Lunch Panel: A Cure for What Ails Us: Celebrating the Impact of Science

Historical Context & Impact of Bioscience:

• Worldwide life expectancy rose from 26 years (1800) to 31 years (1900), but has now reached 67 years globally and nearly 80 years in the U.S.
• In 1900, one in five children in America died before age five; this rate has drastically declined due to sanitation, vaccines, and antibiotics.
• The Human Genome Project (13 years, $3.8 billion investment) has begun revolutionizing the diagnosis, treatment, and prevention of over 4,000 genetic diseases.
• Bioscience investments generated an economic impact far exceeding the original investment and created thousands of jobs.

Current Funding Challenges & Trends:

• Since March 1998, the U.S. has made an incremental $200 billion investment, but adjusted for inflation, actual investment in biosciences has decreased.
• NIH grant success rates have plummeted from an average of one in three over 50 years to well under 20% in the last 10 years due to flat budgets and inflation.
• Recent sequesters removed $1.7 billion, causing grant success rates to fall to approximately 10% or less for new applicants.
• Young scientists are currently constrained by funding cuts, with many questioning their ability to sustain careers in research.
• The cost of obesity and lifestyle-related disease in the U.S. is estimated at $1 trillion annually.

Specific Medical Breakthroughs & Case Studies:

• Polio: Cases dropped from 350,000 globally in 1988 to 650 in 2011 and 223 in 2012; eradication is currently limited to three countries.
• HIV/AIDS: PEPFAR treats 5.3 million people globally and prevented over 230,000 babies from being born with HIV last year.
• Cystic Fibrosis: Discovery of the gene in 1989 led to the FDA approval of Kalydeco in 2012 for 4–5% of patients; drugs are in trials to cover 90% of cases.
• Pancreatic Cancer: A 15-year-old inventor developed a test detecting early-stage pancreatic cancer with 90% accuracy at a lower cost than existing methods.
• Rare Disease Diagnosis: Genomic sequencing identified a single-letter genetic error in the Berry twins (unable to synthesize dopamine/serotonin), allowing dietary intervention that restored their mobility.

Strategic Initiatives & Future Outlook:

• Brain Initiative: A partnership between NIH, NSF, DARPA, and private foundations to map brain circuits, focusing on a decade-long effort to understand complex neural structures.
• NCATS Establishment: The National Center for Advancing Translational Sciences was created to reduce the average 14-year drug development pipeline and the 99%+ failure rate.
• Universal Flu Vaccine: Clinical trials are underway for a vaccine targeting the invariant stem of the hemagglutinin protein to provide broad protection against all influenza strains.
• Global Health Capacity: CDC and FDA have expanded offices in China, India, and other regions to build global surveillance capacity and facilitate data sharing.
• Regenerative Medicine: Interest is growing in 3D printing and stem cell research to regenerate cardiac tissue and organs, potentially eliminating the need for transplants.

Leadership Statements & Decisions:

• Francis Collins (NIH): Emphasized that while innovation potential is high, the "uneasiness" regarding resources for the next generation of scientists is a critical threat to American leadership.
• Tom Frieden (CDC): Stated that "public health is purchasable" and warned that millions of lives could be saved if the U.S. invests in prevention rather than just treatment.
• Nancy Brown (American Heart Association): Highlighted that fewer than 1% of Americans have "ideal cardiovascular health" and called for environmental changes to reverse lifestyle-driven health crises.
• Andy von Eschenbach: Called for "conceptual collaboration" to integrate diagnostics and therapeutics, noting that complex diseases require multi-sector solutions.
• Consensus: All panelists agreed that the U.S. must maintain its commitment to bioscience to avoid losing economic growth (cited as >50% of U.S. growth) and global health leadership.

Disagreements & Tensions:

• There is a stark tension between the urgent need for funding (especially for young investigators) and the reality of budget cuts, sequesters, and inflation.
• The U.S. faces a competitive challenge as India and China significantly increase their bioscience funding, potentially altering the U.S. role in global innovation.
• While prevention is universally cited as the goal, the speaker noted that 90% of current spending still goes toward treatment and care rather than wellness.