Jason Brickner, Ph.D. and associate professor in molecular biosciences, understands the power of federal funding as well as any scientist in the research field. As the principle investigator at his own lab at Northwestern University, he leads research on cell biology, teaches students, distributes the budget, and pays postdoctoral fellows and research scientists. He also provides a stipend for graduate students to complete the work as outlined in his grants. During the 2013-2014 academic year, Brickner says the NIH accounted for half of his funding.

“The fraction of grants that actually get funded is so low that you have to try multiple times to get your grant funded.”

—Jason Brickner, Ph.D., associate professor of molecular biosciences at Northwestern University

so low that you have to try multiple times to get your grant funded,” he explains. Brickner says the sequester is just another tally to add to the multiple cuts of federal funding that have been increasing over recent years.

These cuts make Brickner pessimistic not only about the future of his lab, but also the future of his own research. “The trajectory [for the U.S.] doesn’t look good,” he says, noting that the past 40 years of innovation and discovery within the U.S. biomedical research community was made possible by federal money. Since at least the 1960s, scientific research has been universally viewed as beneficial to the nation’s economy. Lately, that has changed. This shift has left scientists similar to Brickner and Matlin running low on options for finding alternative funding.

Brickner pauses and looks down for a moment, as if to mourn a loss. He begins to discuss the current situation facing medical researchers. “More recently, spending of any kind has become a partisan issue. That is a very different situation, and it’s very difficult for academic professional societies to impact that kind of philosophical debate…and we don’t really want to become partisan players.”

Unfortunately, medical research has been facing judgment in the political world since at least the early 2000s when President George W. Bush restricted federally funded stem cell research. The research uses human embryos, a practice that religious conservatives opposed. President Barack Obama reinstated funding for stem cell research, but he has not been able to block the conservative fiscal movement.

“I would not say that the Obama administration has been successful in promoting science beyond lip service,” Brickner comments. “The reality is that things have gotten worse and continue to get worse. And now they’re as bad as they’ve been in a long time because of the sequester.”

It is Brickner’s hope that members of Congress who are concerned about these budget deficits realize sooner rather than later just how important research funding is. “We train outstanding scientists. We attract the world’s best scientists to this country,” he continues. “So there’s no shortage of good science that we could be doing.”

But convincing the government of what makes “good science” is another hurdle entirely. Stanley Cohn, a professor of biology at DePaul University, says people search for instant gratification and immediate results. This creates an unfriendly environment for science, an industry in which conclusions from basic research studies may not be available until years later. With the absence of results, many politicians see fit to respond with an absence of funding.

“When there’s more focus on distinct medical issues, we lose sight of basic research that can lead to innovations in the future,” Cohn says. “There’s this sense of immediacy… There are people in the government asking, ‘What is this giving us now?’” The 16-day government shutdown in October 2013 may have seemed measly, even comical, to the general public. But it stalled the grant application process for medical researchers so severely that the NIH issued a public notice on its website.

“The shutdown came at one of our busiest periods,” Dr. Sally Rockey, the NIH deputy director for research, wrote on her blog. “And it is going to take some time to bring the extramural programs back to full strength.” Even in a good year, stalls in Congress can affect the sciences, and Rockey’s words are both ominous and worrisome – it could take longer than necessary for the NIH to bring its extracurricular plans back into play.

Photo credit: Matt Higgins

Northwestern, driving home a point that can’t be ignored: The sequester will have an affect on research that is specific to higher education.

At University of Chicago’s Medical Center, Chris Kops, associate dean for finance and administration, concurs: “What has been very disappointing to me is the way the cuts under the sequester are just across the board,” Kops muses, citing his frustration with the situation. “I really don’t feel as though all programs should be cut equally. The sequester has put a tremendous amount of fiscal stress on our institution.”

Since as far back as World War II, the United States has dominated the medical research field with top-notch scholars of all specializations flocking to the U.S. because of its resources and prestige. That prestige and honor is now under a threat because of the competition from other nations.

“Just going through the trade news today, the current recipients of the Nobel Prize in Physiology or Medicine, the kind of basic science that helped these individuals win the Nobel Prize is at risk,” Kops says.

In short, the U.S. is losing in the research race. While there are still those that come to the country to train, these students don’t necessarily rule out leaving in order to pursue science in a country where attaining a grant is more probable.

“In some senses, the probability of getting a grant in India is higher than in the U.S.,” explains Varun Sood, a graduate student in Brickner’s lab. “Because perhaps two decades ago, there was a boost in U.S. funding. India is going through that phase.” The fact that Sood is an international student limits the amount of grants he may apply for. Within one year, he applied for three grants, none of which were accepted. The opportunities are so few and far between that Sood hasn’t stricken the idea of a return to India from his mind, and it’s not a surprise to say that he isn’t exactly sure what to expect for his future.

The exodus of immigrant researchers leaving the country to move back to their native lands has far-reaching consequences for both American medical care and the economy.

Those who leave the U.S. following their research and training, return to their countries having gained knowledge from American universities, but having failed to produce new ideas for the country that trained them.

Those who leave the U.S. following their research and training, return to their countries having gained knowledge from American universities, but having failed to produce new ideas for the country that trained them.

Data from the BBVA’s 2013 research report shows the percentage of those residing in the U.S. possessing graduate or professional degrees is higher among foreign-born than native-born students. “We need to address issues like providing incentives to keep foreign-born graduate students in the U.S. in order to keep our competitive advantage,” explains Fraser, emphasizing that this is necessary in order to increase productivity and create jobs.

Research shows the trend of immigrants coming to the U.S. will continue as long as they can earn more in America than anywhere else, but Fraser is pessimistic America can retain its lead. She implies the edge our country currently has in terms of competitive advantages in research could be lost. “It’s getting to the point where other countries are progressing in higher education, and students are remaining there,” she says. This loss of researchers doesn’t just mean America loses its reputation and its potential for Nobel Prize winners – it also means that the overall U.S. economy suffers.

According to a 2011 study from the Association of American Medical Colleges, every dollar invested in research at medical schools and teaching hospitals leads to an impact of $2.60 of economic activity. The result of this investment includes the salaries paid to high-skilled workers, such as doctors and researchers, and low-skilled workers, such as hospital orderlies.

“Per dollar invested, there’s a much greater return in terms of economic activity that comes from the discoveries that get made through American science,” says Brickner. For his part, he has already seen a progressive decrease in funding at the expense of other countries whose funding has experienced increases, such as China and Asia. “China has aspirations to become a leader in science and technology, and they have not historically been,” he notes. “They’re positioned to invest enough to make that change that may mean researchers leave the U.S. to go to other countries to pursue science.” He goes on to indicate that, in the future, he sees himself going wherever the funding may be.

“The reality is, as an academic scientist, if I don’t have grants, my job becomes very much teaching and administration,” he says. “Although I’m willing to do those things, and I enjoy teaching, that’s not my primary motivation. So, if an opportunity came along…instead of having to fight to just keep my lab afloat, if there were another, more stable funding environment, then I might choose to pursue that. I think most scientists would make the same choice.”

Brickner and other scientists find that their concerns are not only shaped by the shift of America’s dominance in the research field, but also by an apprehension regarding the future of the general population’s wellbeing. “The reason we should all be concerned about the cuts is, absent from the research, we will not have the healthy society we have,” warns the AAMC Chief Scientific Officer Ann C. Bonham. More than economics and skilled scientists, medical research remains at risk.

Take community hospitals, for example. When dealing with older patients who need an aortic valve replacement, hospitals don’t commonly employ a technique known as trans-catheter aortic valve replacement surgery, or TAVR. The procedure, approved in November 2011 by the FDA in the United States, allows doctors to place a new valve in the heart without having to perform open-heart surgery. This technique was first used experimentally at teaching hospitals associated with universities, as well as by those who had access to federal research money. The current cuts threaten procedures such as TAVR, which, without federal funding, would not exist, let alone have the ability to become widespread.

"I am a health policy researcher, and the emphasis on my work is trying to find efficiencies in the health care system,” Farmer says. “So the fact that my work is under threat at the time when the biggest crisis is an efficiency crisis, it just makes no sense…” He shakes his head as he brings up yet another reason why it would be an immense loss for medical research to leave this country: cancer research. “In the immediate term, if research is done in the U.S., [patients] have access to experimental treatments,” Farmer says. “If the U.S. is not playing a role in testing and experimenting with those treatments because research dollars have gone away, then your access to those experimental therapies will be less.”

It’s a similar situation for Bonham, who says that U.S. researchers are close to finding the genome of cancerous tumors. This discovery will lead to more effective treatments for cancer patients, but only if federal funding can sustain that research. “If [that research] goes away, that momentum will go away,” she says. “It’s like digging a thousand-foot hole that you are trying to climb out of.”

In the meantime, what happens when the grant money a lab depends on continues to dry up? It’s a daunting question, and one that points both American researchers and the general public towards a frightening future.

“What you’re really doing is cutting the amount of people who can do science,” stresses Brickner. “We’re trying to survive with less grant money, that’s strategy No. 1. Some people are choosing other careers - and in particular, of the people I train, fewer and fewer of them actually want to pursue science professionally.”

If the soil in science doesn’t look fertile, well-meaning professors have trouble encouraging students to pursue a career in medicine, given its unreliable future. This is the case at DePaul University, where students in Cohn’s undergraduate cellular biology courses now spend time learning the grant writing process.

"...the teaching has turned around and focused on ‘how do I write a good grant?’ That’s not the same thing as doing research.”

—Karl S. Matlin, Ph.D., vice chairman of research and professor of surgery at the University of Chicago

“Whereas 10 years ago, it was possible to imagine that things were kind of going through a cycle of maybe slower growth…right now, I don’t feel like I can be that optimistic.”

Brickner instead sees this as the beginning of the end when it comes to American contributions to medicine. He definitively articulates, “I feel like, right now, we might really be in a phase where we’re kind of presiding over the end of American dominance in science.”

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