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Issues for Medical Center Research
A. L. Chapman
Vice Chancellor for Academic Affairs
University of Kansas Medical Center
In a medical center environment, it is critical
to blend both basic (bench) and clinical research. The latter would
include the application of new knowledge to the treatment of the
patient. Application of new knowledge requires use of industry and
business resources in production, manufacturing and distribution.
The initiation of new knowledge depends, in
large part, on a strong basic research component in the medical
sciences. The major funding for this type of research is generally
dependent upon the federal government, particularly the National
Institutes of Health (NIH) which approximates $13.6 billion in fiscal
year 1998. It is of particular interest to comment on a recent report
submitted to the NIH suggesting areas for future expenditure. This
report was made by the Research and Policy Committee of the Committee
on Economic Development in 1998 and was given to Harold Varmus,
Director of the NIH. The Committee stated that it is essential to
maintain the integral role of government in supporting basic research,
as industry continues to focus on research and development with
specific product-directed goals.
The Committee reported that:
- The return from basic science to the nation's
economy has been substantially higher than the return to private
firms;
- Basic research performed at universities
is correlated with strong economic activities in their neighbors'
locale, e.g., there are more than 1,000 MIT-related companies
in Massachusetts with world-wide sales of more than $53 billion
annually;
- Of some $63 billion that government spends
on research and development annually, $18 billion goes to basic
research compared to $8 billion spent by industry on basic research
from a total of $133 billion in research and development funding;
- 73% of research publications cited by industrial
patents were derived from government-related funding;
- The essential strength of the American system
is the rigorous peer review process;
- The most important American institutions conducting
basic research are the nation's 200 major research universities;
- The biotechnology industry has been the major
beneficiary of the Bayh-Dole Act in 1980;
- University-industry relationships must be
managed carefully and according to strict guidelines that protect
the primary basic research mission of the universities.
Based on this report, the Committee offered certain
principles to NIH for guidance:
- Retain investigator-initiated, competitive,
peer-reviewed grants;
- Increase funds for innovative training and
research partnerships involving business and industry;
- Incorporate fundamental disciplines including
basic scientific and engineering research;
- Revitalize and adequately fund clinical research
and its infrastructure, including clinical research centers;
- Expedite movement of new research findings
from the laboratory and scientific journals to practicing physicians
and their patients;
- Improve support for young investigators,
including training grants and individual fellowships;
- Support construction of new facilities for
research, particularly focused on sophisticated research equipment
and facilities.
Clearly, positioning each of our institutions
to take advantage of federal and private grant/contract funds requires
changes as well as internal investment. One such initiative at the
University of Kansas Medical Center (KUMC) included the formation
of a non-profit foundation-the KUMC Research Institute-in 1992.
Its purpose is to improve working relationships with the private
sector, improve service to the faculty, and provide additional sources
of revenue through an internal grants program.
Achievements of the KUMC Research Institute include:
- Favorable responses from investigators who
appreciate the increased flexibility of grant funding;
- Financial self-sufficiency because the Research
Institute does not require state support;
- Development of three divisions: Grants Management,
Technology Development and Clinical Trials;
- $520,000 disbursed in awards to faculty through
the peer-reviewed small grants program in the last fiscal year;
- 100 invention disclosures received from faculty,
including patenting and licensing;
- Formation of six companies based on faculty-derived
technology;
- Development and management of a research incubator
building;
- Purchase of eight acres of property adjacent
to the Medical Center campus and donation of three acres to the
state for the Center for Health and Aging Building;
- Potential commercial development of the remainder
of the property in support of the research mission;
- Management of 160 clinical trials.
In conclusion, to improve the research
environment, it is critical to include a nonprofit foundation as
part of research management at the institutional level. However,
this is only one small step in addressing the needs of any medical
center. It is clearly necessary for research universities to position
themselves for growth through expanded funding from federal and
private sectors. Those institutions that have demonstrated recent
success in increasing their institutional rankings have received
a significant influx of funds from state and/or private sources.
This has generally resulted in new buildings as well as additional
support for the research faculty.
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