Too hot to research
Before governments dominated the funding and direction of medical research, researchers made breathtaking advances through drugs such as penicillin and antibiotics, vaccines for typhus and polio, and devices like MRIs and pacemakers. Once government took the lead, fundamental breakthroughs — as opposed to incremental improvements — became rare, despite a five- fold increase in R&D. The 21st century to date has yet to claim a giant in science who has cured cancer, developed a vaccine for the Ebola virus or unraveled the reason for the explosion in cases of autism and other auto-immune diseases. Last year’s Nobel Prize in medicine was divided among three researchers who developed commercial drugs useful in countering infections caused by roundworm parasites and malaria — important, no doubt, but hardly revolutionary.
Government’s failure to inspire genius and reward outof-the-box thinking is hardly surprising, and not just because governments reward conformity. Governmentdirected medical research — today the majority of all medical research — is crippled by conflicts of interest that all but guarantee failure in determining root causes.
In the first part of this series last week, I described governments’ profit motive in developing drugs rather than cures: Governments own and control the drug patents discovered through the research they fund, giving them immense revenues through the patent-lease deals they then strike with the pharmaceutical giants. But being in bed with industry, and all the biases that entails, is only one reason to distrust government-dictated research.
Governments are political, leading to science compromised by ideological, populist and partisan needs. Feminism, which influenced gov- ernment policies everywhere, provides one example of how science has bent to meet political imperatives.
With the changes in lifestyle that feminism ushered in — the pill, abortions, working outside the home, changes to breastfeeding, and having fewer children, among other t hings — women’s health changed, not least through a soaring rate of breast cancer. It is now the leading cancer afflicting Western women, befalling one woman in eight,
Numerous early studies implicated changed lifestyle factors in rising breast cancer rates, especially abortions, which studies found doubled breast cancer rates. Other studies later refuted that, but the early studies did reinforce some correlations. Where abortions were discouraged by religious beliefs, women had low breast cancer rates. When abortions were the preserve of the wealthy, breast cancer was a rich woman’s disease, occurring twice as often as in poor women. Once abortion became legal and publicly funded, breast cancer rates for poor women shot up.
This killer that accompanied the many merits that came of feminism should have become a focus of independent science, to understand if and whether women might be at risk, to better let them make informed decisions about having abortions. Instead, the issue became highly politicized, with activist politicians voting for or against abortion- related research based on partisan affiliations, and government agencies such as the National Cancer Institute changing official descriptions of the risks from abortion when their political masters changed.
The politicization of research funding is pervasive and paramount in decisionmaking, so much so that highly charged issues that become too hot to handle can receive no funding at all. In the case of vaccines, for example, the Centers for Disease Control, in testimony before a congressional hearing on rising rates of autism, confirmed that it had never compared the health of vaccinated children to that of unvaccinated children. Yet such a study — if its results supported the government’s position — would settle the issue for most parents who now resist vaccinating children.
Government granting agencies avoid funding research that might arrive at unwanted conclusions. Knowing this, scientists tailor their grant applications accordingly, leading to what a Rutgers University study called self- censorship and “‘a chilling effect’ on the production of new science.” The study concluded that “political controversies can shape what scientists choose to study. Debates about the politics of science usually focus on the direct suppression, distortion, and manipulation of scientific results.”
Political bias intrudes even when research subjects aren’t taboo. Pancreatic cancer kills as many people as prostate cancer, but gets less limelight and so less government funding — about one- ninth as much. It gets less interest from top researchers, too, since they tend to gravitate to fields with funding. Measured on the basis of research dollars spent per death or disability, many diseases get short shrift only because they don’t have celebrities or highprofile events making them seem worthy in the eyes of politicians.
The obvious solution is to get government out of the medical research business. Let pharmaceutical companies, universities and research-oriented NGOs fund their research themselves. Alternatively, governments could let citizens direct research funds, say through the income tax forms, which could allow taxpayers the option of sending a portion of their taxes to a health body they trust. Families of pancreatic cancer victims would then have the same clout as families of prostate cancer victims in seeking a cure to a disease affecting them, and abortion or vaccine research wouldn’t depend overwhelmingly on the preferences of the government in office.
THE POLITICIZATION OF RESEARCH FUNDING IS PERVASIVE AND PARAMOUNT IN DECISION-MAKING.