In the last 10 years, remarkable advances have been made in how we fight cancer, work that was made possible by our nation’s support of biomedical research, largely through the National Institutes of Health. One of the most powerful new tools in our arsenal is cancer immunotherapy, which reawakens the body’s own immune system. Immunotherapy drugs have produced stunning results for many people suffering from advanced cancer.
Immunotherapy saved President Jimmy Carter’s life. After being diagnosed with advanced melanoma that had spread to his brain, he underwent a combination of immunotherapy and radiation treatment. What could have been a sad story of death within months has turned into a compelling story of survival with no signs of cancer.
This paradigm shift in cancer treatment has its roots in the pursuit of basic knowledge about how the immune system is regulated. James Allison, who was just trying to understand how the immune system works, discovered cytotoxic T-lymphocyte associated protein 4. This so-called checkpoint inhibitor puts the brakes on the immune system. Once Allison made this discovery, he developed an antibody that neutralized the brake and reawakened the immune system.
For decades, America’s federally funded research engine has led the world in technology advances such as next-generation sequencing, artificial intelligence, and imaging physics, as well as treatment breakthroughs that have revolutionized the way we care for patients with cancer, heart disease, diabetes, and infection — and the pace is only accelerating.
Of the 15 immunotherapy drugs currently on the market, five were approved by the FDA last year. In my decades of work in the field of oncology, this is the first time that I feel that very sick cancer patients now have the potential to experience long-term survival, or even cures. Our understanding of cancer and the ability to treat it as a disease of the genome — rather than the disease of a specific organ — is greater than ever before. Beyond just treating cancer, imagine a future where vaccines could prevent it.
But that future is at risk.
Federal funding for biomedical research has generally been declining. The budget for the NIH has eroded by nearly 20 percent since 2003. That jeopardizes future advances because breakthroughs take years of trial-and-error research and millions of dollars — research and investments that only the NIH is willing to make because the private sector is often under intense short-term financial pressure.
The best example of the return on basic science investment is the Human Genome Project. According to a Battelle study, the NIH’s investment of $3.8 billion to sequence the human genome has been estimated to have returned upwards of $1 trillion to the economy, while revealing new fields of medicine and creating high-paying jobs in the exploding biotech industry. Thanks to this basic but breakthrough work, we can today tailor specific cancer therapies for individuals.
Failing to invest in the NIH will have long-term consequences for America’s leadership in biomedical research in the 21st century. As federal funding for research has declined in the US, young researchers have left for other countries — or left the field altogether. China is currently investing $9 billion in genomic sequencing, outpacing US investments, and it is expected to exceed US investment in biomedical research and development by 2020. China already has surpassed us in supercomputing.
The future of biomedical research in the US feels like it is on a see-saw. Congress increased the 2016 budget for the NIH budget by $2 billion, the first notable increase since 2003. Congress also passed the 21st Century Cures Act with overwhelming bipartisan support. This act provides $4.8 billion over 10 years to accelerate specific areas of highly promising NIH research, including the national Cancer Moonshot initiative, the BRAIN Initiative, and the Precision Medicine Initiative.
Yet President Trump’s “budget blueprint” for 2018 proposed a nearly 20 percent reduction in NIH spending. That’s at odds with earlier statements made by the president, who is known for keeping his promises. He said in a November video, “Whether it’s producing steel, building cars, or curing disease, I want the next generation of production and innovation to happen right here, on our great homeland, America, creating wealth and jobs for American workers.”
At the same time, Senator Roy Blunt (R-Mo.) and Representative Tom Cole (R-Okla.) have proposed a $2 billion increase for NIH in the FY 2017 budget.
It is important that all Americans, not just the research community, be engaged in this debate. If we wish to remain the preeminent nation for finding cures and treatments for deadly diseases, we cannot afford to flat fund the NIH or reduce its budget, because the march of disease waits for nothing.
Just one statistic about Alzheimer’s disease highlights the challenge we face in biomedical research. We currently have no cure, and no effective treatments, for this disabling and increasingly common disease. If that doesn’t change, Alzheimer’s will cost our nation more than $1 trillion a year by 2050! That’s nearly double what we currently spend to defend the nation.
Amazing progress against the scourge of disease is possible — but only if the president and congressional leaders come together and invest in American research. These investments will save lives, create jobs, protect our national security, and ensure that America continues to lead the world in scientific discovery.
Ronald DePinho, MD, is past president and professor at the University of Texas MD Anderson Cancer Center and vice-chair of ACT for NIH, the leading advocacy organization for NIH funding.