Editor’s Note: This is a commentary on Myers ER, Alciati MH, Ahlport KN, Sung NS. Similarities and differences in philanthropic and federal support for medical research in the United States: An analysis of funding by nonprofits in 2006–2008. Acad Med. 2012;87:1574–1581.
The nation’s deficit and its struggle to reduce discretionary spending, as well as the restructuring and downsizing of the research and development efforts of much of the pharmaceutical industry, threaten to limit resources for biomedical and health research in the coming years. Given the current landscape, support from the philanthropic sector is more critical than ever, not as a substitute for government or industry funding but to provide some of the much-needed “risk capital” to stimulate innovation, help translate basic research findings into clinical applications, support junior, unproven investigators, build new infrastructure, and help fill key funding gaps. In addition to the dollars it provides, the philanthropic sector’s diversity of approaches, independence from political and for-profit pressures and constraints, and ability to make long-term investments that support both people and build infrastructure have made philanthropic organizations critical partners for academic health centers.
Beginning in the first half of the 20th century with efforts like the leadership role of the March of Dimes (formerly the National Infantile Paralysis Foundation) in the development of a polio vaccine, the philanthropic sector has been pivotal in fostering scientific breakthroughs that have improved health. Today, the philanthropic sector is composed of over 80,000 foundations, tens of thousands of voluntary health agencies or public charities, private research institutes, and other organizations. Although the sector’s scope and diversity are some of its great strengths, they make tracking the philanthropic sector’s health research investments difficult. Research!America’s yearly analysis of U.S. investments in health research1 includes an estimate of the philanthropic sector’s contributions, but more detailed and comprehensive data are needed to better understand where gaps exist, what works, and where further investment and advocacy efforts would have maximal benefit. To begin to address this issue, the Health Research Alliance (HRA), a consortium of nonprofit funders of biomedical research and training, has created a comprehensive database of the research and training grants supported by its member organizations. The report by Myers et al2 published in this issue of Academic Medicine provides the first analysis of the HRA’s data on grants awarded by its members between 2006 and 2008. During this three-year period, 32 HRA member organizations committed $4.5 billion to health research. Although this investment is only 5.1% of the $87 billion budget of the U.S. National Institutes of Health during the same period, the impact of these funds has been significant.
Of the 9,934 grants that HRA members funded during this period, 43% were research project grants and 30% were grants focused on expanding the pipeline of investigators by supporting early career grants, fellowships, and institutional training programs. HRA members collectively funded grants to institutions in 49 of the 50U.S. states. Eighty-eight percent of these HRA research funds came from disease-specific organizations that raise public funds. Some of the research grants of disease-specific organizations like the Alzheimer’s Association, the Juvenile Diabetes Foundation, the Children’s Tumor Foundation, and the Multiple Myeloma Research Foundation supported consortia or networks of researchers that foster data sharing and focus on specific targets or tasks essential to developing new therapeutics and diagnostics for their patient groups. These organizations help bridge the “valley of death” between academe and pharmaceutical and biotechnology companies by funding translational research and early-stage clinical trials, establishing patient registries and tissue repositories, and aiding in the recruitment of patients into clinical trials.
What are some of the success stories resulting from the $4.5 billion in philanthropic investments of the 32 HRA organizations during this period? Milestone-driven research supported by the Multiple Myeloma Foundation has significantly increased the pipeline of potential multiple myeloma drugs under development. Pathbreaking research on neural stem cells supported by the Foundation Fighting Blindness laid the groundwork for the recent clinical trial, approved by the Food and Drug Administration, to use neural stem cells to treat patients with age-related macular degeneration. The Alzheimer’s Association’s support of research and consortia like the Alzheimer’s Disease Neuroimaging Initiative has led to a better understanding of the physical changes that occur in individuals with mild cognitive impairment and Alzheimer’s disease. Other organizations, like the Burroughs Wellcome Fund and the Doris Duke Charitable Foundation, have focused many of their resources not on a single class of diseases but on strengthening the pipeline of researchers able to translate basic research findings into clinically relevant observations and on supporting interdisciplinary research pertinent to a variety of disease states. An example of interdisciplinary translational research supported by the Burroughs Wellcome Fund and the Doris Duke Charitable Foundation, as well as the Howard Hughes Medical Institute, is the work of Dr. Joe DeRisis and his colleagues to develop and test a pan-viral microassay referred to as the Virochip as a diagnostic for human diseases.3 The Virochip played an important role in identifying the virus causing severe acute respiratory syndrome, which first emerged in Hong Kong and quickly spread to China, Toronto, and other sites in 2003. Expanding on its long-term strategy of providing stable support to outstanding investigators, the Howard Hughes Medical Institute also devoted considerable resources to establish Janelia Farms, an innovative research facility opened in 2006 to foster long-term, interdisciplinary, high-technology research on challenging scientific problems that would be difficult to pursue with standard grant mechanisms.
These are just a few examples of the many contributions that the HRA’s member organizations made to health research between 2006 and 2008. Myers et al estimate that the HRA data represent 40% of the U.S. philanthropic sector’s investments in health research for this period. Even though the HRA data do not give a complete picture of the philanthropy sector’s contributions to health research, those data are a welcome addition to our knowledge about that important sector. We congratulate the HRA on establishing its new database, and we encourage the HRA to expand thedatabase to collect and share even more data on its members’ grants (such as the duration of different types of grants, age of grantees, and, if possible, output or outcome data on grantees) as well as to include data from non-HRA members in its database. At a time when U.S. investments in health research are likely to be stagnant at best, comprehensive, timely data on the investments in health research from all sectors—government, for-profit, and philanthropic—will enable the community to better monitor trends and identify gaps so that future dollars can be targeted to where they are needed most.
Other disclosures: None.
Ethical approval: Not applicable.
2. Myers ER, Alciati MH, Ahlport KN, Sung NS. Similarities and differences in philanthropic and federal support for medical research in the United States: An analysis of funding by nonprofits in 2006–2008. Acad Med. 2012;87:1574–1581
3. Chen EC, Miller SA, DeRisi JL, Chiu CY. Using a pan-viral microarray assay (Virochip) to screen clinical samples for viral pathogens. J Vis Exp. 2011;(50):2536 Published online 2011 April 27. doi: 10.3791/2536