Federal Research Funding Supports Advances in Medical Research
The National Institutes of Health (NIH) is one of the world's foremost medical research centers, and the federal focal point for medical research in the U.S. It provides grants and contracts to support research in over 2,000 research institutions in the U.S. and abroad, and conducts more than 2,000 research projects in its own laboratories. NIH grants have also trained a host of scientists in its intramural programs and supported the training of hundreds of thousands of scientists at universities and medical schools around the country through research grants. The list of those scientists who have received NIH support over the years includes 106 Nobel Laureates, five of whom made their prize-winning discoveries in NIH laboratories. NIH reports a number of scientific advances supported by its research dollars, including:
* Improved understanding of heart disease. In 1948, NIH inaugurated the Framingham Heart Study, a project to identify the common factors or characteristics that contribute to cardiovascular disease (CVD). At the time, little was known about the general causes of heart disease and stroke, but the death rates for CVD had been increasing steadily since the beginning of the century and had become an American epidemic. Over the years, careful monitoring of the Framingham Study population has led to the identification of the major CVD risk factors - high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity. Since its inception, the study has produced approximately 1,200 articles, making the concept of CVD risk factors integral to the medical curriculum. This has led to the development of effective treatment and preventive strategies in clinical practice.
* Chemotherapy as a standard treatment for cancer. Work done during the 1950's and 1960's by NIH researchers led to the development of the first successful cures for a leukemia. This played a major role in establishing chemotherapy as a standard cancer treatment.
* Cigarette - lung cancer link. In the late 1990's, researchers supported by NIH found the first direct biological link between cigarette smoking and lung cancer. Scientists had long associated cigarette smoking with lung cancer, but this discovery uncovered the molecular basis for how smoking leads to lung cancer.
* Breast cancer treatment validation. In the mid-1990's, researchers supported by NIH showed that women at high risk of developing breast cancer who took tamoxifen had 49 percent fewer cases of breast cancer than those who did not. Tamoxifen has been hailed as the first drug to prevent breast cancer in women at high-risk for the disease.
* Anti-cancer drug. In 2001, NIH funded the lion's share of the basic research that eventually led to the discovery and development by the drug company Novartis of a new drug known as Gleevec. It is the first anti-cancer drug specifically developed to target a molecular problem that causes a particular type of cancer, in this case, chronic myelogenous leukemia (CML).
* Searching for a diabetes treatment. In 2002, scientists at NIH and the University of Texas Southwestern Medical Center successfully used the hormone leptin to treat patients suffering from lipodystrophy, a rare and difficult to treat disorder that shares some of the characteristics of typical type 2 diabetes. Diabetes is the sixth leading cause of death in the U.S. and is responsible for $92 billion in direct medical costs per year.
* Epilepsy treatment. In the early 1990's, NIH scientists helped to develop a major new drug for epilepsy, felbamate, that is safe at high doses and does not have side effects commonly associated with other antiepileptic drugs.
* Decrease in Sudden Infant Death Syndrome. Between 1992 and 1996, the rate of Sudden Infant Death Syndrome (SIDS) dropped by 38 percent. Much of that drop was likely due to a 66 percent decrease during the same period in the number of U.S. infants being placed to sleep on their stomachs. The Back to Sleep Campaign, a national campaign that encourages infants to be placed to sleep on their backs, was launched by the National Institute of Child Health and Human Development (NICHD) in partnership with several other organizations in 1994.
* Advances in rubella detection and prevention. In the 1960's, NIH researchers developed the first licensed rubella vaccine and the first test for rubella antibodies that was practical for large scale testing (rubella hemagglutination inhibition test). Deaths from rubella have decreased 99 percent since the vaccine became available.
* Juvenile typhoid vaccine. In 2001, NIH researchers and others supported by NIH developed and tested the first vaccine capable of protecting children ages 2 to 5 against typhoid fever. Seemingly the most effective typhoid vaccine ever developed, it is also virtually free of side effects. About 16 million people worldwide develop typhoid each year, and 600,000 die from the disease.
* Mother-infant HIV transmission treatment. In the late 1990's, researchers supported by NIH demonstrated an affordable and practical strategy for preventing transmission of the HIV virus from mother to infant. A single oral dose of the antiretroviral drug nevirapine given to an HIV-infected woman in labor and another to her baby within three days of birth reduced the transmission of virus by half compared with a similar short course of AZT.
* Smallpox vaccine dilution trial. In 2002, an NIH-supported clinical trial demonstrated that the existing U.S. supply of smallpox vaccine - 15.4 million doses - could successfully be diluted up to five times and retain its potency, greatly expanding the number of people it could protect from the contagious disease.
* Staph bacteria vaccine. In 2002, NIH scientists and the company Nabi developed the first successful vaccine against Staphylococcus aureus, a major cause of infection and death among hospital patients. Recently, researchers have discovered strains of the bacteria that are resistant to the antibiotics used to treat them, making a preventive vaccine critical.
* Urinary incontinence treatment. In 2002, researchers supported by NIH showed that rural older women with urinary incontinence (UI) could use behavioral changes, such as bladder training, and pelvic muscle exercises with biofeedback, to reduce their UI severity by 61 percent. UI is a leading reason for people in rural areas to move to a nursing home, and controlling it leads to a better quality of life and allows people to remain in their homes longer.
The National Institutes of Health is not the only source of federally-funded advances in medical technology. A number of other federal agencies, including the National Aeronautics and Space Administration (NASA) and the National Institute of Standards and Technology (NIST), have supported research that has improved public health in the United States and around the world.
* Advances in medical laser technology. Laser technology that originated in NASA's satellite-based atmospheric studies in the mid-1980s has been applied to a variety of medical fields. NASA-developed switching technology, for instance, was used to produce a uniform controllable laser beam maintained at a low working temperature. Lasers of this type are being used to correct myopia (nearsightedness) and to perform laser angioplasty, which vaporizes blockages in coronary arteries.
Laser angioplasty is helping to prevent cardiac arrest with a success rate of 85 percent at opening blocked arteries. At the same time, this procedure positively impacts patients' recovery time, costs and productivity. The same type of technology allows medical facilities, in a one-minute procedure, to correct myopia. According to NASA there are an estimated 60 million nearsighted Americans who will not need glasses if they undergo this procedure.
* Breast biopsy system. Technology developed at NASA's Goddard Space Center for the Hubble Space Telescope in 1997 has found a new application in breast biopsies. A high technology silicon chip converts light directly into electronic or digital images that can be manipulated and enhanced by computers. Known as stereotactic core needle biopsy, the procedure is performed under local anesthesia with a needle instead of a scalpel, leaving a small puncture wound rather than a large scar.
Recent statistics from the American Cancer Society show that approximately one in nine women in the United States will develop breast cancer at some point in their lives. This new technique, which is replacing surgical biopsy as the method of choice in many cases, is saving women pain, scarring, time, and money. Compared to traditional surgery, the new procedure is just as effective and can be performed in a physician's office for about one-quarter the cost. NASA estimated in 1997 that this procedure would reduce national health care costs by about $1 billion a year.
* Advanced pacemaker. In 1969, NASA and the Applied Physics Laboratory of Johns Hopkins University began working with private industry to apply NASA-developed aerospace technology into pacemakers. Through this collaboration, technology originally designed for two-way communication with satellites has been used since 1997 as a means of communicating with and reprogramming pacemakers without the need for further surgery. Additionally, space microminiaturization technology and spacecraft electrical power system technology have been applied to produce the first single-chip pacemakers with rechargeable, long-life batteries.
Pacemakers help people with heart rhythm disorders live longer, more productive lives. According to NASA, by the late 1990's, the U.S. pacemaker market totaled over $1 billion annually and was on a trajectory to continue growing at a rate of 8 percent annually.
* New DNA biochip technology. While working on a project to develop advanced biosensors in 1994, scientists at the Department of Energy's Oak Ridge National Laboratory developed a DNA diagnostic biochip. The hand-sized device, which uses less blood than current procedures, may eventually be used to diagnose diseases such as AIDS, cancer and tuberculosis in the doctor's office without the need for a separate testing facility.
According to NASA, many drugs work on less than 50 percent of all patients and there are approximately 100,000 deaths each year in the US resulting from the adverse effects of medication. Biochip technology will support more specific diagnostics, prediction of response to drugs, and safer, individualized medication.
* Infrared Thermometer. NASA's Technology Affiliates Program seeks to improve the competitiveness of American industries by facilitating the transfer of government-developed technology to the private sector. Through this program, technology initially used to view and measure the emitted infrared radiation from planets and stars was refined in the late-1980's and early-1990's to develop the infrared thermometer. This almost instantaneous method of taking body temperatures, introduced to the commercial market in 1990, is easier and much faster (1 second as compared to 30 seconds) than previous oral or rectal methods.
According to NASA, the economic potential for the thermometer worldwide for acute care hospitals is approximately $126 million a year. A roughly similar value is predicted for sales to alternate care facilities, such as clinics, physician's offices, and nursing homes as well as to individuals. Furthermore, infrared thermometers save considerable valuable time for hospital personnel and are less intrusive to the patient.
* Advances in dental technology. In the late 1920's, laboratories at the National Institute of Standards and Technology (NIST) began what continues to be a collaboration with the American Dental Association to develop, refine, and generally improve medical practice through the invention of new dental materials, tools and methods. One of the more significant advances to come out of this collaboration was the introduction in the late 1950s of new polymeric and mineral-based materials for aesthetic tooth restoration and the development of metallic alloys for amalgams.
Over the past four decades, American dentists have made hundreds of millions of restorations with these dental polymers. It was estimated in 1987 that the increased durability of composite restorations, and thereby the reduction of replacement costs of previously used materials, saved Americans more than the combined appropriated budgets of NIST, the ADA, and the National Institute of Dental Research. The U.S. market for these products is now $163 million per year (American Dental Association, National Institute of Standards and Technology, and Strategic Dental Marketing Corp.).
