REDUCTIONS TO HIV AND STD RESEARCH CARRY HIGH COSTS

FEATURING: Carl J. Fichtenbaum, MD, Professor of Clinical Medicine, University of Cincinnati, College of Medicine, Cincinnati, Ohio

 

A LIFELINE FOR THOSE WITH SERIOUS INFECTIONS

The Infectious Diseases Center (IDC) at the University of Cincinnati provides state-of-the-art care to individuals in Ohio, Kentucky, and Indiana through the application of clinical, educational, and research expertise. The IDC treats patients with a wide range of conditions from HIV, to bone infections, to Methicillin-resistant Staphylococcus aureus or MRSA—a deadly staph infection. It is a nationally recognized Center of Excellence for HIV care and is the only site in the tri-state region that provides a comprehensive program of primary and consultative care for HIV patients, treating roughly 1,800 patients with HIV each year. The IDC is also the only program in the region that provides access to clinical trials and pharmaceutical studies. Members of the medical team at the IDC have received recognition such as the Best Doctors in America and Top Doctors in Cincinnati designations for their treatment of patients with infectious diseases. The IDC is a lifeline in the region for individuals with serious infections, as well as a source of hope to all for future therapies and cures.

FEDERAL PARTNERSHIPS NECESSARY TO AN AIDS-FREE GENERATION

  • The IDC relies heavily on an array of federal support to operate the three main components of its mission: treatment; education; and research.
     
  • The IDC is an indispensable partner to the federal government in enabling care for those with HIV/AIDS and working toward a cure. This public-private partnership has been proven to work. For example, at the IDC in 1995, 157 people died from AIDS compared to 27 individuals in 2008 demonstrating how research into antiretrovirals through the ACTG has impacted lives.
     
  • The AIDS Clinical Trials Unit (ACTU), which is the clinical and translational research arm of the IDC, is supported by the National Institute of Allergy and Infectious Diseases (NIAID) AIDS Clinical Trials Group (ACTG) within the National Institutes of Health (NIH). The ACTG is the largest network of expert clinical and translational investigators and therapeutic clinical trials units in the world. These investigators and units serve as the major resource for HIV/AIDS research, treatment, care, and training/education in their communities.

LOST OPPORTUNITIES CARRY HIGH COSTS

Dr. Carl Fichtenbaum is the principal investigator for the IDC’s ACTU. When considering the University of Cincinnati for employment, he placed great value in the institution’s federal grants portfolio. The University of Cincinnati ACTU has been funded by NIH/National Institute of Allergy and Infectious Disease (NIAID) since 1987, which has enabled it to draw top physician-scientists and other talent. However, that funding stream has diminished over the last several years while the costs associated with conducting research have increased. As a result, the ACTU has shed 20 percent of the high-skill jobs once supported and is pursuing fewer lines of inquiry. Carl has had to pick and choose which studies to pursue, knowing that discarded research could have produced tangible outcomes for patients. As a nationally recognized top physician, had Carl opted to work elsewhere, not only would the research conducted at the IDC have suffered a loss, but so too would his patients. As Carl explained:

As a result of NIH/NIAID funding reductions over the last few years, we have cut back our operations, hampering our ability to conduct clinical trials. We’ve gone from a staff of 15 highly skilled professionals to 12 in a short period. We can’t be as effective in enrolling patients as we were just a few years ago. Roughly one-third fewer patients are now enrolled in our studies, which slows down the progress of our research projects, and impedes our ability to help people.

Public research universities across the country, where much of the NIH budget is spent, are facing a perfect storm of declining federal and state support and rising financial need on the part of students. At the same time, discoveries for some of the most challenging health conditions are seemingly just out of reach. Despite a formal end to the recent recession, public universities continue to struggle to make ends meet. In its 2014 budget, the University of Cincinnati cut $3.7 million, or 1.5 percent, from its general fund—a cut made on the heels of a $16.6 million cut in 2013.i Carl conveyed that public research universities are not capable of backfilling resources lost to NIH funding reductions:

Recognizing the value of our research to the community and the nation, the University of Cincinnati has provided $130,000 per year in additional support. However, it doesn’t close the gap. Policymakers are expecting universities to pick-up the slack, but they can’t fully.

Senior researchers at the ACTU fear that decreasing federal support for biomedical research and increasing competitiveness for grant dollars will discourage students and young investigators from pursuing careers in the field, causing irreparable damage to our nation’s long-term scientific competitiveness. “How will we attract and retain young investigators?” asked Carl. “Our current model is unsustainable.”

The IDC clinic is the only provider in the tri-state area to receive Ryan White “Part C” funds to

provide clinical care for HIV. For many years, Ryan White programs, administered by the Health Resources and Services Administration (HRSA), have not kept pace with the needs of rising patient caseloads as new infections are diagnosed and people are linked to care.

The IDC is a local performance site of the Pennsylvania/Mid Atlantic AIDS Education and Training

Center (PA/MA AETC). The PA/MA AETC is funded by HRSA and provides educational opportunities for health care providers of individuals with HIV infection.


AUTHOR
Infectious Diseases Society of America & HIV Medicine Association

SOURCES
i Driehaus, B. (2013, August 27). UC celebrating top rank for return on investment while hammering out contracts. Retrieved from http://www.wcpo.com/news/education/uc-tops-at-return-on-investment-while-hammering-out-contracts