Medical research funding is stagnant

A few weeks ago, an article was published in the Journal of the American Medical Association comparing the United States’ medical research funding to that of other countries. Looking across all sources of funding--pharmaceutical/biotech/medical device companies, foundations and charities, all levels of government, NIH grants, and various private funders--the article authors found that there was a significant increase in funding between 1994 and 2004, but that the increase tapered off between 2004 and 2012. This graph shows a large increase in medical research spending 1994-2004 and illustrates virtually level funding in the past decade.

Though it’s always easy to blame the government of all of our problems, and all levels of government increased their research budgets by just a pittance, the overall leveling off isn’t just due to decreased government spending. Biotech and medical device companies have only increased their spending a tiny bit since 2004. Shockingly, the pharmaceutical industry has slightly reduced its investment in research in that time period.

This isn’t great. Considering the United States has some pretty big health issues to address, I would have hoped to see increasing investment rather than the flat levels of the past ten years. Since the cost of research goes up each year as the questions researchers ask and the technology they use becomes more sophisticated, funding should also rise. And since it can take 25 years or longer for new technology to become clinically useful, we will see the effects as many of us age and need advanced medical interventions.

The authors conclude (bold emphasis is mine):

Clearly, the pace of scientific discovery and need for service improvement have outstripped the capacity of current financial and organizational models to support the opportunities afforded. The analysis underscores the need for the United States to find new sources to support medical research, if the clinical value of its past science investment and opportunities to improve care are to be fully realized. Substantial new private resources are feasible, though public funding can play a greater role. Both will require nontraditional approaches if they are to be politically and economically realistic. Given global trends, the United States will relinquish its historical innovation lead in the next decade unless such measures are undertaken.

So successfully increasing medical research spending will all come down to how much the public believes that (1) the research is crucial and (2) if the United States doesn’t invest more money, it will lose its place as the most innovative country. Tomorrow, I’ll talk about the new Pew report “Public and Scientists’ Views on Science and Society,” which addresses this very issue.

Source: Moses, H., Matheson, D.H.M., Cairns-Smith, S., George, B.P., Palisch, C., and Dorsey, E.R. The anatomy of medical research: US and international comparisons. JAMA. doi:10.1001/jama.2014.15939

Note: My views do not represent the views of any person or any entity associated with the National Cancer Institute, the National Institutes of Health, the United States government, or anything else. These ramblings are mine and mine alone.

Friday Five: Merck for Mothers, Gates Foundation, mental health, antibiotics, housing

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Merck for Mothers expands to the US

The US’s high infant mortality rate is often cited as an indicator of our nation’s poor health. However, the maternal mortality rate is often ignored while the number of pregnancy-related deaths has doubled since 1990. Pharmaceutical giant Merck established its Merck for Mothers overseas to help reduce maternal mortality and has just announced it will import those programs to work with expectant mothers in the US. It will provide $6 million in funding for initiatives in ten states and three cities, including Baltimore and Philadelphia. The project will also work to standardize procedures for pregnancy-related emergencies.

Maternal mortality by GDP per capita. I've highlighted a few countries for comparison. While the US does have a comparatively low maternal mortality rate, it is far above other countries with similar GDPs. The size of the circles represent the size of the population, and the color indicates the geographic region. Source: Gapminder


The Gates Foundation funds all kinds of new public health ideas

The Bill and Melinda Gates Foundation is dedicated to improving public health around the world, and its Grand Challenges Explorations is a way to promote innovation. This week, the Foundation announced the 81 winners of this year’s $100,000 grants. All of the grants awarded fall into these categories:

  • Increasing the interoperability of good data (ex: improving humanitarian information management in crises)
  • Develop the next generation of condom (ex: condom applicator that can minimize interruption)
  • Labor saving innovations for women smallholder farmers (ex: participatory reality TV show encouraging the use of draught animals)
  • New approaches for the detection and treatment of selected neglected tropical diseases (ex: artificial snail decoy to confuse a parasite)
  • The ‘One Health’ concept: bringing together human and animal health for new solutions (ex: new canine rabies vaccine)

Non-specialist health care workers in developing nations are successful at mental health care

A report published this week shows good news for mental health in low- and mid-income countries. Examining 38 studies, researchers found that non-specialists (such as doctors and nurses rather than psychologists and psychiatrists), who have some mental health training, have been successful in alleviating mental, neurological, and substance abuse issues. Compared to untrained health care workers, patients of trained workers had a positive affect on depression, youth PTSD, and problem drinkers. The researchers caution against making assumptions about what kinds of interventions might work. But the bright side is that training primary care workers to consider mental health needs could help get much-needed care to people who may otherwise go without. You can read the report—and a plain language summary—here.

Tonight’s nightmare is…bacteria that no antibiotic can kill

New Zealander Brian Pool died in July, but the specifics of his death were just reported this week. While in teaching in Vietnam, he underwent surgery and contracted KPC-Oxa 48, a strain of bacteria that is resistant to all antibiotics. That’s right, all of them. New Zealand authorities were strict about quarantine, so there’s little worry that the bug will spread from this particular incident. If you’d like to learn about all the things at risk if we lose the ability to kill bacteria, Maryn McKenna has a terrifying run down.

Why we need public housing

I’ve recently become interested in the importance of safe, stable, and affordable housing as a prerequisite for good health. Ensuring everyone has their basic needs met is perhaps the most important public health issue. How can anyone expect to have a successful smoking cessation intervention if participants don’t know where they’ll sleep tonight? Now that I’m paying attention to the issue, I’m seeing it everywhere. This infographic explains how public housing can be a part of the solution.