Vigilance for viruses requires money, bipartisan support

Why aren't more young doctors going into vital areas of biomedical research?

Last year, I interviewed both Dr. Robert Gallo, co-discoverer of the virus that causes AIDS, and Dr. Alfred Sommer, whose work on vitamin A deficiency is credited with saving millions of lives around the world. Without prompting, both men expressed profound concern for biomedical research: Washington, they said, had stopped supporting it at levels commensurate with national and global need, forcing young doctors to choose other careers and causing research gaps that could have dire consequences.

As the Ebola virus kills a frighteningly high percentage of those who contract the disease in West Africa, and as officials in the U.S. work to contain it and develop a vaccine, those warnings from Gallo and Sommer bear repeating, especially in a country that considers itself medically and scientifically exceptional.

Gallo and Sommer are generational peers, highly regarded for their accomplishments and leadership. At 77, Gallo is a world-famous virologist based at the University of Maryland School of Medicine, where he directs the Institute of Human Virology. Sommer, 72, is a widely respected ophthalmologist and epidemiologist who served as dean of the Johns Hopkins Bloomberg School of Public Health.

In separate conversations last year, both men questioned the nation's dedication to advancing medical knowledge. Funding of the National Institutes of Health, the world's leading grantor of research dollars, is still in the billions, but it has been on a downward drift for 10 years. One result of that, Sommer said, is fewer doctors emerging from medical schools and seeing a future in research.

That's a problem in many realms, but perhaps foremost in virology. It's one of Gallo's big concerns. He was a researcher at the NIH for 30 years before coming to Baltimore in the 1990s to establish the institute. Among medical students, he found few who wanted to study viruses.

"I don't see the same awe many of us [at the NIH] had when we said, 'My God, we're able to ask questions related to solving problems of human life.' I think that has definitely declined," Gallo said. "I have a particular concern about medical virologists — people who are expert in viruses, young people coming into the field. That's definitely on the decline globally."

That needs to be fixed, Gallo said. A gap in virological expertise can have large human consequences. Doctors need to remain vigilant for viruses because, he said, for every outbreak of a deadly disease, history shows a lapse in research. It happens about every 25 to 30 years, Gallo said.

He elaborated on this at a conference last year, citing three events: The great influenza epidemic after World War I, the polio epidemic in the late 1940s and 1950s, and the period in the 1970s just before the pandemic of deadly acquired immune deficiency syndrome, caused by the retrovirus Gallo later identified.

"It is eerie to read accounts of [the polio outbreak] showing that medical science in particular and society as a whole were focused on chronic degenerative diseases, believing serious infectious diseases to be 'conquered,'" Gallo said. "Eerie also because that was precisely the attitude once again by the late 1970s, evidenced by the closure of some [university] microbiology departments, and threats of increasing reductions to [the Center for Disease Control and Prevention]. … Some even felt humans could not be infected by retroviruses."

Like Gallo, Sommer saw the danger in such lapses.

With NIH funding for new research in decline, fewer young investigators are getting into the lab for a career. That means the loss of knowledge and expertise over a generation. "By losing them," Sommer warned, "we will lose those training and mentoring the next generation of researchers, which means the entire biomedical research enterprise in the United States, which has led the world in discoveries resulting in both better preventives and treatment, runs the risk of being permanently lost."

Francis Collins, head of the NIH, said in a recent interview with The Huffington Post that, if not for a "10-year slide in research support," an Ebola vaccine might have been developed by now. He also noted — because it's been impossible to miss — the usual array of talking heads using Ebola "for political purposes to sort of shoot at the government."

Well, yeah. That's what happens, even in a matter of public health. Partisan politics infests everything now.

Rep. Andy Harris, Maryland's only Republican in Congress, is among those who lined up quickly to criticize the government for an insufficient response to the arrival of Ebola in the U.S.

What phonies. They've never been interested in seeing government function smartly. They're interested in downsizing government, pushing austerity, turning off some services and turning others over to the private sector. They've opposed expanded health care. They've portrayed public employees as public enemies. They've sounded anti-science themes.

I believe Drs. Sommer and Gallo about why more young doctors aren't going into vital areas of biomedical research. But it might have been 30-plus years of negative messages about government and public service that turned them off, too.

So, here we are.

drodricks@baltsun.com

Dan Rodricks' column appears each Tuesday, Thursday and Sunday. He is the host of "Midday" on WYPR-FM.

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