In the latest issue of the New England Journal of Medicine, Eric G. Campbell, Ph.D., writes about “The Future of Research Funding in Academic Medicine.”
The premise:
Medical schools and teaching hospitals in the United States are essential producers of basic scientific and clinical knowledge that drives our supply of new medicines, devices, and other health care innovations. Today, the funding for this work is dwindling, rendering the current structure of the biomedical research enterprise unsustainable. Given the economic crisis, the fiscal and operational models of this enterprise must be restructured if the stability of academic institutions is to be maintained and our growing health care needs are to be met.
Financial support for biomedical research in the United States comes from 3 main sources:
- Government (federal and state)
- Pharma/biotech industry
- Nonprofit foundations
The problem:
For the near future, the outlook for research funding from any of these sources is rather bleak. States are expected to reach a combined budget shortfall exceeding $200 billion… Industry is spending more on research and development, but fewer drugs and medical devices are being approved for the market, and tightened regulation may be hurting profits… Evidence of a downturn in foundation support is already emerging. Since last October, unprecedented declines in the stock market have reduced foundations’ endowments by an average of 30%.
The solution (this one is a lot more difficult to predict and articulate):
If U.S. science is to continue playing a key role in global progress, some major belt tightening will be required. …major reform, with an eye toward long-term sustainability and management of research-enterprise growth, is essential. Although academic institutions face great challenges, our country’s unprecedented hardships may provide them with a long overdue stimulus to make needed changes. A failure to seize this opportunity could have dramatic consequences for the health of the research enterprise.
