Nonscientists likely were puzzled this year when newly appointed National Institutes of Health Director Francis Collins announced his top five priorities. For most Americans “translational research” isn’t exactly a household term.
But we urgently need to translate more basic science from the bench to the bedside — or from laboratories to hospital rooms. Otherwise the burden of disease on individuals as well as the public health care system might overwhelm our aging society.
I learned my own lesson about the need for translational research while serving as director of the National Institute on Drug Abuse from 1994 to 2001. One of my greatest regrets was that I failed to help provide the world with an effective medication for treating cocaine addiction — a problem still being pursued by scientists and clinicians.
Fortunately new pharmaceutical targets are being investigated to try and ease cocaine cravings to reduce stress or perhaps even to block the drug before it reaches the brain. And cocaine use among 10th and 12th graders has been declining thanks in large part of NIDA’s efforts. But that still leaves too many U.S. high school students reporting they used cocaine within the past year: 3.4 percent of seniors according to NIDA’s 2009 Monitoring the Future survey from the University of Michigan.
With the new year approaching and many of us making resolutions for a healthier 2010 it’s a good time to reflect on why the quest for an anti-cocaine medication fell flat.
Simply put there was a failure of communication and it was the same problem that has more broadly slowed the development of many new medical treatments.
Why is it so hard to move medical advances into clinical practice? Traditionally scientists working in government and university laboratories have toiled in isolation expecting venture capitalists and corporations to discover their good ideas in science journals and then independently drive those concepts into the marketplace. But this is a poor communication method and consequently efforts to combat cocaine addiction have focused on ineffective pharmaceutical targets for years.
Experts like Amy Comstock Rick of the Parkinson’s Action Network have pointed out this traditional approach to developing new medicines — relying on corporations alone to push promising ideas into production — isn’t working. To be blunt — the historic model for translating research into practice doesn’t work as well as we need for it to work.
In fact the pace of American drug development seems to have declined sharply in recent years: The number of new drug applications submitted to the U.S. Food and Drug Administration dropped by 21 percent between 1999 and 2004 according to a report by the U.S. Government Accountability Office.
The drug-development pipeline remains clogged for a number of reasons including inconsistent federal funding for basic research as well as corporate reluctance to wager on high-risk ideas — particularly in a recovering economy.
The Council for American Medical Innovation also pointed to a shortage of U.S. patients participating in clinical trials.
But as I learned at NIDA simple communication can be a primary stumbling block. Laboratory scientists have too few opportunities to share their insights with clinicians. At the same time researchers pursuing fundamental new knowledge may work in a vacuum never interacting with corporate teams capable of speeding new discoveries into doctors’ offices.
There is a better way as Dr. Collins and others have recognized.
Consider the example of bioengineer Erin Lavik of Case Western Reserve University. As a translational researcher Lavik collaborated with clinicians to develop a new drug-delivery technology that shows promise for improving glaucoma care. The payoff could be high: Glaucoma affects millions and as they lose vision patients’ health care costs can skyrocket.
Having made great progress on the glaucoma front Lavik’s group now is working to generate blood vessels and even rebuild the blood-spinal cord barrier of injured animals. To speed new treatments for many different health challenges she urges researchers to work in teams where bench scientists compare notes with corporate innovators and medical practitioners alike.
This is of course easier said than done. But as our population ages America must pick up the pace of medical innovation.
Anyone reading these words already has become a part of the solution by learning more about the promise of translational medicine. And that’s a promising start to a healthier new year for America.
Alan I. Leshner is chief executive officer for the American Association for the Advancement of Science and executive publisher of the journal Science.