Government Funding for RA Research Compared to Other Serious Illnesses
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.1 It is estimated that over 12 million Americans have some form of cancer (American Cancer Society)2, 25 million suffer with a form of diabetes (American Diabetes Association)3, and over 26 million are diagnosed with heart disease (Centers for Disease Control and Prevention).4 According to the CDC, half of adult Americans suffer from some sort of chronic illness and heart disease and cancer account for almost 48% of deaths.5 The CDC reports that 53 million adults have a doctor diagnosed form of arthritis with 22 million reporting a disability in a usual daily activity.6 Arthritis is the leading cause of disability in the United States (Arthritis Foundation).7 According to the most recent study on the dollar costs attributable to arthritis conducted in 2003, medical costs and lost income was $128 billion.8 This amount would obviously be much higher today.
The 53 million Americans with arthritis include people with the more common osteoarthritis that tends to occur in older populations. It is estimated that rheumatoid arthritis, an autoimmune disease that can strike all ages, impacts over 1.5 million Americans (Arthritis Foundation).9 Of the 116 million Americans diagnosed with one of the major chronic diseases noted above, all forms of arthritis accounts for 45% and rheumatoid arthritis accounts for almost 1.3% of the population. These statistics prompted me to investigate research funding priorities.
The National Institutes of Health (NIH) is the government agency designated by the United States government to address health research and policy. The NIH awards billions of dollars every year for research for 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. 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.10
NIH public information provides some measure of the emphasis put on various diseases. The NIH publishes annual lists of projects funded by disease category.11 The grants are awarded competitively – researchers submit proposals and they are peer reviewed by other scientists for worthiness and potential impact.
According to their report of the latest actual spending in 2014, the NIH funded $239 million in projects targeted at arthritis that includes osteoarthritis, rheumatoid arthritis, and other related diseases like lupus and gout. Of the numerous grant projects funded in 2014 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 2014 project called Loss of B Cell Tolerance in Rheumatoid Arthritis12funded for $416,250 to scientists at Yale University is clearly RA related. The project Annexins and Osteoarthritis13funded for $372,900 to the New York University School of Medicine is related to only to osteoarthritis. The NIH gave $822 million for projects categorized as autoimmune diseases that include many diseases other than RA. But projects related to RA are categorized in both the arthritis and autoimmune categories.
The amount of funding given to arthritis and autoimmune diseases has held steady since 2011. It appears that most disease categories maintained a level of funding over the past few years. There have been no dramatic increases or decreases in arthritis funding by the NIH.
According the NIH report, heart disease received a combined $1.2 billion of funding for 2014, diabetes received $1.1 billion, and cancer received $5.3 billion in grants. Clearly cancer is a top policy priority of the national government. Other top funding categories included biotechnology at $5.9 billion, HIV/AIDS at $3.0 billion, infectious diseases at $ 5.0 billion, genetics at $ 7.3 billion, neuroscience at $5.6 billion, and prevention at $6.9 billion.
Given the actual impact to populations as a whole and its impact on disability, it appears 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.
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?