Tuesday, October 9, 2007

The rise and fall of the NIH

Monday, the NIH issued a press release touting the fact that two of the three winners of the 2007 Nobel Prize in physiology/medicine were funded by the agency. That's certainly a notable achievement and the NIH deserves praise for having the foresight to recognize the value of the scientists' research several decades before (the NIH funding began in the late 60's/early 70's) it would officially be recognized by the Nobel Prize committee.

The previous business day, however, the NIH issued a release that should cast serious doubt about the agency's scientific credibility and raise questions about where its headed. In the Oct. 5 release, the NIH boasted that it had expanded its
National Center for Complementary and Alternative Medicine to include three new Centers of Excellence for Research on Complementary and Alternative Medicine (CAM).

This is disappointing for at least three reasons and maybe more, but it's late and I'm tired and 3 seems like more than enough.

First, there is no "alternative medicine" or "alternative scientific method" for investigating whether a particular modality has a benefit in treating disease. Something has either been proven to work using established and accepted methods or it hasn't. There isn't an alternative scientific system in some far-flung corner of Dover, Pa., or a parallel universe.

So there is no need for the NIH to segregate out and separately fund so-called "complementary and alternative medicine" therapies. If there are indications any of these strategies actually offer some benefit, the NIH could --and should-- fund research into them via any of its other institutes, using the rigorous --albeit not perfect-- review strategies it already has in place.

Second, the NIH not only appears ignorant of this, they actually tout their commitment to wasting millions of dollars on CAM (the proposed 2008 budget for NCCAM is $121.7 million):
"The addition of these centers ... confirms our continuing commitment to rigorous CAM research," said Ruth L. Kirschstein, M.D., NCCAM Acting Director.

Third, these new CAM centers will be focusing on therapies that are almost certain to be ineffective. How can I say this so confidently? Because they're focusing on diseases, such as pancreatic cancer, multiple sclerosis and Alzheimer's disease, where treatment options are limited or often not effective, meaning any pharmaceutical or biotech company could make a bundle with an effective therapy (The research involves using lycopene (a chemical found in tomatoes) and green tea preparations to treat pancreatic cancer, reservatrol, a grape compound, for treating multiple sclerosis, and another grape compound called polyphenols for preventing Alzheimer's).

If these treatments were so promising, a researcher who was intent on pursuing them would have no problems getting funding through the normal channels of one of the 26 other institutes of the NIH, and it's very likely a pharmaceutical or biotech company would already be busy exploring them or funding the research.

More disturbingly, none of these research pursuits is likely to lead to the types of breakthroughs and widespread implications that get awarded with a Nobel prize decades down the road. And we may never know what kinds of discoveries we've missed out on because legitimate, basic research was not supported, while NCCAM instead squandered millions of dollars on fruitless endeavors.

P.S. Dr. Steven Novella recently wrote a post that quite nicely explains the problems with NCCAM. Check it out at his site. Steven Salzberg recently posted four examples of quackery funded by NCCAM at the expense of taxpayers (and common sense).


Steven Salzberg said...

Excellent points. The more of us point out the problems with NCCAM, the better the chance that someday NIH will be able to shut it down and put the funds back into high-quality biomedical research. Keep hammering at them!

such.ire said...

I don't know if the NIH should congratulate themselves so much. They did, after all, at one point turn down Capecchi's grant proposal on gene targeting, as stated in the Nobel Advanced Information section!

Sports News

News of the Odd