Basic Research and Its Contributions to Science and Society

It is the weight of cumulative evidence that drives changes in health care provider behavior as well as changes in funding priorities. But do changes in clinical practice alone get the job done? Absolutely not.
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Chemistry test tubes containing blue liquid on a white background
Chemistry test tubes containing blue liquid on a white background

Written by Edward Liebow

The social sciences are under fire once again. This time the attack is from Rep. Lamar Smith (R-TX) and the weapon is his "High Quality Research Act," which would require the National Science Foundation to prove before awarding any grants that social science research it wants to fund has a direct payoff for advancing the national health, prosperity, welfare, and national security.

This legislative proposal is troubling for two reasons. First, it short-circuits the process of peer review, taking the judgment of scientific importance out of the hands of scientists, placing politicians in the role of judging gaps in knowledge that need to be filled. Second, it assumes that to be important, research projects must have a clear and direct path to improving jobs, health, and national security.

The president and his top Science Policy adviser, John Holdren, have both weighed in on the success of the peer review process for driving scientific advances. We applaud the president on his vocal support. The path from basic research to its possible societal benefits is often not direct, however. It would be a big mistake to pre-judge basic research as unworthy because its contributions cannot be seen ahead of time. As Dr. Holdren said, it would make no sense at all to "throw out the basic-research baby with the bathwater, inasmuch as basic research constitutes precisely that subset of research activity that is aimed at expanding knowledge without reference to possible applications."

Even in the health and life sciences, the path from basic research to better health is far from direct. I have written about this connection, as I am an anthropologist who is interested in risk and innovation, particularly among health scientists. I have found that it is indeed quite rare that a single research project results in a direct breakthrough of the sort Rep. Smith expects to be utterly normal.

Take childhood asthma, for example. Asthma's prevalence in the U.S. has nearly doubled since 1970. It now affects about one in 12 children, making it one of the most common chronic childhood diseases in the U.S. In addition to making kids sick, missing school, having restricted physical activity, leading to overweight and childhood obesity, asthma also results in parents missing work, and additional medical expenses. Low-income and minority households are disproportionately affected, and children from these homes are more likely to be treated in emergency and urgent care facilities because they lack adequate health care insurance coverage.

Significant public funding has been invested in research to understand and reverse the dramatic surge in asthma. But how might this research eventually translate into a drop in disease rates? The basic research funding supports fundamental advances in our understanding of biochemistry and genetics, organ systems, and disease processes. But does that translate directly into better prevention and treatment? No, not directly.

These findings must be translated into clinical care guidelines, patents, technology commercialization, drug development, and testing for safety/efficacy. To do this translation, the initial work must be replicated, to make sure the findings are not a fluke. The use of research findings for clinical application typically depends upon compilation of evidence from multiple research studies.

Do these translated findings alone result in a drop in new cases childhood asthma? No, not directly. Once published, clinical guidelines and recommendations related to practice, treatments, and drug use are closely monitored and evaluated, again through further research. It is the weight of cumulative evidence that drives changes in health care provider behavior as well as changes in funding priorities. But do changes in clinical practice alone get the job done? Absolutely not.

For that we also need changes in air pollution laws and associated implementing regulations, changes in land use and zoning ordinances to reduce vehicle emissions, laws that authorize school nurses to administer rescue medicines rather than sending kids to the emergency room, and community education activities. Legislative change and rule-making often rely on expert testimony, with experts selected based on their scientific track records.

Do we ever see Eureka! moments of discovery? Of course. The identification of a chemical left by cockroaches, a key trigger for many children with asthma, pointed the way directly to an effective approach to reducing severe attacks. But this sort of discovery is the exception.

More typical are research discoveries that have unexpected and seemingly unrelated benefits. Research on gene sequencing techniques in one disease area may then be applied to understand a genetic condition that increases susceptibility to asthma triggers. Research on fireflies (yes, fireflies!) has led to affordable diagnostic laboratory tests. The steps from these basic discoveries to societal payoffs follow a winding path. For most of society's complex problems, there is no magic bullet solution that will come from a single research project's results. We anthropologists know this reality as well as any scientists, as our work emphasizes the interconnections between culture and behavior, and among a world of globally connected cultures.

We scientists are grateful for the public support we receive for our research. We appreciate the importance of using taxpayers' funds wisely, as we are taxpayers too. We are also convinced that there is no adequate substitute for the expert peer-review process in assessing the adequacy of proposed research and its contributions to science and society.

Edward Liebow is the Executive Director of the American Anthropological Association.

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