Posted by Camillo Ricordi on October 16, 1997 at 20:54:16:
In Reply to: Re: Prevention vs. Cure Funding Distribution posted by MAR on October 16, 1997 at 16:21:29:
Let me follow up on the Gordon Weir article. If you read it carefully, the message between the lines is that less than 1% of NIH funding on diabetes (NIDDK) went to support treatment/cure oriented transplantation research, whether it was encapsulation or tolerance, whole pancreas or islet cells etc.
The problem is not to take away from one side (i.e., prevention) to give to another (i.e., cure). The problem could be much worse! It could be that there is no piece of the pie ... Try to cut out a piece from your child next b-day cake that is less than 1% of the whole cake ... It is rather challenging.
I believe key issues that need to be constantly brought up with any funding agency are:
1. Define the size of the slices, and then set up mechanisms to allow the best research in those areas to be funded. For example: it may be of relative importance whether research for a cure should get 10 or 30%, but what becomes of absolute importance is that there should be no mixed language like "this funding will be available to support competitive, peer reviewed research to cure and prevention of diabetes..." because here is were you expose the system to the less than 1% versus 99% potential differences, depending upon many variables including the composition of the study section that will evaluate those proposals... A criticism to this could be "but any real cure should include prevention of recurrence of the disease (e.g., following transplantation)" and we can discuss this at another time.
2. The other major issue is how much of the pie should be invested in "high risk - high return" research or bench to bedside research as opposed to more conventional basic research. This was one of my proposals at the recent NIH conference that I hope will be supported. We should support some projects that may make a big difference if successful, even if their likelihood of success is small. It is like for those in business, who diversify their investments in higher and lower risks rather than keeping everything in a checking bank account. If you invest only in low risk research you may get only low degree increments.
3. Which part of the research is not already sponsored by industry (i.e., because of a lack of commercial interest) and how we can make a difference?