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With all due respect, although we as a society can afford to fund all the research money can buy, we are stuck with what we can influence Congress to spend on it, and that has to get divided among some 500+ diseases and non-disease specific basic research. To date no one has come up with agreed upon criteria for doing this. I would think such criteria would include things like the number of people having the disease, whether the disease is fatal, whether the disease is contageous, economic cost to patients and society, amount of pain and suffering, amount of research supported privately, amount of money researchers can use well, making up for past underfunding, number of birds that can be killed with one stone, and probably more. Until we have such criteria, there is little basis for any statement that one disease deserves more funds than another. When a construction contractor does an estimate, he/she estimates each part of the job, then adds it all up. To arrive at a research funding allocation which is fair, we would need to do something like 1. In general, identify all the relevant factors affecting priorities; 2. Determine how these translate to dollars; 3. Assign a relative weight to each factor or otherwise determine how it all should fit together; and 4. Get general agreement on all the above. Then for each disease or for groups of like diseases, quantify for each factor and take the total. Perhaps this sounds like bean counting, but it would yield a result which is based mostly on data, not emotion or politics, and that, I would argue, is fair. How else would you do it and not leave a lot of disagreement in the wake? The NIH is about to schedule a meeting open to the public on the subject of public input to setting research priorities. This will be a followup to the Sept. 23 meeting on NIH communication with the public, about which see http://www.nih.gov/news/NIH-Record/10_20_98/story01.htm. If it is anything like the Sept 23 meeting, there will be invited participants from among private individuals who have had on-going positive relationships with NIH, and the public in the audience will not be allowed to participate, just observe. I believe, however, that written comments can be sent to the NIH Office of Communications. This might be the time to get one's thoughts on this subject in order. It looks like a good window of opportunity to influence NIH research priority setting. I hope the PD organizations are preparing for it, but I am not aware of this. All of the above is a distinct from such issues as the degree to which we should fund research for the rest of the world, and whether people should be financially responsible for their illnesses in some proportion to their own contribution to them. Phil Tompkins Hoboken NJ age 60/dx 1990