Breakthroughs in Bioscience From NIH-Funded Basic Research to Improved Health Ohio

National Institutes of Health (NIH)  Nation’s medical research agency  Funds the science that leads to medical advancement  Campus in Bethesda, MD – but most funding is distributed to university researchers throughout the United States  Ohio ranks 10 th overall in NIH funding ($630 M)

Research Is Critical to Ohio’s Economy  Case Western Research University received the most NIH funding in the state of Ohio in FY2008 (165M).  The University of Cincinnati Medical Center creates a total economic impact of $3.05 billion on the Ohio Tri-state area.  The potential economic impact of new biotech activities on the Tri-state could be in excess of $100 million over the next 10 years.  The Ohio State University Biomedical Research Tower is expected to generate an estimated $3.7 billion in economic impact and 17,000 jobs during its first 10 years in operation.  Ohio's academic health-care industry generated an economic return of $37.2 billion in 2007.

Leverages the State’s Investment with Extramural Research Dollars  Since 1993, research and development expenditures at Ohio universities and colleges have increased 70% - nearly $1B combined in FY2001  Ohio is home to 2 of the country’s top 10 pediatric hospitals and 4 of the top 50 cancer facilities  Ohio ranks among the top 8 states in the total number of clinical trials hosted  The Third Frontier Project commits $500M over the next 10 years to fund new technology and research and more than $500M to enhance research facilities  Ohio is ranked 6 th in the nation for total employment in high-tech industries with 484,245 workers

NIH: Saving Lives Through Science  Current annual budget of around $ 29.3 billion  Greater than 80% distributed throughout the country  More than 50,000 grants  212,000 scientists  2,800 universities  Portfolio of basic, translational, and clinical research NIH has been involved in nearly all the medical & health related discoveries of the past century

How NIH Makes Science Happen…  Researchers working at local universities, hospitals and research institutions are dependent on federal support to fund their research, hire lab personnel and train young scientists  They write research grant proposals to compete for funding  Must explain why they think it’s a good idea, how they’re going to do the experiments, and what impact it will have on science & medicine  Proposals are reviewed in a two-tiered system  Peer-reviewed by scientists to ensure highest quality science  Reviewed again for applicability to scientific or health priorities by NIH officials and other stakeholders, including public members  NIH review system is the envy of the world!  Very competitive!!!  Before - 1 in 3 proposals funded; now closer to 1 in 6  High quality research is not being done for lack of funding

Basic Research: From Bench to Bedside  Much of NIH funding goes to basic or fundamental research  Basic research is driven by interest in a scientific question  The main motivation is to expand knowledge and understanding, not to create or invent something  However, the insight into how the human body works and understanding of how diseases and disorders operate provides the foundation for medical progress "People cannot foresee the future well enough to predict what's going to develop from basic research. If we only did applied research, we would still be making better spears." Dr. George Smoot, Berkeley National Lab

What about medical breakthroughs?  Medical breakthroughs often come from unrelated areas of science or medicine  Research on cancer biology has led to drugs for: heart disease; viral diseases like influenza, Herpes & AIDS; and osteoporosis  Physicists studying the effects of magnets on atomic particles made the discovery that gave us MRI  Usually based on years or decades of fundamental knowledge  Over time, scientists solve or find different pieces of the puzzle  This makes it difficult to predict where the next breakthrough will come from  Makes it imperative to support a broad range of scientific research  Much of this research is too basic for the private sector  The federal investment often lays the foundation for advances in healthcare

Evolution of Research to Healthcare Selected modern examples…

Cardiovascular disease  Information on the biochemical structure & synthesis of cholesterol led to the development of statins  Discoveries in basic kidney biology and blood pressure regulation converged with an unexpected finding involving snake venom to yield ACE inhibitors, one of our most effective hypertension medications  Understanding how the blood clots, together with a new cancer treatment and the first commercial use of recombinant technologies, resulted in rtPA, a clot- busting drug that can prevent death from heart attack or stroke RESULTS?? 63% REDUCTION IN DEATHS FROM HEART DISEASE AND A 70% REDUCTION IN DEATHS DUE TO STROKE; MORE THAN 1 MILLION LIVES SAVED IN 2006 ALONE

Cardiovascular disease Deaths per 100,000 Year ~ 514,000 Actual Deaths in 2000 ~ 1,329,000 Projected Deaths in year Investment per American ~$ Total Economic return of improved treatment & prevention $2.6 TRILLION

HIV / AIDS  Fundamental knowledge of how viruses replicate gave scientists targets for therapy. Researchers looking for a new cancer drug hit one of those targets when they discovered a way to block replication, resulting in the development of AZT.  Increased understanding of how HIV operates at the cellular and molecular level identified more targets, and eventually led to the combination of drugs knows as the ‘triple cocktail.’ RESULTS?? AIDS HAS BEEN TRANSFORMED FROM AN ACUTE FATAL ILLNESS TO A CHRONIC CONDITION; THE PROPHYLACTIC USE OF ANTI-VIRALS PREVENTED ALMOST 350,000 DEATHS WORLDWIDE IN 2005

Deaths from AIDS dropped nearly 70% between 1995 and 2000 HIV / AIDS Survival rates for those infected with HIV has increased by 10 years

Cancer  Basic research into the shape and characteristics of the estrogen receptor gave us tamoxifen, which can reduce breast cancer incidence among women at risk by over 45%.  The breakthrough finding that human papillomavirus (HPV) could cause cervical cancer has led to a new vaccine that NIH estimated could reduce cervical cancer incidence by as much as 90%.  While investigating the cellular machinery controlling cell growth, scientists developed bortezomib - now used to treat patients with multiple myeloma. RESULTS?? FROM , CANCER DEATH RATES DROPPED 1.1% PER YEAR; MORE THAN 2/3 OF PEOPLE DIAGNOSED WITH CANCER CAN EXPECT TO LIVE 5+ YEARS

Cancer Millions of People Increase in Cancer Survivors 30-year Investment per American ~$ Total

Infant mortality  Studies on lung function led to the discovery of surfactant. This protein-lipid mixture is crucial for the survival of premature infants, decreasing the number of infant deaths from respiratory distress from 15,000 per year to less than 1,000.  The use of anti-virals to prevent mother to child HIV transmission has reduced the rate from 25% to about 1% in the U.S.  Studies on a metabolite of progesterone, known as progesterone 17P, have led to the finding that injections of this compound can reduce pre-term deliveries by as much as 30%, a particularly important result for African American women. RESULTS?? IN LESS THAN A CENTURY, INFANT MORTALITY IN THE U.S. HAS BEEN REDUCED BY 90%, TRANSLATING TO ALMOST 500,000 BABIES SAVED PER YEAR

NIH-Funded Discoveries in Ohio  Early use of gene therapy to treat recurring brain tumors (University of Cincinnati College of Medicine)  Developed deoxycoformycin to cure hairy cell leukemia (Ohio State University College of Medicine and Public Health)  The University of Cincinnati Children’s Hospital Medical Center is one of the seven institutions leading the NIH’s effort to evaluate new vaccines for avian flu  Discovered the role of T-helper cells in controlling infection by a tumor virus (Ohio State University College of Medicine and Public Health)  Determined that calcium and vitamin D supplements in postmenopausal women have a modest benefit to bone mineral density and prevent hip fractures in certain groups, but do not prevent colorectal cancer and other bone fractures (Ohio State University Medical Center)

The Bottom Line…  People are living longer, healthier lives because of NIH funded medical research  What were once swiftly fatal illnesses have become treatable or manageable conditions  For those suffering from diseases that have no current treatment or cure, medical research provides hope – which has a major impact on quality of life

The Challenge…  NIH funding is entirely dependent on Congressional support  In recent years, Congressional support has diminished, and the NIH budget is slowly eroding from lack of funding and inflation  Lack of understanding in Congress about the importance of medical research and the treatments and hope it provides  As the NIH budget falls, the success rate in Ohio also falls Diminished investment in NIH = loss of talented researchers = missed opportunities = delays in medical progress

Ohio’s Members of Congress Need to Advocate for NIH Funding  Nothing should surpass improving our health as a national priority  Opportunities for discoveries that translate to improved health for our citizens have never been greater  The Cincinnati region has high incidence rates of cancer, heart disease, and diabetes – research can touch the lives of each Ohio resident

We Need your Help: Working Together for NIH  Contact Senators Brown and Voinovich, or the Congressional Representative for your district  Let them know that medical research is important to you and what a bargain it is  Write a letter to the newspaper and talk to your friends  Help educate policymakers and neighbors about the important work NIH is doing  Nothing is more important than our health  The National Institutes of Health (NIH) should be an American priority

Want to know more?? Please visit Federation of American Societies for Experimental Biology (FASEB)