MOST PEOPLE WOULD AGREE that AIDS research is an important target for government dollars, but digging deeper reveals the desperate scramble that advocates for various diseases must undertake to secure competitive research funding.
Particularly disadvantaged in this fight are advocates for rare diseases. The Wall Street Journal reports that rare diseases have received between 3 and 15% of NIH funding per year from 1998 to 2008. Much of that funding, according to a study by Management Science, is thanks to lobbying; in that sense, rare disease lobbyists are succeeding. Critics, however, protest that more of those funds should be given to research diseases that have the largest negative impact on the populations, so even rare diseases are not without controversy.
By contrast, AIDS is one of the largest disease beneficiaries of government funds, both through NIH and the Bush administration’s PEPFAR initiative, and the funding, by most measures, has been tremendously successful. In a 2013 report, the UNAIDS initiative reports that 26 countries reduced the number of new HIV infections by 50% since 2001, with a similar global reduction targeted for 2015. Likewise, antiretroviral treatments, reduction of HIV transmission via drug injections, and closing the global AIDS resource gap all enjoyed varying degrees of success. Unfortunately, though, the successful trends that the fight against AIDS is enjoying may come to the detriment of other causes.
Because advocates are often competing for the same money, someone will inevitably lose out. In a recent article, The Hill notes that Alzheimer’s disease is eating up an ever-increasing portion of the Medicare and Medicaid costs: from 18% this year to an estimated 31% by 2050. As a result, Alzheimer’s research funding for the National Institutes of Health has increased to $600 million, but advocates hope that will increase to as much as $2 billion. Still, Alzheimer’s must compete with “scarier” diseases such as AIDS and cancer for funding; as Rep. Bill Cassidy (R-La.) points out, “Are we going to wait until we figure out a vaccine for [AIDS/HIV] before we begin shifting to a new battle?”
There seems to be no easy answer to the conundrum of what portion of NIH funding diseases should receive. Until the social and economic toll of Alzheimer’s reaches an untenable peak, or until Alzhiemer’s lobbyists find a sufficient receptive Congress, Alzheimer’s research may not see the success that AIDS has enjoyed.