Where health research goes wrong

The ideas and innovators shaping health care

Oct 04, 2024 View in browser   By Carmen Paun, Erin Schumaker, Daniel Payne and Ruth Reader FORWARD THINKING The strategic vision is lacking, two critics of the American research enterprise say. | Shutterstock America needs “a bold reimagining and reconfiguration” of biological and medical research to ensure that it responds to the health challenges most relevant to Americans, two top experts argue. The National Institutes of Health, the largest federal funder of such research, doesn’t offer that, Drs. Victor Dzau, the president of the National Academy of Medicine, and E. Albert Reece, director of the Center for Advanced Research Training and Innovation at the University of Maryland School of Medicine, wrote this week in The New England Journal of Medicine. The NIH’s 27 institutes and centers lack purposeful and structured coordination and focus, they argue. The U.S. should set up a national advisory body that would oversee a national strategic vision for U.S. biomedical research, Dzau and Reece wrote. “Such a strategy could also help to ensure that federal research dollars do not inadvertently reinforce entrenched health inequities,” they wrote. Why it matters: Breakthroughs in treatments for cancer, cardiovascular disease, HIV/AIDS and obesity, for example, haven’t improved the health of racial and ethnic minority groups, they contend. They cite a Washington Post report pointing out that adults between 35 and 64 who live in southern and midwestern states die younger than they did 40 years ago. And much of biomedical research still doesn’t account for the biological differences between males and females, leading to differential success in treatments and outcomes, the two wrote. “Too many therapies fail to close the last mile of delivery, leaving many groups of people — including racial and ethnic minority, LGBTQIA, rural, Indigenous, disabled, uninsured, and impoverished people — without access to the vast benefits science can provide,” they added. Dzau and Reece call on the federal government to focus on better understanding and then removing the barriers that prevent those groups from reaping the full benefits of medicine. To do that, the federal government should invest in research into social sciences, economics, community engagement, health care delivery and population health while focusing on lack of trust in government and misinformation, they argue. WELCOME TO FUTURE PULSE Nashville, Tenn. | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Coyotes may be able to make the same "puppy dog eyes" that dogs do, throwing cold water on the theory that the pleading look evolved as part of the human-dog relationship, Smithsonian magazine reports. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.  WASHINGTON WATCH Researchers need to work better together, a new report says. | afagen/Flickr The National Academy of Medicine's concerns about the health of America’s biomedical research are also the subject of a new report in which NAM says coordination among the government, the private sector and philanthropists is insufficient. That’s leading to what’s known as the “funding valley of death,” when promising discoveries are never translated into therapies, drugs and tests that could help patients. The report recommends: — Developing a biomedical research funding collaborative that would organize and allocate shared investments from the government, the private sector and philanthropies — Increasing coordination among entities supporting federal research to yield faster breakthroughs that could benefit the public sooner — Bolstering the biomedical workforce by expanding funding opportunities for entry-level researchers, diversifying the workforce and allowing international scientists on temporary visas to apply for federal research funding During a panel discussion on the report this week, National Institutes of Health Director Monica Bertagnolli described how her agency tries to increase coordination to bolster the evidence undergirding the medical treatments. Why it matters: Only 7 percent of recommendations doctors use to guide treatment decisions are based on the highest level of evidence, according to Bertagnolli. “The rest are based on evidence that can be very fallible,” she said. As head of NIH, Bertagnolli is working to build a system that prioritizes high-quality evidence. “One of the advantages of being part of the U.S. government is we have probably the biggest payer right there with us working on this,” she said, adding, “This is one of the cross-government activities that I think you’ll see more research focused on.” INNOVATORS There may be a way to save some of the 8,000 donor kidneys that go to waste each year. | Getty Images The Advanced Research Projects Agency for Health wants to salvage donor kidneys that would otherwise have gone unused to make more kidneys available and save lives. The agency is putting $44 million over five years toward a new project called No Kidney Left Behind, which seeks to develop a process to restore kidneys that would have been deemed unusable for transplants. How so? Public benefit corporation 34 Lives will lead the project, which plans to advance cold- and warm-preservation techniques. The methods will enable donor kidneys to recover functionality so they can be transported and transplanted. If the new technology is successful, the team hopes to apply it to other types of transplant organs. Why it matters: More than 8,000 donor kidneys can’t be transplanted annually because doctors have concerns about their viability, according to ARPA-H. Meanwhile, kidney transplant recipients wait an average of six years for viable organs. “Recovering 50 percent of kidneys that might go unused would meaningfully increase supply and ultimately save many more lives,” Jason Roos, scalable solutions director at ARPA-H, said in a statement.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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