It's Time For NIH To Expand Its Focus Beyond Cancer

If we are going to change this we will need to contact the NIH. Its quite distressing that no stroke organization was quoted. Statistics should have been easily available.
http://www.forbes.com/sites/johnlamattina/2012/03/13/should-the-nih-adjust-its-funding-priorities/

The National Institutes of Health (NIH) is not a single institution but is made up of over 20 centers, including the National Cancer Institute (NCI), the National Institute of Mental Health (NIMH), and the National Human Genome Research Institute. Its stated mission is: “To seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability.” The work both performed and supported by the NIH provides the seeds for understanding the basic cause of diseases. This basic research is the starting point for the majority of projects tackled by the biopharmaceutical industry. In effect, the NIH funding lays the foundation for the drugs that will be discovered over the next 20 years. Therefore, when a large discrepancy exists in the NIH’s funding priorities, it’s concerning.

In reading the 2013 proposed budget for the NIH, as reported in a Chemical & Engineering News, I was surprised to see how dominant the NCI is in terms of funding. It is the clear leader at almost $5.1 billion, dwarfing the $1.6 billion budgets of the National Institute of Diabetes & Digestive & Kidney Disease (NIDDK) and the National Institute of Neurological Disorders and Stroke (NINDS). The work the NCI does is crucial in advancing how to treat and ultimately cure this horrible disease. In fact, the work that the NCI has supported over the last four decades has spawned many new treatments for lung cancer, kidney cancer, melanoma, etc. Furthermore, it is estimated that over 1,000 potential new medicines are in clinical trials around the world to treat various forms of cancer. Many of these experimental medicines were initially pursued based on insights generated by research funded by the NCI. Not all of these will become marketed drugs, but anywhere from 100 – 300 may. If that is correct, we will reach a point, perhaps in our lifetime, when cancer is not a death sentence but a manageable disease.

Let’s contrast this with the state we are in with other diseases. According to the Alzheimer’s Association, there are 5.4 million Americans with Alzheimer’s Disease (AD); by 2050, that number will triple. Today, the cost of treating AD is about $180 billion annually. By 2050, these costs will have devastating effects on the economy unless some medical advances can be made. Currently, there are no therapies available that can arrest or reverse AD; current drugs like donepezil only slow the onset. There are some interesting new compounds in late stage clinical trials, but there is no guarantee that they will be effective. There is no doubt that more fundamental research is needed in AD. Yet, the NINDS budget of $1.6 billion is meant not just for support of AD research but also to research in stroke, multiple sclerosis, Parkinson’s disease, and epilepsy.

A similar story can be told in the area of psychiatric disorders, such as schizophrenia, depression, post traumatic stress disorder and anxiety. Unfortunately, most of the major pharmaceutical companies are dropping out of this research. One of the reasons is that, despite the deficiencies of current treatments, there are no new biological targets to pursue that could lead to improved therapy. Ironically, Congress declared that the 1990s were to be the “Decade of the Brain.” Unfortunately, this proclamation didn’t stir a major boon in R&D in this field. Basic research is needed in psychiatric disorders to help in the discovery of new medicines in this area, and the NIMH could be a big help here.

A case could be made for any number of other major areas in need of increased funding. We are in the midst of a major obesity epidemic which is leading to a parallel increase in Type 2 diabetes. New drugs are needed to treat infections that are becoming resistant to current anti-infective agents. Heart disease is still a major killer. All of these areas can benefit from greater funding. Perhaps now is the time to revisit NIH funding priorities and shift funds from the NCI to other Institutes. I am not advocating slashing the NCI’s budget by half. However, would a redistribution of NCI funds to other Institutes be totally unreasonable in light of other needs? I believe the NCI should continue to be the NIH’s top funding priority, but I also believe it is time to add resources to fight other diseases. Not doing so is shortsighted and neglects to address epidemics that we can confidently predict are in the not-so-distant future.

I fully appreciate the importance of cancer research. I also realize that this is not a single disease, but one with multiple causes and one where patients will require more than one medicine to survive. I have a personal commitment to fighting this disease in my work with the Terri Brodeur Breast Cancer Foundation – work that is a priority for me. However, reducing the NCI budget by $500 million and redistributing this money to fight AD and diabetes might be more beneficial to overall healthcare in the U.S. At a time of tight budgets with no possibilities for increases in the near future, along with the enormous costs that other diseases are going to place on our healthcare system in the next decade, I believe that the NIH needs to revisit its funding priorities.