
NIH Spending vs. Diseases That Kill Us - superfx
http://moalquraishi.wordpress.com/2014/08/31/nih-spending-versus-diseases-that-kill-us/
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niels_olson
As a physician and researcher, I look at these and see two categories: poor
decision-making and genuine molecular biology problems.

Heart disease, COPD, and type 2 diabetes are tractable now. Eat less, don't
smoke, exercise. The other diseases are horrible luck played out at the
molecular level. Type I diabetes belongs in this other category.

HIV treatment is pretty well at a management phase. A vaccine would be great,
but this goes to the general problem of human molecular biology still being
not entirely known. Funding is to some extent molecular biology research.

Cancer is a molecular biology problem. Same as HIV.

Neuromuscular diseases are molecular biology problems.

My dad has prostate cancer. I'm working on prostate cancer. But the studies
involves pathways in the embryogenesis of fruit flies and tested in zebra
fish, and a lot of the work on these pathways has been funded by breast cancer
research, agriculture companies, DoD looking for dual use agents, all sorts of
weird cross-talk.

Meh.

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lutusp
The very interesting linked article only counts death, not suffering, lost
employment or quality of life, as charted factors. Because the ultimate issues
are political, a chart that included these factors would be more informative.

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exratione
Some data for you:

[http://www.chronicdiseaseimpact.com/](http://www.chronicdiseaseimpact.com/)

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exratione
Some items for context:

1) Almost all high risk, new, next generation early stage research is funded
by philanthropy. Major funding institutions won't give anyone money unless
they can essentially demonstrate a proof of concept, and that what they have
works. Similarly the for profit world doesn't tend to fund high risk new
fields, but steps in at about the same point as public institutional funding.

2) Almost all funded research for the major killers involve diseases of aging,
and almost all of that research is aimed highly inefficient ways of producing
marginal gains. Which is to say that researchers work backwards from the very
complex end state of a disease, attempting to produce a treatment from each
new proximate cause they uncover. These treatments largely involve attempts to
manipulate a very complex and poorly understood state of metabolism / biology.
Only a very, very tiny slice of all this research funding goes towards
prevention or repair or other ways to address the root causes of these
diseases of aging, which is to say the processes aging itself. Until this
changes, progress is only very loosely coupled to levels of funding. You can
spend a bunch of money paying people to drain a lake with spoons, or you could
spend a lot less doing something better and more effective, and that's really
a fair analogy for where medical research is with respect to the diseases of
aging. A disruption is underway, but it is going very slowly, as things tend
to in the research world, and hasn't yet had much of an impact on the bulk of
the mainstream.

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xaa
Re #1, you are mostly correct that only philanthropic organizations will
accept grants that are explicitly high-risk. But the way it works in practice
is that most investigators write a NIH grant with conservative aims, then use
the money however they want, including projects they see as high-risk, high-
reward.

Re #2, from our previous conversations I know that you and I would both like
to see increased funding for aging research. Still, you must agree that there
are many ways to treat heart disease, cancer, etc, without addressing the
aging connection. To give a simplistic example: the heart is a pump, and you
can fix it either by identifying and preventing age-related damage, or simply
by repairing or replacing the heart itself, e.g. with an artificial heart.

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payne92
What's far more interesting (IMHO) is research spending vs disease/condition
costs.

For example, diabetes may not be the primary cause of your death, but you (or
someone on your behalf) will spend a LOT of money managing the condition &
associated complications.

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russell
The title is completely bogus. The chart is of private donations as far as I
can tell, NIH expenditures are completely different. I havent tried to tally
the figures across the various diseasecategories, but heart disease is huge,
aids is quite large, while breast cancer is more modest.

[http://report.nih.gov/categorical_spending.aspx](http://report.nih.gov/categorical_spending.aspx)

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dang
Doesn't this post attempt to make a corrected chart using that data?

