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On the Folly of Big Science

Author: Larry H. Bernstein, MD, FCAP

Principal, Triplex Medical Science

To the reader:

The very to the point and interesting OP-ED in the Sat, Oct 3, New York Times titled “The Folly of Big Science Awards” by Vinay Prasad is of considerable interest for discussing a problem that goes deeper than the awards.

It is a valid and important points that Dr. Prasad makes that the Dickson, Lasker-DeBakey, Canada Gairdner, Breakthrough and Nobel awards are expending significant resources in support for established investigators at the apex of their careers, that there is always a trailing of leading investigations that have anticipated the awards, and that young investigators are currently squeezed by this structure of scientific endeavor.

In a historical perspective, the tradition of major centers of research is at least 200 years old, and it precedes the Nobel Prize. Notable centers of research in Europe were Cambridge, Copenhagen, Italy, Berlin, and several universities in Germany, from which evolved theoretical and experimental physics,
organic and inorganic chemistry, and this had an impact on the basic science requirements for medical education that came from the Flexner Report, and the establishment of Johns Hopkins University Medical School, and the Rockefeller University.  In the evolution of the medical and supporting scientific disciplines there is a long audit trail of top investigators coming through the laboratories of one or more of the most respected laboratories. This is highlighted in Germany by the Kaiser-Wilhelm Institutes. It is important to emphasize the importance of mentoring to the development of young investigators as well as continued support of their career development. The observation is quite impressive that eighty percent of the funding to basic research goes to one fifth of researchers.

The developments in medicine and in preparatory scientific education and research have for a long time aggregate resources to a small number of highly productive centers. This was in part driven by the ties of these centers to major universities and the review committees that serve NIH funding allocation. In addition, there is also a clustering of major centers of discovery and the instrumentation and technical development industries. A major additional funding comes from a select group of billionaires whose support has been essential beyond the dwindling, politically fragile federal support. The large science awards are for recognition, and they follow the course set by the Nobel Prize. There are also Young Investigator awards that are given by professional organizations.

The idea of breaking down the largest awards perhaps needs consideration. However, the most important consideration is to make adequate funding available to promising investigators irrespective of their university affiliation.  That is also complicated by the fact that funding for research belongs to the institution, and not the investigator. I cite the recent lawsuit won by the Scripps Research Institute in a suit filed by an investigator who was recruited from University of California, San Diego (#16) to the Keck School of Medicine at University of Southern California (#47). The funds could not be transferred. An adjacent problem to that described is how funding is directed to established research, and some good research may be squeezed. Only recently has proteomics and metabolomics opened up after the many years of emphasis in biological research on the genome. This occurred because of better understanding of cell signaling and regulatory pathways.

A different problem is that important discoveries may lead to patents, but the cost of development is a multiple of the cost of the patent. Companies that are dominant in the industry might want to buy the patent, but then they might shelve it because it may compete with another method that has not had its return on investment, or they might try to redesign the method with no significant improvement prior to introduction. This is the way the world works.  The United States has become a leader, and it is also the most wasteful in its success.

Larry H. Bernstein, MD, FCAP