile, NIH-funded researchers have found that a synthetic form of a naturally occurring hormone can cut preterm birth by 45 percent among at-risk women. This may reduce the serious medical problems and long-lasting disabilities caused by preterm birth, which cost our nation an estimated $26 billion per year. There is almost no other investment the government makes that has these kinds of payoffs!

The good news here is that science has never been more exciting than now, and that's also the paradox of it all. Whether you are interested in cancer, basic science, infectious disease, clinical research — pretty much anything you can name is at a remarkable pace of discovery. That ought to be a strong draw for young people involved in science to stick it out through this bumpy landscape, in expectation that things will smooth out in the future.

AAAS MC: In addition to the Twitter feed, you also wrote a song about the funding cuts, titled, "Sequester Blues." How did this come together?
Collins:
I am an incorrigible amateur musician and I find music sometimes is a useful way to break the ice — to keep science from appearing too stuffy. What better musical form to fit the sequester than the blues, because this mindless slashing of support for research has given us the blues. We need to sing about the blues; we need to laugh about it so we don't cry.

I was also asked to write a song for the awarding of the Lurie Prize, a new prize given by the Foundation for the National Institutes of Health. It seemed like an appropriate moment to turn sequester into a song, and so, \"Sequester Blues\" was born. I didn't expect it to go beyond that evening in Chicago, but once something gets on YouTube, you never know what's going to happen! The current version that people have listened to is probably a little confusing in the last verse because I wrote it in reference to the Lurie Prize and people aren't quite sure what that is — so I just rerecorded a more general version that's all about the sequester, which we posted on YouTube:

AAAS MC: I was recently at a science conference where a Brazilian cancer researcher was eagerly recruiting scientists for his lab. It's quite possible we may start to see scientists going abroad if positions are not available or are hard to come by here in the states. What should institutions/universities be doing to keep them here?
Collins:
It's very troubling to see this trend. Universities are in a bind because they are dependent upon NSF, NIH and other government agencies for the vast majority of research they do. And while I'm sure they would like to have other means to try and retain the best and brightest — and not have them find greener pastures in China, India, Brazil, Singapore and South Korea — they have limited means to do so. Universities are also in a tough squeeze right now over their own finances.

We at NIH are trying to do what we can to give young scientists a special leg up in terms of being supported. For example, when a young scientist comes forward with a new grant application and it's their first try, we put them in a pool where they are competing against other first-time investigators as opposed to competing against experienced people with longer track records — it does help.


But we've lost 25 percent of our purchasing power for research in the last 10 years; there's no way around the fact that it's pretty tough right now. It would help of course if our immigration policies were not also contributing to the problem — where talented individuals who come to the U.S. for scientific training and want to stay are often times finding that difficult to do — because of the onerous process and limited opportunities to obtain the appropriate visa status needed to continue their research careers here. There is some hope that might potentially be addressed, certainly the Senate Immigration Bill did tackle that, but of course that did not become law.

AAAS MC: You've voiced your disappointment with having to defund grants because of the budget cut. You've called it "a lost investment." What can researchers do to maximize their chances of getting that all-important renewal?
Collins:
The most important thing is to propose exciting, visionary, groundbreaking research. We are determined to keep the door wide open to people with innovative ideas. To the extent that people can come forward and express those ideas well, they are still going to get supported even in this very tough circumstance. But I do worry that it's getting increasingly difficult to tell the difference between a grant that scored at the 17th percentile and one that scored at the 14th. And in this climate, the former won't get funded and the later will. Those distinctions are impossible to make, even with the best peer-review system in the world. The real solution is to have those success rates go back up again. One of the tragic aspects of all this is that, because of the low success rate, scientists are having to spend an increasingly large portion of their time just resubmitting, rewriting, thinking about their idea, and sending it in again, instead of doing research. Everybody is sitting at their computer tearing their hair out. What a terrible waste of talent.

AAAS MC: If Congress does not pass a continuing resolution for the 2014 fiscal year budget, the agency will lose another $600 million beyond what's already been lost. What's that going to look like?
Collins:
The consequences of that will probably be close to 1,000 grants that will not get supported that we normally would have funded had we been able to just stay flat relative to FY12. And those ideas will be lost. I worry investigators who might have been on the path to winning the Nobel Prize will begin to wonder whether they should do something else.

AAAS MC: To people outside the STEM world, the loss of $1.5 billion in funding from an overall budget of $30.7 billion might not seem like that much money. How can we in the scientific community show the public that this cut has huge implications for the future?
Collins:
This comes on the heels of 10 years of declining support, so it's not just the fact that we had the sequester in the middle of this year. Since 2003, we've been losing ground. What we have as far as purchasing power for research is down by about 25 percent — and nobody would say that is a minor number.

The sequester hitting as it did in the middle of the year meant that about 640 grants that would have been supported and highly regarded by peer review are now not going to receive funds. And those ideas are not going to happen. And breakthroughs that they might have represented will not occur. We will not know what we've missed because it's gone. Imagine 640 bright, motivated scientists on the brink of doing something powerful that could have changed the way in which we diagnose, treat, and cure cancer or influenza or diabetes or some rare disease that desperately needs an answer; it's just not going happen. I would argue with anybody who says that's a minor consequence. It's not; it's a major negative outcome and a tragedy for what had been the world's most successful search-engine in biomedicine.

Other countries, meanwhile, have read our play book and see their future in trying to do what we used to do. As we seem to be backing away, they are increasing their support. And if people care about American leadership, they should be worried.

Science Under Sequestration:

Tales From The Shutdown:

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NIH Director Francis Collins says the result of the budget crisis on life science means that breakthroughs that might have changed people's lives will not happen. "We will not know what we've missed because it's gone," he told AAAS MC. (Photo: Courtesy National Institutes of Health)
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