There are many diseases in the world that impact people’s lives. According to the United States Centers for Disease Control (CDC), the most common chronic diseases include heart disease, cancer, stroke, arthritis, and diabetes.[i] It is estimated that over 12 million Americans have some form of cancer[ii], 25 million with diabetes[iii], and 25 million with diagnosed heart disease[iv]. The CDC also claims that,
Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations.[v]
Of course, those 19 million Americans include people with the more common osteoarthritis which is caused by mechanical processes in the joints and is usually associated with age. It is estimated that rheumatoid arthritis, an autoimmune disease which can strike all ages, impacts over 1.5 million Americans.[vi] Of the 81 million Americans diagnosed with one of the major chronic diseases noted above, all forms of arthritis accounts for 24% and rheumatoid arthritis (RA) accounts for almost 2% of the population This prompted me to investigate research funding priorities.
The National Institutes of Health (NIH) is the federal government agency designated by the United States government to address health research and policy. According to their information,
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services , is the nation’s medical research agency—making important discoveries that improve health and save lives. More than 80% of the NIH’s budget goes to more than 300,000 research personnel at over 2,500 universities and research institutions. In addition, about 6,000 scientists work in NIH’s own Intramural Research laboratories, most of which are on the NIH main campus in Bethesda, Maryland.[vii]
The NIH awards billions of dollars every year for research into a wide variety of health related issues. Dr. Francis Collins, the famous scientist who led the Human Genome Project, is the current NIH Director. Funding from the NIH does not include research funding in other countries, research funded by corporations like pharmaceutical companies, or research funded by non-profit organizations or foundations. Clearly, pharmaceutical companies have large research and development departments whose goal is to develop new drugs and bring them to market for profit purposes. Non-profit agencies such as the Arthritis National Research Foundation (http://curearthritis.org/) dole out donated funds to researchers. The Bill and Melinda Gates Foundation is the largest private foundation in the world and one of their areas of emphasis is global health. But their main focus is on infectious diseases, family planning, and nutrition in developing countries.[viii]
NIH data can provide some measure of the emphasis put on various diseases. The NIH publishes annual lists of projects funded by disease category.[ix] The grants are awarded competitively – researchers submit proposal and they are peer reviewed for worthiness. According to their report of the latest actual numbers in 2011, the NIH funded $231 million in projects targeted at arthritis which includes osteoarthritis, rheumatoid arthritis, and other related diseases like lupus and gout. Of the numerous grant projects funded in 2011 for arthritis research, some were focused on osteoarthritis and others on RA. It’s a difficult process to wade through the hundreds of projects and some knowledge of the topic would be required to determine exactly which is RA focused. For example, a project called IL-10 Regulates Mast Cell Function and Survival was funded for $354,622 to Virginia Commonwealth University. This is probably RA related because IL-10 is one of the immune system regulatory chemicals involved in RA. The project Attenuation of Pain in Men and Women: Mechanisms of Exercise-Induced Analgesia funded to the University of Wisconsin for $157,028 is related to all forms of arthritis.[x]
The NIH gave another $869 million for projects categorized as autoimmune diseases which includes many diseases other than RA. There are many RA related projects funded in this category such as Effect of Chronic Inflammation on Atherosclerosis Outcomes in RA for $744,283 to the University of Texas Health Science Center. There are many projects funded in this category that are connected to general autoimmune processes that may or may not be involved with RA. For example, the project Innate Immune Signal Transduction Specificity in Inflammatory Disease was funded to Case Western Reserve University for $315,446.
The amount of funding given to arthritis and autoimmune diseases has held steady since 2008. There were some upward bumps in funding in 2009 and 2010 but that is because of extra stimulus funding from the American Recovery & Reinvestment Act. It appears that most disease categories maintained a level of funding over the past few years. There have been no dramatic increases of decreases in arthritis funding by the NIH.
According the NIH report, heart disease received a combined $1.673 billion of funding for 2011, diabetes received $1.076 billion, and all cancers combined received $7.413 billion in grants. Clearly cancer is the top policy priority of the national government. Given the actual impact to populations as a whole and its impact on disability, it seems that arthritis should receive a larger proportion of funding. That case could also be made for heart disease and diabetes. But it is heartening to see a large proportion of funding going to arthritis in general and RA in particular.