My jaw dropped when I opened the Wall Street Journal on January 5 to find a commentary by Dr. Tom Stossel, a visiting fellow at the American Enterprise Institute (AEI) and professor emeritus at Harvard Medical School. The headline set the tone for the article: Don’t thank big government for biomedical breakthroughs. This piece is complemented by a more extensive articulation of the argument by Dr. Stossel in the January issue of National Affairs . Once I got my jaw closed, I knew I had to respond.
Dr. Stossel argues that it is industry and not the federal government through the National Institutes of Health (NIH) which fosters discoveries, breakthroughs, and innovation in bioscience. Nothing could be further from the truth. And it is not just me or academic leaders who have vested interests who say this. When I talk to industry leaders in pharmaceuticals, bioengineering, or emerging scientific technologies, I hear the same thing over and over—NIH funding over the last half century has been the engine driving American biological research and medical progress. In industry, there is a wide consensus that NIH should be funding more, not less, basic research. In this view, NIH needs to do more in funding training of the next generation of scientists. Pharma’s medicine cabinet would have a hollow echo today without the NIH longterm support for basic research,.
Yet let me be clear—basic research is the means but not the ultimate end for public investment. Without an innovative bioscience industry, we would indeed have no new medicines or treatments. Ours is a mixed economy and without industry, our science would be pointless. Science is a complex ecosystem where different organisms play different roles. No single species can survive alone. Without a healthy diversity of public funding and private investment, our biomedical ecosystem would collapse.
Let’s unpack this a bit further.
First of all, basic science is a public good. A public good is a benefit that is provided or consumed in common. It needs to satisfy both the condition of non-exclusivity and non-rivalry. I often like to use the metaphor of the lighthouse. No ship’s captain would ever pay to build a personal light tower to signal perilous shoals for navigation. After all, other ships would benefit from the lighthouse—why should one pay to solve the problem when others will benefit? The fact that one captain can use the signals from the lighthouse does not exclude other captains from reaping its safety benefits. That this is why governments build lighthouses, not individual sea captains. And that is why government funds the vast majority of basic research.
In science, open-ended, curiosity-driven scientific inquiry is the lighthouse. Government funding of this public good is how basic science advances our basic biological understanding and opens whole new avenues to therapy. Few private agents would fund a public good like basic bioscience research. Even if they could afford it, a for-profit corporation would be unable to profit from a conceptual breakthrough discovery for long. What CEO would sign off on paying for research in yeast on how cells secrete bioactive substances, based on the very slight chance that in 30 years, this knowledge might revolutionize drug delivery? What shareholders meeting would sit through a presentation on a 1% chance of ROI in 10 or 20 years?
Given the enormous uncertainty and the long trek from discovery to commercial payback, relying on the private sector to carry the lion’s share of funding for basic research would bring discovery to a grinding halt. Virtually every single new drug or therapy that we are deploying today in clinical settings rests on fundamental knowledge that was produced, thanks to taxpayer-funded research, through basic science experiments. Think of vaccines, antibiotics, cancer drugs, antiretroviral therapy, and new transformative technologies such as CRISPR/Cas9. They all rest on very basic discoveries, initiated by NIH-funded research. Public funding of a public good is the only effective way to unleash scientific curiosity on the bewildering complexity of biology.
This is the crux of the matter. Biology is terrifyingly complex. The more we learn, the more we know how much more we don’t know. In recent years, industry has learned that brute force—mass screening of molecules to detect effects and avoid toxicity—was not the most efficient way to find new drugs. After the low-hanging fruit was picked, the search quickly bogged down. The bottleneck, industry realized, was our ignorance of how complex biological systems work in cells, in tissues, and in whole systems. All this has to be understood in detail. Otherwise, industry would be groping in the dark for innovative therapies. For this reason, industry has been partnering more and more with academic centers to tap their great wealth of knowledge about biological systems. Increasingly, industry is opening its doors to collaboration. A landmark 2010 Morgan Stanley report, titled Pharmaceuticals: Exit Research and Create Value, broadcast the message to industry: to look for new approaches to R&D, look to partnerships with academia. This recognition has spread through the pharma industry. Today they realize that corporations can no longer afford R&D in privately owned, top-to-bottom research silos, as they did in the early days of antibiotics and chemotherapy drugs. Science has simply become too complex. Understanding biological systems requires teams of basic researchers working on a wide front that is beyond the capabilities of industrial research. In short, a public good requires public funding.
Contrary to the WSJ headline, I am very thankful to the American government for biomedical breakthroughs. And yet, while I strongly disagree with Dr. Stossel on the role of NIH, I think there are some important points in his arguments, especially those in the less punchy National Affairs article.
I agree that the relationship between government-funded research and industrial utilization needs to be improved. The incentives for corporate innovation need to be revisited. Our current system of regulatory process and of intellectual property needs a boost. Rather than destroying the public element in research, we need to foster tighter, open partnerships between academia, government, and industry. These three sectors often do not understand each other’s motives, incentives, or goals. That should change.
With the new administration on the launch pad, I would take Dr. Stossel’s provocative piece as a stimulus for an essential national conversation on how to enhance communication between the government, academia, and industry compartments of bioscience. This could be the opportunity to look at what I think is a core and ever-important issue. Something good could come out this conversation but we need to start with setting the record straight. Government funding for science, and for basic bioscience in particular, has been the bedrock for America’s powers of discovery. It would be disastrous to dismantle such a public-private enterprise, which is the envy of the world. If we turn off the lighthouse, the sun will rise on the shipwreck of American science.