For the thousands of biomedical researchers whose livelihoods depend on the fortunes of the National Institutes of Health, 2015 ended on a positive note: Washington boosted the NIH budget by $2 billion, or 6 percent, for the coming year.
Unfortunately, the increase makes barely a dent in the decade-long financial squeeze that the NIH has operated under. The restriction had already taken a significant toll on a generation of biomedical scientists, pushing the average age that scientists win their first major NIH funding to an ancient 42. Without those big NIH grants, scientific progress is stymied, as are scientific careers, leading many biomedical researchers to leave the field in search of faster tracks and better pay.
One area particularly hard hit by the NIH austerity is neuroscience, which includes the study of the brain and of mental health. But cutting biomedical research dollars to save money is like cutting your car expenses by not buying motor oil: You'll just end up paying much more, later. And you might break down on the highway.
According to a World Bank report, neuropsychiatric disorders such as Alzheimer's and depression are disabling to individuals and enormously costly to society. They account for 12 percent of the global burden of disease, second only to infectious diseases. Barring any major breakthroughs, experts predict that by 2030, depression will be the leading cause of economic disease burden worldwide.
From a financial perspective, it makes sense to invest in neuroscience, psychiatry and related areas.
Fortunately, philanthropy has made up for some of the inadequate federal dollars for neuroscience. One such funder is the Leon Levy Foundation, created in 2004 by Shelby White, Levy's widow, with the $500 million fortune he'd amassed as an investor on Wall Street. The Levy foundation now supports research and work in six areas: the ancient world, arts and humanities, preservation of nature and gardens, brain research, human rights and Jewish culture.
The foundation's support for brain research takes the form of the Leon Levy Fellowship in Neuroscience. After 10 years, the fellowship has awarded more than $20 million to approximately 40 early-career scientists at the five leading neuroscience research institutions in New York City: Columbia, NYU, Rockefeller University, Mt. Sinai and Weill Cornell. The foundation says no other fellowship has provided as much money to neuroscientists who take on novel, even risky ideas.
Like much of the philanthropic funding that cropped up as the NIH budget shrank, the Levy fellowship supports scientists at the start of their career, giving them the support they need to develop the ideas and data that will give them a shot at NIH funding.
"There's really no opportunity in government funding for people just starting off, so a whole generation could be lost if they don't get early experience and support," said Robert Goldrich, Leon Levy Foundation president. "The Levy Foundation wanted to make a difference in neuroscience, and the problem of early-career support was identified as an opportunity."
The Levy foundation doesn't select fellows to fund; it leaves those decisions to the institutions. But the support is oriented toward basic science, the fundamental biological processes that advance entire fields and lay the groundwork for future therapies and cures. "Our fellows are hopefully going to be the kind of people who solve complex problems and questions in brain science," said Goldrich.
Not surprisingly, as public funds dry up, major neuroscience departments have come to rely more and more on philanthropy during the past decade.
"When the NIH budget contracted, compounded by the recession, we saw that the traditional business model for academic medicine was no longer viable," said Jeffrey Lieberman, MD, Chair of Columbia's Department of Psychiatry. The portion of Columbia psychiatry's research budget from philanthropy grew from about 3 percent a decade ago to nearly 15 percent today, and it's still growing, he said.
Philanthropy like the Levy fellowship not only keeps the lights on in neuroscience labs doing important research, said Lieberman, it's crucial for retention of human capital at many departments. "We wouldn't have been able to hold onto some of our best and brightest junior faculty members without the funding—they would have been stolen away," he said.
Part of the reason neuroscience has been underfunded is that it's actually a pretty young discipline: it didn't even really exist before the 1970s. For most of human history, understanding of the brain and treatment of neuropsychiatric disorders moved slowly. The brain is fantastically complex, and no amount of autopsies and microscopes could reveal all its secrets.
But just as the microscope revolutionized understanding of germ theory and led to actual cures for infectious diseases, Lieberman pointed out, relatively new technologies like MRI, CAT and PET scans are finally making it possible for scientists and physicians to understand the brain's physiological processes and disorders. That means neuroscience has entered a sort of golden age that may finally devise truly effective treatments and even cures for serious and costly health problems, like dementia, depression, autism, schizophrenia and so many other disorders.
The catch is that even as exciting new breakthroughs have become more possible, funding has become more scarce.
Even with the support of philanthropy and the recent NIH budget increase, Lieberman says neuroscience is dangerously underfunded. "One of the biggest threats to the country's economy is health care costs, and mental health is an uncontrolled part of that," he said. "But the government has not addressed the costs associated with mental health in a rational way."