AIDS, Breast Cancer Research Favored

A new study suggests that diseases such as AIDS and breast cancer get a disproportionately large share of federal research dollars in relation to the toll they take on public health.

The study, published in today's New England Journal of Medicine and conducted by researchers at Johns Hopkins University, is the first systematic comparison of National Institutes of Health funding for specific diseases and the burden imposed by these illnesses.

Overall, the study found a strong correlation between NIH funding in fiscal 1996 and the years of life lost to disability and death from 29 diseases in the world's industrialized nations -- a measure called disability-adjusted life-years, or DALYs.

However, the study found that diseases with strong political lobbies -- especially AIDS -- got more money according to the DALY measure than diseases with less vocal advocates, such as emphysema and depression.

AIDS got $1.4 billion in grant money in fiscal 1996 and was estimated to lead to the loss of 1.27 million DALYs -- about $1,114 per DALY. Breast cancer received $381.9 million for 1.42 million DALYs, or $269 per DALY. Depression got $148.8 million for 8.4 million DALYs, or $17 per DALY. Emphysema got $62.4 million for 2.28 million DALYs, or $27 per DALY.

The study also found a fairly strong correlation between NIH funding and two other commonly used measures of the burden of disease: deaths caused and years of life lost to premature death.

But Cary Gross, who led the study, said the DALY measure is superior because it better captures the effect of chronic, debilitating diseases such as mental illness and diabetes.

In an accompanying editorial, Harold Varmus, the head of NIH, cautioned that NIH considers many factors when awarding grants, including whether a big push in a particular area is likely to yield major scientific gains or public health benefits.

Test May Improve Care for Diabetics

The government yesterday approved a test that could dramatically improve how doctors care for diabetics by providing the first continuous measurements of a patient's glucose levels.

But MiniMed Inc.'s "continuous glucose monitoring system" won't replace those painful finger-prick blood tests that diabetics must perform regularly, the Food and Drug Administration warned.

The glucose monitor instead is for doctors to use occasionally to help adjust patients' treatment. But it marks a big step toward development of a continual glucose monitor that diabetics would always wear.

Diabetics' bodies cannot regulate glucose, or blood sugar. Millions control their glucose with insulin shots, other medications and special diets. To know if treatment is working, diabetics prick their fingers several times a day to perform a blood test. The tighter control maintained on glucose, the less likely diabetics are to suffer blindness, heart disease and other complications.

Under the new system, a sensor would be implanted just under a diabetic's abdomen skin for up to three days. The sensor records glucose levels every five minutes. A computer program downloads the records so the doctor can analyze daily glucose fluctuations and customize treatment.