The 20th and 21st centuries have arguably been the “Golden Age” for science in the US and other developed countries. Within a generation we have gone from people routinely dying as a result of simple bacterial infections to the power of antibiotics in preventing most deaths. We have gone from polio, smallpox and even chickenpox to vaccinations that largely eliminate disease in immunized people. Even many dreaded types of cancers are slowly becoming, in some cases, manageable diseases with the advent of new therapeutics, including the remarkable new chimeric antigen receptor T cell therapy (CAR T) that is based on taking a patient’s T lymphocytes and engineering them to express a protein that selectively attacks the patient’s cancer cells—before returning them to the patient’s bloodstream to take on the cancer cells in battle.
There may be no “magic bullet,” but torrents of sticks and stones, along with researchers who are determined to better understand our natural world, are steadily improving human health. If there had been similar advances (to those in biomedical research and science in general) in preventing war, terror, and discrimination over the past hundred years, the world would be an infinitely better place to live in—as we generally live longer and healthier within it.
Despite these dramatic advances, I am convinced that the public lacks a crucial appreciation of the value of science and scientific research, and just as importantly, there is a lack of understanding how scientific research works. What evidence is there for these claims of mine? First, the White House and administration have been calling for massive (20%!) cuts to the National Institutes of Health, the chief funder of biomedical research. Fortunately, bipartisan support for research in congress has rebelled against these calls and continued its support for science. But now a new proposal threatens science and research from another angle.
Senator Rand Paul (R-Kentucky) has introduced a new bill (S. 1973, The Basic Research Act) that proposes to fundamentally alter grant review at both the National Institutes of Health (NIH) and National Science Foundation (NSF). What is he proposing? That on every grant review panel there be two additional “reviewers:” one who is outside the general field of research who would independently judge which fields are most worthy of funding, while the other panel member would be a “taxpayer advocate” who would be there to ensure that “there’s no silly research that the government has no business funding going on.” Worse yet, for the NSF, there would be a new “Office of the Inspector general and Taxpayer Advocate for Research” that would randomly sift through top-rated proposals that were reviewed to decide if these proposals “deliver value to the taxpayer,” and this office would have absolute veto power over funding of any NSF proposal.
The senator’s proposed bill threatens to seriously undermine and damage the grant review system and research in this country. It is agreed by most researchers that our peer review system isn’t perfect. Just as democracy isn’t perfect (trust me, look at what happens when an intellectually and emotionally unfit person is elected to the highest office). But despite being imperfect, the peer review system still works—even under the highest levels of stress. As a reviewer at NIH, I frequently see that reviewers independently manage to identify strong grants and weak grants. There are relatively few disagreements; where it becomes trickier is separating the very good from the excellent. Can reviewers really discern between a grant that is in the top 8% compared to the top 14%? And are these comparisons mostly subjective? Despite these issues in grant review, which are worsened by insufficient funding in the system (if the top 25% of grants were all funded, these would not be concerns), reviewers do a good and thankless job overall.
Why is Senator Rand’s proposal so damaging to scientific research? Because it illuminates his own ignorance of science and the scientific process. It characterizes his misunderstanding of how scientific advances are made. It ignores the principle that science is built brick-on-brick, and goes from fundamental understanding to applications for diseases. It ignores centuries of knowledge beginning with Darwin, demonstrating that humans are part of an evolutionary ladder, and fails to realize that lower organisms are frequently a very useful tool for scientists to understand how humans function—at physiological, cellular, molecular and atomic levels.
Without basic studies on proteins, their structure and function (would the taxpayer advocate care about protein structure?)—how would we be able to engineer vaccines? Without genetic engineering—coming from the study of bacterial enzymes (would the taxpayer advocate care about bacterial enzymes?), would we be able to edit DNA in cells and reprogram enzyme production in children with human enzyme deficiencies? Without the very same genetic engineering techniques (and again, would the taxpayer advocate care about these things?), we would never have been able to produce insulin for diabetics.
Another fine example: would the taxpayer advocate have thought that it was worth the taxpayers’ money to study how bacteria can acquire resistance to bacterial pathogens (called bacteriophages)? These studies ultimately led to the CRISPR/Cas9 method for targeted gene editing, opening a new era in molecular biology, leading to over 20 new clinical trials to ‘correct’ defective human genes, and likely on route to future Nobel prizes.
The public needs to be better educated about how scientific discoveries are made so that people understand that science is not a parochial system. It is not nationalistic. It is global. One discovery leads to another. There are no artificial boundaries, and science cannot be lumped into useful and wasteful categories. Often times bizarre findings in one field can have a huge impact on another. The identification of enzymes from bacteria at Yellowstone hot springs—enzymes that are resistant to high temperatures—led to revolutionary advances in molecular biology and genetic engineering, and have been the foundation of much of modern medicine. So the public needs to be better educated about how science actually works—so that it refrains from electing senators who threaten the advance of science and biomedical research through their ignorance.