To the Editor:
I am writing in the hopes of providing some context for statements of mine quoted in your piece, “At Moment of Danger, NIH’s Director Is Seen as Its Chief Protector,” (The Chronicle, March 27). Without the context surrounding my statements, the points I was attempting to make became lost in the points the reporter wanted to make. He isolated several remarks of mine from a conversation that extended over 90 minutes and ranged quite broadly over a variety of important topics.
Let me be clear — I am not claiming to be misquoted, nor am I known to shy away from being provocative. I am quite outspoken about what I see are the problematic issues in the complex relationships among the level of NIH funding, basic biomedical research, and the progress needed in health and disease research. The reporter and I had a lengthy conversation about questions requiring complicated and nuanced discussions. Our conversation was initiated by a comment I posted on a science policy listserv suggesting that the proposed NIH funding cuts might provide an opportunity for the biomedical research community to look inward and consider whether it was truly using the current levels of funding to the best of its abilities rather than immediately claiming that any funding cuts would decimate the opportunities for progress.
My call for reflection was about the nature of basic biomedical research and was concentrated on conceptual questions – are we pursuing the right questions, with the right methods, and with the best outcomes for the everyday people who believe so strongly that science is working in their best interests? Rather than focusing on “how much” I was asking for the biomedical and science policy community to focus on “for what?” One of the first comments I made to the reporter during our call was that I thought significant cuts to NIH funding was untenable, but that the possibility of tightening budgets should initiate soul-searching analysis rather than an immediate defensive outcry.
Every biomedical researcher I know will agree with me that much of what is funded by the NIH is not going to cure cancer or reverse the ravages of neurodegenerative diseases (the two examples most often used to rally support) but that is not a reason to cut funding. But, it might be a reason to re-allocate funding or think about a different kind of biomedical research system. One suggestion I made (not quoted in the article) was that we, as a society, should have a national plan for creating a more rational and sustained way of supporting the scientific enterprise than the one currently in place.
Scientific research, especially biomedical research, is at its core an essential human activity susceptible to economic and social rewards and incentives. I questioned if the current system was capable of making the kind of progress we would like to see it make or whether, like most aging systems, it had become too “klugy” over the past few decades and in need of a major reboot rather than minor tweaks or repairs. It was this line of conversation that led to my speculation that perhaps Dr. Collins, despite his prominence as a first-rate scientist, might not be best suited for the role of “disrupter.” I suggested we might need a rebalancing of the national research investment towards, for example, more human-centered rather than animal-model driven research and public health and epidemiology research that focused on chronic diseases and behavioral health. I raised these points as questions for discussion – stating that it was hard to tell what might be better or worse in the long run.
There is only one thing I am certain of — as we go forward into a time where it is unlikely the federal budget will grow, the scientific community will be forced to make the difficult decisions it will have to make. Refusing to reflect inwards and to reach outwards in a truthful and honest way is unlikely to be a successful strategy for determining how to use precious resources in societally productive ways.
Susan M. Fitzpatrick
James S. McDonnell Foundation