The Valley of Death

November 20th, 2008 by Nick Jacobs Leave a reply »

Sharon Begley wrote for Newsweek Magazine an article entitled Where Are the Cures? Scientists call the gulf between a biomedical discovery and new treatment the “valley of death.” This has been a topic about which I have written several times. As a relative newcomer to the world of scientific research, my journey has been somewhat perplexing and always disconcerting. Every day articles, web stories, and scientific papers cross my desk touting the amazing discoveries that are being made at the basic research level. When I query my insiders, however, they point out that these discoveries very rarely ever get to the public for their care and treatment.

Some of the reasons behind this gap in medical science lead back to a broken system with inappropriate incentives locked firmly into place. How do we get the basic discoveries to be translated and moved into actual treatments?

Why are so few of the discoveries making their way to both treatments and cures? It is because our system of NIH-sponsored science is set up to discover things; plain and simple. Once the discovery is made, articles can be written, which is the sought after reward in academia since these publications lead to more grants from the NIH, and so the circle goes round and round.


Image Credit: Corbis

The obstacles to translational research in which the studies actually move from the scientist’s bench to the patient’s bedside are so intense that they are referred to in some areas of the scientific community as the “valley of death.” According to Begley’s article, “The valley of death is why many promising discoveries-genes linked to cancer and Parkinson’s disease; biochemical pathways that ravage neurons in Lou Gehrig’s disease-never move forward.”

The author challenges the incoming Obama administration and Congress to take a look at this daunting dilemma and to begin to revamp our biomedical research system by creating what Richard Boxer, a urologist at the University of Miami, and Lou Weisbach, a Chicago entrepreneur, call a “Center for Cures” at the NIH. Interestingly enough, the model that they endorse is exactly what was created here in Windber where multidisciplinary teams of biologists, proteomic and genomic scientists, technicians, and biomedical informatics specialists work together with Walter Reed Army Medical Center to move a discovery to an actual cure.

Of course, with the cuts made to the NIH funds, creating anything new that is unfunded could take away from basic research, and limit hopes for these cure discoveries. The article explains that while the NIH budget was doubling, new drug approvals fell from 53 in 1996 to 18 in 2006. What’s wrong with this picture? Twice the money, less than half the discoveries.

The sad case, however, is that even those organizations that try to establish these new world order cure centers are not funded by the NIH because of this fundamental design to enhance only basic research. The article ends with this: “I’d be willing to put up with potholes in exchange for a new administration spending serious money to take the discoveries taxpayers have paid for and turn them into cures.”

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11 comments

  1. Mike says:

    Conducting research for the sake of publishing papers without any application to improve in this case healthcare would be a travesty. This “valley of death” that you mention Nick I assume is very convoluted and mired with fiscal constraints.

    Could it be that some of these discoveries while worthwhile would be cost prohibitive to bring to fruition? How many of these discoveries are considered ophan break throughs were the return on investment is just not there and they are discarded?

    It would interesting since I have a fondness for research to learn more about this valley of death that you speak of.

  2. nick jacobs says:

    The Valley of Death is caused by a system that has inappropriate incentives. The reward is for small science leading to small discoveries, and there is no real incentive to SHARE . . . It is a system that needs re-worked from top to bottom. It is not the place of the bench scientist to take the discovery to the end, but, at this point there are very few inceitives for ANYONE to take the discovery from the bench to the bedside. Hope Obama takes a look at this, too. Kind of like the architect that works on a commission based on the cost of the buildng or the builder who can make more money by NOT doing what the plans say. UPSIDE DOWN incentives. Hospitals kept women in for a week after a baby UNTIL the incentive changed. Now it’s practically drive by births. Not looking for the extreme, just sanity.

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