THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, September 24, 1996 TAG: 9609240001
SECTION: FRONT PAGE: A14 EDITION: FINAL
TYPE: OPINION
SOURCE: By NEAL D. BARNARD, M.D.
LENGTH: 94 lines
At the Democratic National Convention, Christopher Reeve appealed for research on spinal-cord injury, multiple sclerosis and other serious conditions. We put a man on the moon, he said. Now is the time to direct the same effort toward health problems. But Reeve's passionate dream could fail miserably unless we recognize the four problems that have kept most American research endeavors from rivaling NASA's 1969 achievement.
First, as obvious as it sounds, we need to start with a plan. When President Kennedy set the nation's sights on the moon, NASA developed a detailed plan, enlisted the help of expert consultants and contractors, anticipated myriad technical problems and then reached its goal in less than a decade. Yet most large research endeavors have no overall plan. Instead, research bureaucrats simply set up a pool of money and let anyone with a laboratory and half an idea apply for a check.
Universities encourage their faculty to try to steer research funds their way, whether they have a genuinely important project or not. This is not just to pay for their academic reveries. For every dollar that finds its way to a university research fund, between 30 and 60 cents are taken by the universities themselves for ``indirect costs'' - heating, landscaping, new buildings or whatever else they choose to fund.
Second, we should study human illnesses, not rats and mice. Thanks to computerized tomography, positron emission tomography and other state-of-the-art techniques, we can look inside the human body in ways we never could before. The war against polio was aided immeasurably when cell cultures replaced the monkeys that had been used as living test tubes for the virus. Monkey tests had suggested that the virus entered the body via the nose, leading to all manner of useless treatments before it became clear that the monkey results did not apply to people.
Much of the controversy as to whether tobacco does or does not cause cancer was due to problems caused by animal tests. Animal inhalation tests in the 1960s showed that tobacco smoke did not cause cancer, while painting tar on a mouse's skin did cause cancer. It was only when careful human population analyses were done that the truth became abundantly clear.
But animal experimenters continue to take billions of dollars every year, with little to show for it in one tragic disease after another: Of the 25 treatments that reduced the effects of stroke in animals, not a single one worked in humans. Likewise, birth-defect tests on animals are notoriously unreliable indicators of human risk. In cancer research, the National Cancer Institute became so concerned the animal cancers were fundamentally different from those in humans that it stopped screening potential anti-cancer drugs in mice and began using human cancer cells instead.
The industry that sells animals and cages tries to portray itself as the potential savior of humankind. For example, some less-than-honest animal-industry lobbyists have claimed that animal experiments were essential for developing treatments for spinal-cord injury, particularly the drug methylprednisolone. It certainly is a good drug, but it was in use long before such animal experiments were conducted, and we did not need animal experimenters to show us how to use it correctly.
Third, we need to accept what research shows us, even if it is unpopular. Human clinical and population studies showed that the B-vitamin folic acid can prevent neural-tube defects, yet controversy over whether or not we should act on this information has left thousands of babies' lives hanging in the balance. Likewise, in decades-long research, Portland's Dr. Roy Swank showed that cutting animal fats from the diet could essentially arrest multiple sclerosis for many people. But in spite of a warm reception from medical journals, neurologists have all but ignored this treatment that is simpler, yet more effective, than drugs.
Fourth, we must demand honesty and integrity from researchers. In order to continue feeding at the public trough, experimenters often portray their work as something other than it is. Cocaine experimenters have tried to justify their grant requests by pretending to work toward an anti-craving pill. Animal sex researchers have begun claiming relevance to AIDS.
Too many experimenters have pretended to be more in the dark than they really are. After all, if we really do know, once and for all, that tobacco causes lung cancer, the public will no longer pay for lung-cancer experiments and will, instead, put its money into anti-smoking programs. So some researchers have portrayed themselves standing endlessly at the door of discovery that a few more dollars might open, even though we already had the needed answers.
Two decades ago, human population studies showed that at least 80 percent of cancers were caused by identifiable factors (30 percent are due to tobacco, and roughly 50 percent are due to diet, among other causes). But some cancer researchers still pretend that we have no idea what causes most cancers.
The bottom line: It is not enough to buy more microscopes or more rats and mice and hope that they will solve the problem. It is time to conduct research as if someone's life depends on it. We need population studies to show us more about the causes of human birth defects. We need human clinical studies to help us refine treatments for diseases. We must take advantage of new test-tube methods and imaging techniques. But ``research for research's sake,'' that never-ending enterprise without a goal, is no longer tenable. MEMO: Dr. Barnard is president of The Physicians Committee for
Responsible Medicine, the author of four books and the editor of Good
Medicine. by CNB