Better funding to weather
public health crises

Published May 4 2016

Late in 2014, at the height of the Ebola epidemic that took the lives of more than 10,000 people in western Africa, President Barack Obama requested more than $6 billion in emergency funding. The money was for research that would expedite understanding of the virus and help speed approval of an Ebola treatment that could bring the disease under control. A month after the president’s request and nine months into the Ebola outbreak, the United States Congress finally took action and earmarked more than $5 billion to the National Institutes of Health, Centers for Disease Control, Food and Drug Administration, and other agencies to fund a U.S.-led effort to combat Ebola that has proven to be a global health success.

I wrote a blog post for the American Society for Biochemistry and Molecular Biology’s Policy Blotter in the fall of 2014 expressing my concern that emergency requests for massive infusions of new funding to combat a disease can set a dangerous precedent for biomedical research funding. I argued that funding “disease du jour” research is not sustainable and that the NIH had limited resources and needed to choose areas of research for funding based on national priority. Ebola was already a fairly well-understood disease. In my post I argued that it was also not an existing threat to the American population and that the massive increase in funding to fight the disease might come at the expense of research into other diseases that were less well understood.

This year, one of those other, less understood diseases is in the spotlight. The Zika virus, currently wreaking havoc in Brazil, is predicted to spread to the U.S. mainland within the year. To date, more than 300 American citizens have contracted the virus, and globally more than 4,000 birth defects are blamed on the mosquito-borne illness. Unlike Ebola, not a lot is known about Zika, and at a press conference led by the National Institute of Allergy and Infectious Disease director, Anthony Fauci, U.S. public health officials announced that they are finding the disease more dangerous with every new bit of research they conduct.

Once again, the political response to a public health crisis is to provide a bolus of funding to solve the problem. The White House is requesting $2 billion for Congress to combat Zika, and predictably, Congress is not enthusiastic about releasing the funds. In 2014, it took a month of debate in Washington, D.C., to provide the president with the Ebola funding he requested. Today, Appropriations Committee Chairman Rep. Hal Rogers (R-Ky.) says that funding is likely to come but not for several months.

The reality is the need for these often politically charged funding requests is a symptom of a larger issue. Federal investments in biomedical research at the NIH have not kept pace with research needs for nearly a decade, and as a result, the NIH hasn’t had the resources to research a multitude of diseases that are health threats to many, such as heart disease, cancer and Alzheimer’s disease. Disease-focused translational research has moved slowly into the spotlight, leaving basic discovery research — the type of research that may benefit those focused on major diseases and minor diseases — a seemingly lower priority. NIH Director Francis Collins published a letter in Science last month reaffirming the NIH’s commitment to basic research and the important role it plays, but that he felt a need to write such a letter indicates a recognition that basic researchers are feeling heavy pressures resulting from a decade of flat funding.

Understanding how specific cancers metastasize, figuring out how the brain works, and investigating the underlying mechanistic makeup of flaviviruses like Zika are all equally important areas of research, and only when the biomedical research enterprise is funded appropriately can we truly be prepared to respond to tomorrow’s unexpected public health crises.

Benjamin Corb Benjamin Corb is director of public affairs at ASBMB.