The Scientist is running an excerpt (H/T: Science Progress) from the forthcoming memoir of Dr. Harold Varmus, former National Institutes of Health Director, Nobel laureate, and future co-chair of the President’s Council of Advisors on Science and Technology.  The book will be called The Art and Politics of Science, and covers the bulk of his career.  The excerpt focuses on the funding challenges – particularly in setting research priorities – that any NIH Director faces.  While Varmus doesn’t use the language, the excerpt describes several instances where advocates for particular trees (diseases) weren’t concerned with the other parts of the forest that could help fight their cause.  Pieces of the excerpt after the jump.

“One of the most difficult aspects of the job of running the NIH, or of directing any individual institute, is the designation of research priorities. This is an emotionally and politically sensitive part of the job because it is closely watched by some of NIH’s strongest supporters, who often advocate for the NIH because of a passionate interest in a small fraction of what the NIH does. That fraction is almost always a specific disease or even a subset or facet of that disease.”

…

“Advocacy narrowly focused on a single disease is often problematic for leaders of the NIH, because such advocacy is likely to be inconsistent with the ways science works best. Furthermore, the goals of such advocacy are often spending levels that are difficult to measure accurately. For example, research on a specific neurological disease, like ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), should, in principle, include basic studies of nerve cells and mechanisms of cell death, in addition to clinical trials in ALS patients, which are readily classified. The basic work may be impossible to classify by disease category, since it could help to understand many neurological diseases or others. This is where the concept of scientific opportunity comes into play: Spending funds to seize a chance to understand a fundamental principle in biology is often a more effective approach to disease than mandating funds for research on a specific disease. Furthermore, efforts to understand another disease, even one that does not affect neurons, might prove to be a more valuable means to understand ALS than work on ALS itself.”

…

“These comments are not meant to imply that advocacy for research on specific diseases is necessarily wrong, or that NIH leaders can simply divide up the funds according to the quality of grant applications, regardless of the research objectives. NIH must be (and it is) attentive to subject matter, and it must ensure (and it does) that at least some work is going on in all important areas. It should (and does) stimulate work on relatively neglected problems, especially when new opportunities arise, by advertising that funds are available for such research. One of the potential strengths of the NIH is its ability to encourage scientists throughout the country to pay greater attention to underserved and deserving problems, even when the new opportunities may not be obvious. Simply by encouraging attention to such problems—autism, rare neurological diseases, imaging methods, emerging infections or bioengineering, to mention a few areas promoted during my tenure—new ideas may emerge to create those opportunities. In this regard, the NIH must walk a narrow line: to respond responsibly to public health needs and yet to provide the freedom for investigators to exercise their imaginations as fully as possible.”

Yes, it’s a long selection (from an even longer excerpt), but I think this is a valuable insight not only into the process at NIH, and possibly a description of a challenge for non-medical sciences.  As disciplines have been seeping into other disciplines (see the drift of biology into physics and chemistry, as well as the drift of neuroscience into economics and behavioral sciences), the direct cause and effect between funding a particular research program and achieving the answer to a desired research question (or social outcome) disappears.  Perhaps it was never there to begin with.

This may be true for more than just the biomedical sciences; the challenges faced by interdisciplinary researchers suggests there is some merit to this.  As a result we have yet another line of argument to undercut one of the linear models.  While they probably sounded like a good idea politically at the time, providing American researchers some autonomy, they (and other science and technology policy fables) have made it all the more difficult to assess the effectiveness of sponsored research in acheiving desired goals.