Francis Collins, director of the National Institutes of Health, administered a dose of truth to political Washington last week.
For this honest service, Collins was pilloried.
In an interview, Collins shared with the Huffington Post’s Sam Stein his belief that, if not for recent federal spending cuts, “we probably would have had a vaccine in time for this” Ebola outbreak.
This should not be controversial. His conjecture was based on cold budgeting facts. NIH funding between fiscal year 2010 and fiscal year 2014 had dropped 10 percent in real dollars — and vaccine research took a proportionate hit. Research on an Ebola vaccine, at $37 million in 2010, was halved to $18 million in 2014.
Officials at the National Institute of Allergy and Infectious Diseases report that budget cuts forced them to shelve 14 Ebola-related grants, roughly a quarter of the total. NIH was forced to prioritize spending to react to the most pressing current threats rather than potential ones, and because there was little Ebola activity at the time, shifting money to Ebola from, say, cancer or Alzheimer’s research wasn’t a viable possibility.
With Ebola vaccines now entering clinical trials, it’s not much of a stretch to conclude that, with those extra research dollars, vaccines would now be on the market — potentially saving thousands of lives in Africa and avoiding panic in the United States.
Yet conservatives pounced. Commentator Michelle Malkin’s website, “Twitchy,” called Collins a “fool” (this fool previously led the mapping of the human genome) and assembled tweets saying the Ebola vaccine could have been paid for with money spent on President Obama’s vacations or the White House vegetable garden, among other things.
Republican candidates have begun making a campaign issue of waste at the NIH and its sister agency, the Centers for Disease Control and Prevention. “Have you seen what the NIH spends money on?” Sen. Rand Paul, R-Ky., asked, mocking Collins’ claim at a rally I attended Wednesday. “$117,000 spent to determine that most monkeys are right-handed, and like to throw poop with their right hand, apparently. $2.4 million of the NIH dollars was spent on origami condoms.”
The senator, who then proposed more budget cuts, ought to update his examples. The right-handed monkey study? Done between 1992 and 1997. Origami condoms? The new device worn by women could protect millions, particularly in Africa, from AIDS. But perhaps Paul, an ophthalmologist, thinks that’s frivolous.
Collins, an evangelical Christian, was aghast that his remarks “turned into this really nasty political outcome that has resulted in attacks on NIH,” he told me. “People are saying I’m overstating the circumstances, which I don’t think I am.”
Collins said he was equally appalled by an ad last week by the liberal Agenda Project Action Fund that juxtaposes Republicans saying the word “cut” with images of Ebola carnage. “Republican Cuts Kill,” it concludes.
Collins sees his beloved NIH falling into the gaping maw of politics that has consumed most everything else. “I’ve tried so hard in the 21 years I’ve been at NIH,” he said, “to keep medical research from becoming a partisan issue.”
Even hard-core libertarians tend to agree that medical research and public health, like national defense, are among the few things that should be a federal responsibility. Eric Cantor, the recently deposed House majority leader, made a big push for government funding of medical research.
But while NIH funding grew steadily over the years, it leveled off at $28 billion in 2004 and was at $29.3 billion in 2013. When you factor in medical inflation, NIH’s purchasing power is down 23 percent over that period.
Collins admits it’s a mistake to think “throwing money at a medical problem automatically results in breakthroughs.” But there are a few major research projects on the cusp of success that could bring financial benefits far beyond the cost.
NIH-funded researchers are “a few years away,” Collins said, from a universal flu vaccine that could protect people against virtually all strains without the need for annual shots. Yearly flu epidemics suck an estimated $87 billion out of the U.S. economy and can claim tens of thousands of lives; a pandemic strain could be much worse.
Who, of any political philosophy, would say it’s not worth $121 million — and more — for a universal flu vaccine?
Who would say, given the economic catastrophe that an Ebola outbreak could cause, that spending tens of millions more for an Ebola vaccine is wasteful?
Only a fool.
Dana Milbank is a columnist for The Washington Post.
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