The 2017 annual meeting of the Society for Neuroscience was held November 11-15 in Washington, DC. For some, the meeting’s proximity to Capitol Hill provided an opportunity to speak up for neuroscience research—and funding, in particular—in a number of ways, including meeting with US congressional representatives. Two scientists pressing for immediate funding for pain research were Robert Gereau and Jose Moron-Concepcion, both of Washington University, St. Louis, US.
The two researchers met with members of the staff from Missouri Senator Claire McCaskill’s office on Tuesday, November 14. Gereau was inspired to request the meeting by a chance encounter with Senator McCaskill on an airplane. When she heard that Gereau headed the Washington University Pain Center, “she reached over and grabbed my arm and said, ‘What are we going to do about this opioid situation?’ This was in 2012,” well before it had become the nationally recognized crisis that it is today. “She was way ahead of the curve in understanding this wave, this opioid epidemic that was coming,” Gereau said.
Gereau and Moron-Concepcion met for about an hour with three staffers from McCaskill’s office. Chronic pain, they said, is an underlying public health crisis that must be addressed.
“We all recognize it’s a crisis,” Gereau said of those working in the pain field, many of whom worked to craft the National Pain Strategy and the Federal Pain Research Strategy, among other documents. “So many experts have spent so much time discussing this—it’s shameful that not much has happened,” Gereau told PRF. “It’s time to do something real. People are dying, and we have 100 million people with chronic pain,” with opioids among the few treatment options available.
The staffers, Gereau and Moron-Concepcion said, were already aware of the huge problem of chronic pain and were incredibly well informed, and they seemed keenly interested in helping to find solutions.
Out of proportion
As it is, pain research is sorely underfunded relative to the impact pain has on society. Of the money paid out by the US National Institutes of Health (NIH), only a tiny fraction goes to chronic pain research—less than $500 million in 2012. In contrast, cancer research was funded to the tune of $5.5 billion, and HIV/AIDS research received more than $3 billion. The funding seems to reflect an imbalance in priorities, given that the societal cost of AIDS has dropped to only $500 million per year, whereas the cost of chronic pain exceeds that of cancer, heart disease, and diabetes combined, at an estimated $635 billion annually (Gereau et al., 2014).
Big problems can be solved with sweeping NIH funding initiatives for research, as was seen with the HIV/AIDS crisis. What was initially a mysterious disease with a nine-month death sentence has rapidly become a manageable health condition, thanks to intensive research and clinical trials.
“But that isn’t happening for pain,” Moron-Concepcion said.
Moron-Concepcion and Gereau presented the chronic pain epidemic as a public health crisis on par with the HIV crisis at its peak. “This is the type of game-changing effort that the federal government needs to take,” in the form of NIH funding, Moron-Concepcion said.
And yet, hundreds of millions of NIH dollars remain specifically allocated for HIV research, sometimes even going unused. “Could those funds be reallocated to shift around to where the crisis is?” Gereau said he asked in the meeting. “The HIV crisis is not there anymore.”
Gereau said there are other examples where “amazing, incredible advances were made in a shockingly short amount of time, because there was a pool of resources available.” For example, “it’s stunning to see how much progress has been made with the BRAIN Initiative,” he said of the Brain Research through Advancing Innovative Neurotechnologies Initiative, an Obama-era program that is providing hundreds of millions of dollars in neuroscience research funding over a decade. “Now, we need a PAIN Initiative,” Gereau said.
“Let me make clear: I'm not saying that money shouldn’t be spent on [drug] treatment management,” Moron-Concepcion said of the opioid crisis, “but more money is needed to invest in basic research. We cannot find new approaches to pain when we don’t know what pain is doing in the brain.”
Another topic of discussion in their meeting was US Food and Drug Administration (FDA) approval of new drugs.
“Nothing we use to treat pain now would make it through the FDA today,” Gereau said, because the bar is so high. “Of course we should be concerned about risks with any new drug, but the risk should not be considered in a vacuum. It should be considered in the context of the risk of not having those drugs. And what we have now is opioids, and we know that opioids are dangerous. So that’s a way the government could respond, to decrease the regulatory burden.”
McCaskill’s staffers had plenty of questions for the researchers, ranging from FDA regulations and safer opioid drugs, to the effectiveness of cannabis for chronic pain.
The officials told Gereau and Moron-Concepcion that Senator McCaskill would use her voice to support more funding for pain research as she was able, but that the members of the U.S. Senate Committee on Appropriations would ultimately be the best targets to pressure.
“We’ll see what happens,” Gereau said. “We’re going to keep working.”
Back at the ranch….
While Gereau and Moron-Concepcion were in the congressional meeting, a forum titled “Advocating for Basic Science Research in a Disease-Focused World” was being held at the SfN conference. The forum, which was well attended by several hundred neuroscientists, was chaired by Bill Martin of BlackThorn Therapeutics, a company in San Francisco, US, that is developing new treatments for neurobehavioral disorders.
A panel of speakers included Mary Woolley, president of Research!America, a nonprofit organization advocating for health research in the US. Woolley had a frank message for the scientists: “You can’t outsource advocacy.”
Researchers, she said, must advocate for themselves in whatever way they can, from meeting with elected officials to writing op-ed pieces in local or national publications. “Never forget,” she said, “information drives policy.” People—including policy makers—are interested to know what sort of research is being supported by their tax dollars and is taking place in their communities, Woolley said.
Woolley had an action item, too. The NIH has lost 22 percent of its funding capacity over the past decade, but the US Senate appropriated a $2 billion increase in funding for fiscal year 2018 in an effort to restore the NIH budget. Budget caps on both defense and non-defense spending, however, will prevent the funding from reaching the NIH, unless Congress removes them. Woolley urged the audience to tweet at US House Speaker Paul Ryan (@SpeakerRyan) to raise the non-defense budget spending caps and allow research to get funded.
Despite polling figures indicating that the majority of Americans support funding for research, a growing number of people seem to find little value in it, or even harbor anti-science stances. Anti-science movements can be found across the political spectrum, from climate change denial to extreme animal rights activism and anti-vaccine campaigns, Woolley said. When engaging someone in a conversation about science who does not share your views, Woolley told the scientists in the audience, say, “I can see that you’re skeptical. That’s how I was trained, too.” It can be a bridge to a shared understanding.
Woolley urged SfN attendees to be open to a new conversation on the plane ride home. “When someone asks what you do, this time, don’t say, ‘I’m a neuroscientist.’ Try saying, ‘I work for you.’ You’ll be amazed at where the conversation may lead.” (To read more about the forum, see RELIEF related content).
Other scientists, too, got into the spirit of advocacy during the five-day SfN meeting. According to a Society spokesperson, members of the North Carolina Triangle Chapter of SfN visited congressional offices, as did the Portland, Oregon-based nonprofit neuroscience outreach group NW Noggin, led by Bill Griesar, who also held a congressional briefing on Capitol Hill. In addition, SfN hosted eight tours of the poster floor for representatives from nine congressional offices, including two members of Congress.
Woolley had a parting comment for those at the forum: “If you’re not an advocate, it could be hazardous to your career.” The panel’s overall message for researchers: Speak up for science—your job security depends on it.
Stephani Sutherland, PhD, is a neuroscientist, yogi, and freelance writer in Southern California.
Image credit: Martin Falbisoner/Wikimedia Commons.
