How Much, How Soon?

Is the U.S. spending enough money on lifesaving medical research? Could such killing and crippling diseases as cancer, heart disorders, arthritis and mental illness be brought under swift control by a crash program like World War II's Manhattan Project? What should be the Federal Government's share in financing research? Informed answers to these questions--literally, matters of life and death for millions--came this week from a committee set up a year ago by the Department of Health, Education and Welfare.

Chaired by Louisiana-born Dr. Stanhope Bayne-Jones, 69, onetime dean of the Yale School of Medicine and lately boss of Army medical research, the committee concluded that things are pretty good now, but the explosive expansion of the last decade in outlays for medical research must go on at least until 1970. The goal then: $900 million to $1 billion a year. In effect: no blitz, but a powerhouse drive down the field.

In ten years, the U.S. has multiplied its total outlays for medical research by a factor of four (see diagram). The sum will reach at least $400 million in 1958, including $220 million in congressional appropriations. $130 million spent by industry, $50 million by foundations, voluntary health associations, universities and their medical schools. Is this enough? For the present, yes was the consensus of the experts quizzed by Bayne-Jones's group. Or as Dr. James A. Shannon, director of the National Institutes of Health (which handles 70% of the Government's outlays in this field), last year told Congress: "For the first time in the history of medical research, the limitation on progress is due more to [shortage of] manpower than moneys available."

A Baby in a Month? If a crash program, atomic style, could get started, would it pay off? Probably not. according to President John T. Connor of New Jersey's Merck & Co.. Inc. (TIME, Aug. 18. 1952), who gave the committee the results of his company's private survey: "There is real concern that the public is being misled into believing that you can buy discovery with money, that nine times as much money will cure nine times as many diseases or one disease in one-ninth the time. As one of those interviewed put it, 'You can't produce a baby in one month simply by making nine women pregnant.' "

The Bayne-Jones committee grasped unflinchingly the prickly questions of how good a job the Government agencies are doing and whether there is a danger in letting Big Government get a still bigger role in research. (Its share of costs has zoomed from 32% to more than 50% in ten years.) On the first score the committee concluded: NIH has done a generally excellent job; its system of making grants to universities and independent medical schools and research groups (TIME, Nov. 18) has avoided "the twin dangers of bureaucratic interference with science, leading to loss of freedom by scientists and universities, and of bureaucratic lassitude." But the committee warned that NIH should not go on expanding research inside its own walls, which now house 6,700 employees, including 900 M.D.s and Ph.D.s. Instead, it should boost its support to outside institutions.

A Doctor an Hour? But before anybody can boost research to rocket speeds, the committee pointed out, the U.S. must more than double the number of people engaged in it--from 20,000 to 45,000. And this means not only more technicians but more physicians, whose training is long, costly and difficult. The U.S. must train 8,900 new M.D.s every year by 1970, as against 6,800 a year now--which will mean setting up 14 to 20 new medical schools. Personnel is already in hen's-teeth supply, causing barefaced piracy. Merck's Connor quoted one drug company's research director: "I have the greatest spy service in the Western Hemisphere. We scout people all the time. It's a dangerous game, but the stakes are high."

Last week the nation's outlay for medical research was sure of a gentle uplift from Congress, possibly much more. As against a total of $211 million for NIH ($153 million of it for research) in the fiscal year ended June 30, the House voted $219 million for NIH, while the Senate's bill called for an Everest ascent to $321 million. At week's end House-Senate conferees were deadlocked, decided to take a two-week breather. But if the Senate prevailed over the House--even so far as to win a split-the-difference agreement --the nation's medical research outlays would be starting up the Himalayan curve recommended by Stanhope Bayne-Jones and his colleagues.

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