Insight on Research

Every so often you will come across a depressing article about someone (usually a young child or an adolescent who is the star student and athlete, yadda yadda yadda) who is fighting a debilitating disease. The disease is usually progressive, and typically very aggressive or rapid in its progression and with a poor prognosis. Everyone is clamoring about how sad it is (which it is) and how everyone should pray, and that they hope they find a cure soon. Likewise, I typically see donation stations for various foundations that donate money to research asking for $1 here or $3 there to be donated to researching the cure for disease X. Then I'll hear groups (usually right wing groups) complaining about how millions of dollars are poured into researching these diseases and yet we have had no cures or new medications, and so they whine and complain about how it's wasting their tax dollars and we could use the money better elsewhere. In all of these situations however, people need a much better understanding of scientific research, if for no other reason than to prevent them from getting upset or having false hope. Realistically, a cure is not going to be discovered overnight and save the life of featured new story child, nor is a cure/medication going to be discovered suddenly, a mission accomplished flag waved, and research money allocated elsewhere preventing the complaints of the economic conservatives. You may have heard it before elsewhere, but for any drug, the time from research to market is approximately 20 years. In those 20 years, let look at the breakdown of the process. The money given to the research is used to buy equipment, reagents, and pay the salaries of the interns, students, technicians, and professors researching. A discovery might be made in-vitro at first, after which it is then tested in an animal model (rats, mice, etc.). Animal studies take time, and a lot of money, so again, we use some research bucks and the clock ticks by. If the treatment or drug seems to work with some statistical significance in helping animals with similar symptoms/disease characteristics (this is key, because a mouse with disease X or similar symptoms is after all a mouse, and does not guarantee that the same therapy will work in humans) then the research will progress to clinical trials in humans. This is where you'll begin to hear advertisements on the radio for an easy $3200 if you'll only let someone inject you with something and stay overnight for 4 days. Additionally, human clinical trials are broken into 3 phases. At first, a phase I clinical trial is performed to determine the metabolic and pharmacological actions of the drug/treatment, its side effects at different dosages, and to see what early signs of effectiveness are evident. If everything appears to be working, the study is progressed to Phase II where additional trials evaluate how effective the treatment is for a particular indication or patients with a given disease to see what the short-term side effects and risks are. If the drug/treatment seems safe and still somewhat effective, then the study is progressed to Phase III, where expanded tests are performed to further evaluate the effectiveness of the treatment and to better determine the benefit versus risk of the treatment so that the treatment has a good indication of appropriate use for physicians. If everything is still fantastic, then we have the treatment evaluated and approved by various regulatory bodies like the FDA, and the treatment is eventually brought to market. This is all in a perfect world where nothing goes wrong. In reality, a treatment or drug will often not function the same in animal models as it does in cell culture or other in-vitro studies. It may work wonderfully in animals but not be efficient at all in humans, or worse, cause a myriad of side effects not observed in animals due to the physiological differences of humans. The treatment may fail at Phase I due to complications or study participant toxicity and fatalities. It may fail at Phase II due to a lack of effectiveness or an excessive risk to the patient. In the end, it is exactly what it appears to be at face value: a study; an experiment; a scientific venture. Science is precise, and exact, but it does not carry a 100% success rate. It is a field of educated guesses and trial and error. Breakthroughs are not made overnight, and even a 50% success rate can be the best you can hope for at a given time. The sad truth is that real science does not work like it does on shows like CSI where analysis and solutions to problems are found in 5 minutes or by the end of the 1 hour program. Experiments take time, failure, re-analysis, and new attempts. New treatments and cures will be found eventually, but it will take time, testing, regulatory approval, and more time to bring to market. Disease are constantly evolving, and with them so must treatments; a cure or treatment for one type of a disease may not work for a second type of the disease, no matter how closely related the symptoms are. There will most likely never be a cure-all for cancer or other debilitating diseases, but rather better treatments and earlier detection techniques that enable earlier interventions. The sooner the general population realizes this and tempers their hopes with a healthy does of realism and understanding of the nature of scientific research the better. Does this mean we should fund these areas less? Of course not. We should fund them more so that breakthroughs can be made faster. But faster means 17 years instead of 20; not a cure you can pick up from Walgreens in 6 months.

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Federal funding and the average commenter

So I read an article today on NPR that discussed how birth control ultimately saves tax dollars. It puts forth very simple arguments that are based solely on cost analysis and how a given policy that costs XXX dollars ultimately saves taxpayers XXX dollar due to the reduction in unplanned pregnancies, and ultimately, babies that are born into households that are either ill-prepared to handle them, or are downright incapable of handling them. The article was quite well written, and provided a very unbiased analysis of this ongoing controversy regarding coverage of birth control and family planning services by employers and tax payers. It doesn't matter what side of the fence you lean on, or what color flag you fly when it comes to politics; numbers speak for themselves. Anyone who has ever read about, or performed any branch of the sciences know that ultimately, the data speaks for itself. True, accidents happen, miscalculations are made, and a thorough analysis is always needed. However, at the end of the day, if the data goes against (or with) your current hypothesis, you have to give it some credit. That being said however, one would be quite surprised to read the comments that begin to flow following the article. Thanks to the ability for anyone and everyone to comment, we now see a nice image of just how uneducated, ignorant, and oblivious some people can be. People begin raising all sorts of slippery slope fallacies about how if we pay for contraception and family planning that we're one step closer to imposing a 1-child policy like China. Or then there are the individuals who feel it is necessary to go on and on about Obamacare and the liberals forcing their ideals down their throats regarding birth control. The last time I checked, there are all sorts of subsidies and uses of federal funding that I don't necessarily agree with. However, it ultimately is for the good of the whole and so you take the good with the bad. You implement funding and policies that enable people to live their lives according to their own beliefs without forcing something upon them one way or another. Think of it like education. The federal government provides subsidies for colleges and higher learning institutions nationwide; because of this funding, college tuition are lower than they would be without them (expensive instead of ridiculously expensive). By doing this, more individuals are provided the opportunity to attend college, and pursue their own goals, without forcing everyone to go to college. Every citizen has a share of their tax dollars going to this federal subsidy, however as we all know, not everyone goes to college. Some individuals simply don't want to, and that's fine. That is their choice and they have made it. If we replace education with birth control and family planning, there is no difference. More individuals who wish to take advantage of birth control and family planning services are allowed to do so, while those who do not, don't. Everyone pays in, and those who want to utilize the services do so according to their own beliefs and needs. The same could be said for many other funding issues and law making controversies. Simply because something is legal or funded does not mean that you are FORCED to perform that legalized act or use the funded service. Farming is highly subsidized, however I have never been approached my a government agent instructing me to be a farmer "OR ELSE." Yet here we see countless Americans, many of whom are probably registered voters, clamoring on in a very tabloid like fashion about conspiracy this, liberal that, Obamacare this, etc. etc. The opposite side of this coin remains the same for left-leaning individuals who start freaking out about legislation and spending policies that go against their grass roots nature. Both sides need to realize that the world will never be completely conservative, or completely liberal. NEVER. As such, we have to have everything in balance, where government functions to maintain the safety of the state, while allowing each individual to live their lives as they choose. It's the reason we have religious freedom, freedom of speech, and freedom to bear arms. Unfortunately, it seems as though some people have stopped enjoying being an adult and would rather have a government entity make their lifestyle choices for them. If that's what they want, to be treated as a child, then fine. But children are not allowed to vote, and neither should they. Besides, would you rather pay a little for some federally funded condoms now, or pay a lot more when all of those ill-timed babies grow up to be the next generation of Walmart shoppers that sell their food stamps for liquor and suck up welfare money like a gap toothed sponge?

Here is the original article:

http://www.npr.org/blogs/health/2012/03/06/148042609/how-birth-control-saves-taxpayers-money

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