On the Editorial by Richard Smith, MD, Associate Editor, British Medical Journal.
A National Health Research Policy: Needed to Shift the Emphasis of Research
(BMJ, October 1, 1988)

If you wonder why the United States still lags behind other industrialized nations in public health indicators such as infant mortality, cancer rates and AIDS, you are not alone. While there are a few clues, no one seems to know exactly why. You might wonder: how can such a "knowledge gap" persist, with some $100 billion invested in medical research since World War II? The reason is that the US government has never fully probed the environmental causes of spontaneous abortion, premature infant death, cancer, etc. To do so would have threatened the petrochemical industry and the military-industrial complex during the Cold War period.

To this day the National Institutes of Health (NIH) spends about 0.3% of its annual $11 billion research budget on genuine "public-health research", i.e. epidemiological studies of the chemical and radiological causes of infertility, birth defects and disease. The lion's share of the US medical research budget has always been expended on experiments on animals and patients, many of which are of little, if any benefit. While our de facto research policy, with its emphasis on experimentation, has long suited the military-industrial complex and the pro-vivisection lobby, as early as 1962 the NIH director himself pointed out that it could not possibly help us to understand how to prevent human disease.

In testimony before the Senate and House Subcommittees on Labour, Health and Human Services in 1962, under the heading: "Atherosclerosis and the Need for Epidemiological Studies", Dr. James A. Shannon stated:

"...atherosclerosis is one of several areas in which research has reached the practical limits of laboratory investigation - with the present state of knowledge and techniques. The road to further progress now seems to lie in large-scale and long-range epidemiological studies utilizing large population groups as the basic unit of study ..."

While the need for human population studies was already clear to Shannon in 1962, when the billions started flowing into medical research during the Nixon Administration most of the research dollars were diverted to experimentation on animals and human subjects and not to public-health research. The imbalance in research funding progressively worsened during the 1970s and 1980s, a fact which the US pro-vivisection lobby effectively prevented from being aired in an American forum. In the November 5, 1988 British Medical Journal (BMJ) under the ironic heading: "Threats to Research", Assistant Editor Richard Smith reported: 

" 'The balance of medical research is under threat', said Dr. Samuel Their, president of the [US] Institute of Medicine. ' Basic research, clinical research, and public health research should be balanced ... the importance of basic [laboratory] research is over-emphasized.'" 

That the president of our own Institute of Medicine (IOM) could only feel free to speak his mind in a British forum speaks volumes about the strength of the US pro-vivisection lobby, particularly the Federation of American Societies for Experimental Biology (FASEB). It so happens that, two years later, the president of FASEB repeatedly attacked Dr. Their for issuing a report calling for a mere two percent shift of biomedical research funds from basic [animal] research to training of physician-scientists. According to the October issue of Science magazine , FASEB president Edgington accused Dr. Their's IOM of "trying to prevent life-saving research" by "placing too much emphasis on infra-structure and training and too little on the plight of the individual researcher seeking grants." In defending his report, Dr. Their explicitly raised the issue of FASEB's bias against public-health research. According to the December 7, 1990 issue of Science:

"(Dr.) Their was particularly upset that Edgington ... accused the IOM of stacking its panel with university administrators anxious to solve their financial problems at the expense of individual scientists. Dr. Their reported in an interview ... that more than half of the 18 panelists were working scientists, and he accused FASEB of failing to recognize that epidemiologists and sociologists are scientists too." 

In fact, while in the United States Dr. Their's IOM was practically begging for a paltry two percent shift in research funds, in Copenhagen, the European Office of the World Health Organization (WHO) was advocating an immediate LARGE-SCALE shift in research funding. Although never reported by the American press, WHO issued a series of three reports urging all industrialized nations to establish a clear national health-research policy to facilitate a shift in emphasis from 'traditional biomedical research' to public-health research and health-services research (to assess which treatments actually help the patient). Again reporting for the BMJ, in response to the WHO reports, the ever-alert associate editor Richard Smith wrote:

"If funds are going to have to be taken away from biomedical research to fund public health research, then the research establishment...is going to sabotage the plans ... Governments everywhere ... are unenthusiastic about health-services research because it illustrates their failures. They much prefer scientists to mess around with rat mitochondria."

We in the United States desperately need a coherent national research policy, not just to shift funding away from useless animal and human experiments [all of these are useless], but to shift funding toward public-health research and health-services research. Without such research, health-care expenditures will soon exceed $1 trillion a year for treatments of dubious value; unless we have a full accounting of the environmental causes of cancer, AIDS, infertility and birth-defects, these scourges will continue to ravage the American population.

- Brandon Reines, DVM 
- National Anti-Vivisection Society
- Newsletter, 1994 

Richard Smith's Editorial from the October 1, 1988 British Medical Journal.