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A self-inflicted crisis in biomedical research could delay discoveries and cures for years
American medical research, a crown jewel of the world scientific community, faces a profound crisis in the age of COVID-19. Without policy changes by the federal government, the academic biomedical research sector could be hobbled for years to come and could lose its competitive edge to other nations.
Over the past six months, medical researchers have been battered by a triple blow. First, most clinical trials in the United States came to a halt to protect participants and staff from COVID-19 infection. Then, academic hospitals and medical centers, financially crippled by the pandemic, dramatically cut back on research funding. Finally, the Trump Administration stopped issuing visas to foreign scientists, cutting off a wellspring of talent on which American research teams depend.
"It is the most turbulent time for academic biomedical and clinical research you can possibly imagine," said Paul Glimcher, Julius Silver Professor of Neural Science at New York University's Grossman School of Medicine. "We have seen a freeze in cutting edge research on everything from cancer to depression to Alzheimer's disease. In the longer term, funding cutbacks for exploratory research and restrictions on immigration could put limits on our ability to create new cures and new jobs and to compete on the world stage."
The United States has long been considered the world's leading center of medical research and innovation. The industry supports hundreds of thousands of jobs at universities, academic medical centers, and companies across the country. It provides trillions of dollars of value in everything from foreign exports to increased longevity.
With the onset of the pandemic, thousands of clinical trials, totaling 80 percent of non-COVID trials, were stopped or interrupted. And many researchers turned their attention solely to the development of COVID-related treatments and vaccines.
In the private medical research sector alone, nearly 100 companies and 240 trials have experienced disruptions. Pharmaceutical manufacturers like Eli Lilly, Merck, and Pfizer all announced delays in enrollment for ongoing studies and initiation of future studies.
At hospitals and health systems, the American Hospital Association estimates a total financial impact of $202.6 billion in losses between March and June of this year from a drop in elective procedures and an array of increased costs for staff support, emergency equipment, and treating COVID-19 patients. One result has been a dramatic drop in funding for academic research from hospitals and health systems.
"Laboratories have been closed," Michael Lauer, the deputy director for extramural research at the National Institutes of Health recently said to The Lancet. "Communications have been shut down, conferences have been canceled, supply chains for equipment have been lost, resources have been lost. There have been widespread financial losses within academic medical centers that have spilled over onto their research operations."
Altogether, the impact could last for years.
Certainly, private pharmaceutical companies with access to capital will eventually be able to resume clinical trials. And the federal National Institutes of Health continues to play its role as the largest source of funding to academic researchers. But these factors alone are unlikely to stem all the damage.
Perhaps most harmful to the long-term health of biomedical research is the Trump administration's irrational decision to crack down on visas for highly trained scientists and technicians from other nations. It would cause a deep and self-inflicted wound.
In June, President Trump suspended new work visas and barred hundreds of thousands of foreigners from seeking employment in the United States. This represents part of a broad effort to limit the entry of immigrants into the country and provide Americans with more jobs. The ban will affect tens of thousands of scientists and technologists.
However, more than 45 percent of scientists and engineers working in the United States with doctorates were born abroad. To Glimcher, the New York University professor and researcher, the effect of anti-immigration rhetoric and actions have been devastating.
"For every one foreign PhD we hire, we create four jobs for American citizens," said Glimcher. "But we can no longer hire top PhDs, people who would have immigrated to the United States and who would have happily become U.S. researchers for the rest of their lives. It is no secret that, as a result, we will see Europe and China play more of a dominant role in global medical research."
Saving biomedical research from a decline in the United States requires quick and effective federal action. Congress should fund academic medical centers to make them whole for the losses they have sustained due to the pandemic. In addition, the next Trump or Biden administration should put an end to the visa ban and other anti-immigrant policies that prevent or dissuade foreign scientists from working here.
Finally, the National Institutes of Health, which has nobly continued its funding of scientific research, must be protected from the kind of controversies that have enveloped the Centers for Disease Control and the Food and Drug Administration. Despite attempts by the Trump administration to cut its funding, Congress has protected the NIH. It must continue to do so since its funding is a lifeline line to biomedical researchers at a time when this crucial American intellectual asset is critically under siege.
Peter Kerr is the president of Ulysses Communications and a former reporter for The New York Times.