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As a result of its work since 1940, the AFMR believes firmly thatimproving clinical research in the U.S., which weakened significantly duringthe Bush administration, is a lynchpin to achieving sustainable change in theU.S. health care system. The AFMR pledges the full support of its humanresources, medical expertise and scientific knowledge to Mr. Daschle and theObama administration for the advancement of clinical research, including itsleading U.S. physician members and Nobel laureates who have made significantcontributions to modern medicine and patient care through clinical research.
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"Medical science and the U.S. health care system cannot progress withoutclinical research," said Dr. Alan Buchman, president of the AFMR and aprominent physician in gastroenterology. "Yet our nation has neglected theadvancement of clinical research -- that which involves patients directly-- which can prevent disease, lead to more effective disease treatments,medical breakthroughs for chronic diseases, and cut the astronomical costs andinefficiencies that plague our health care system. Mr. Daschle has theopportunity to fix this fundamental issue early on, which will have anenormous positive ripple effect on the rest of the health care system," saidBuchman.
The U.S. clinical research crisis stems from two primary issues:1) Federal budget cuts for the NIH, particularly in funds spent on clinicalresearch and the education and training of future clinical investigators andphysician-scientists, and 2) Lack of support for future physician-scientists,whose job it will be to bring modern medicine and quality patient care tofuture generations.
According to the Centers for Disease Control and Prevention, chronicdiseases account for seven out of 10 deaths in the U.S. and for 75% of everyhealth care dollar spent each year. Yet federal funding for clinical researchhas decreased in recent years, and funding that has been apportioned, has gonemainly to basic research rather than clinical research - the only kind ofresearch that generates disease-specific breakthroughs and patient treatmentalternatives.
The NIH budget for the current fiscal year, $29.2 billion, represents a$329 million increase over last year, but the actual growth for NIH programsis much less because $200 million of the increase was earmarked for theDepartment of State Global HIV/AIDS fund. When the $200 million is subtractedfrom the budget, the actual increase in NIH programs is reduced to just $133million (0.5%) over last year. It is not yet known how the FY 2009 budgetwill be impacted, although the statement accompanying the signed bill fromPresident Bush indicated his intention to submit an FY 2009 budget proposalthat will "once again restrain spending."
One program impacted by the tightening of the NIH budget is the ClinicalTranslational Science Award program (CTSA) -- the NIH-supported clinicalresearch program intended to speed the translation of scientific discovery tothe treatment of patients. As a result of the cuts, the NIH is unable to fullyfund the evolution and expansion of the CTSA program, which has become acritical training and research structure for junior investigators.
Another alarming issue is the growing scarcity of human resources in theclinical research field. The current generation of physician investigators isaging rapidly and there aren't enough investigators to replace them becausesupport for new investigators entering the field has decreased significantlyin recent years.
According to the NIH, the average age of physician scientists in 1980 was39. By 2015, the average age is expected to be 52. If action is not takennow, the U.S. will face a critical shortage of qualified physicianinvestigators within the next decade, creating a massive knowledge gap betweenaging physicians and the next generation of physicians.
"The cost of not advancing research and training future physicianscientists is one that will be paid by the entire world. The United States isa global feeder pool of physician scientists," said Buchman. "A furtherbreakdown in clinical research and failure to revitalize thephysician-scientist workforce of the future will impact medical breakthroughs,treatments and critical training throughout the world. The pharmaceuticalindustry cannot be counted on to undertake clinical research alone, and froman economic standpoint, clinical research dollars are being focused away fromthe U.S. and concentrated on China and India."
The AFMR is an international, multi-disciplinary association of physicianscientists engaged in all areas of patient-oriented clinical, translationaland laboratory research. The organization promotes understanding of advancesin the prevention, diagnosis and treatment of disease, facilitates theexchange of ideas and information among physicians and investigators concernedwith the treatment of disease and works to improve public health by fosteringresearch across medical disciplines through public policy initiatives andeducational programs. The AFMR also works to develop future generations ofclinical researchers through its own programs, while encouraging public,private, and governmental investment in such initiatives.CONTACT: Gwendolyn Knapp TOP SHELF Communications & Public Relations 502-265-0216 [email protected]
SOURCE American Federation for Medical Research
