Optimism for science in 2009 (and two budget-saving ideas)

As 2008 ends, I’m feeling very optimistic about the new year, principally because we here in the U.S. have elected Barack Obama, a new President who represents a dramatic change away from the policies of the past eight years. In the scientific arena, the Bush administration has been a disaster in more ways than I care to list. Not only have the Bushies politicized many, many areas of science, but their political views have almost always hindered or reversed progress in important scientific areas. But let’s look forward to the new year and to a new, re-invigorated U.S. science program.

Of course, the Bushies have also saddled us with an enormous debt burden, over $10 trillion dollars by one recent estimate (Harper’s magazine, December 2008). That number is so stunningly large that it might seem to leave no room for optimism – with such a gigantic debt, how can we hope for progress in anything, much less “discretionary” areas like scientific research?

Well, I’m still optimistic, but I know we’ll see little or no increase in the budgets of the U.S.’s top scientific agencies, including NIH, NSF, NASA, NOAA, and others. So here are two constructive suggestions for how to save significant funds at one agency, NIH, without adversely affecting scientific progress.

1. Get rid of the security fence and all the additional pointless security operations at NIH headquarters in Bethesda, Maryland. For those who haven’t visited NIH in the past few years, there is now a high metal fence (operational since 2005) surrounding the entire campus, and an elaborate security screening operation that every visitor must go through. Getting a car onto campus is now nearly impossible – every car has to be searched – and visitors have to plan for at least 20 minutes of extra time to get to their destination. This makes it much more difficult for NIH scientists to have visitors or to host conferences on the NIH campus – and it’s an utter waste of money.

Over at scienceblogs.com, there was an entertaining post on this topic last month by Mark Hoofnagle, who offered the opinion that “NIH security is run by paranoid idiots.” While I can’t say I agree with that sentiment, I share his feeling when he writes, “I hope in the next administration the first thing they do is tear down that stupid fence and treat the NIH like any other academic medical campus.” And if they get rid of all the accompanying security – which is really just “security theater”, as a writer in The Atlantic recently opined – they can save millions (probably tens of millions) of dollars per year.

2. Readers of my blog will probably guess my second cost-cutting suggestion for NIH: eliminate the National Center for Complementary and Alternative Medicine (NCCAM). This center was created at the behest of Iowa Senator Tom Harkin in 1992, not for any scientific reason, but because he personally believed in the efficacy of bee pollen as a medical treatment (see this NY Times article). There was never any need for this – any promising therapy can be studied in one of the existing Institutes, as has happened many times in the past. NCCAM has become a center for a raft of poorly-designed studies that would not pass review at the other institutes. Furthermore, in its 16 years of existence, NCCAM has failed to show that any “alternative” treatment works – the best that I can say about it is that some of its studies have showed that some pseudo-scientific treatments don’t work.

Like many government projects, though, part of NCCAM’s mission now is to perpetuate itself. So one of its major activities is to fund training centers that will educate health professionals in CAM treatments – even though its own studies have failed to show that those treatments work. This is how a government agency perpetuates itself. NCCAM is hopeless: its advisory council is required to include at least half its members from CAM disciplines such as “chiropractic, acupuncture and Oriental medicine. naturopathic medicine and massage therapy” – and when the board recently dropped below that percentage, CAM advocacy groups such as he Integrated Healthcare Policy Consortium and Academic Consortium for Complementary and Alternative Health Care wrote to NIH to complain. These groups are very active in promoting NCCAM, and they will continue to be as long as they make money by offering their various (and ineffective) alternative therapies.

Let’s get rid of NCCAM entirely before it’s too late. Former NIH Director Harold Varmus tried to put more scientific controls on the original CAM office, and Harkin responded with legislation that made NCCAM into a much-larger Center, with a budget that now exceeds $200 million. These funds could be put to far better use elsewhere in NIH. So without increasing the NIH budget, we could effectively increase the funds available for research by eliminating NCCAM.
(Note that others have suggested eliminating NCCAM too – see the excellent article by Wallace Sampson at Quackwatch).

I know that both these suggestions – modest as they are – are unlikely to be followed any time soon. But I will remain stubbornly optimistic that the Obama administration will choose a new NIH Director who has a strong, positive vision for the future of biomedical research, and who will be willing to take on anti-science interest groups – including Senators who want to promote pseudoscience – and start reversing the last eight years of policies. A few weeks ago the Obama administration announced that Varmus will be co-chair of its scientific advisory committee, and Varmus has shown in the past that he’s willing to take on NCCAM. Perhaps with stronger support from the President this time, he and others who agree with him will succeed.