NIH Spending vs. Diseases That Kill Us

Heart disease, COPD, and type 2 diabetes are tractable now. Eat less, don't smoke, exercise. The other diseases are horrible luck played out at the molecular level. Type I diabetes belongs in this other category.

HIV treatment is pretty well at a management phase. A vaccine would be great, but this goes to the general problem of human molecular biology still being not entirely known. Funding is to some extent molecular biology research.

Cancer is a molecular biology problem. Same as HIV.

Neuromuscular diseases are molecular biology problems.

My dad has prostate cancer. I'm working on prostate cancer. But the studies involves pathways in the embryogenesis of fruit flies and tested in zebra fish, and a lot of the work on these pathways has been funded by breast cancer research, agriculture companies, DoD looking for dual use agents, all sorts of weird cross-talk.

Meh.

1) Almost all high risk, new, next generation early stage research is funded by philanthropy. Major funding institutions won't give anyone money unless they can essentially demonstrate a proof of concept, and that what they have works. Similarly the for profit world doesn't tend to fund high risk new fields, but steps in at about the same point as public institutional funding.

2) Almost all funded research for the major killers involve diseases of aging, and almost all of that research is aimed highly inefficient ways of producing marginal gains. Which is to say that researchers work backwards from the very complex end state of a disease, attempting to produce a treatment from each new proximate cause they uncover. These treatments largely involve attempts to manipulate a very complex and poorly understood state of metabolism / biology. Only a very, very tiny slice of all this research funding goes towards prevention or repair or other ways to address the root causes of these diseases of aging, which is to say the processes aging itself. Until this changes, progress is only very loosely coupled to levels of funding. You can spend a bunch of money paying people to drain a lake with spoons, or you could spend a lot less doing something better and more effective, and that's really a fair analogy for where medical research is with respect to the diseases of aging. A disruption is underway, but it is going very slowly, as things tend to in the research world, and hasn't yet had much of an impact on the bulk of the mainstream.

For example, diabetes may not be the primary cause of your death, but you (or someone on your behalf) will spend a LOT of money managing the condition & associated complications.

http://report.nih.gov/categorical_spending.aspx