Dr. Augustine M.K. Choi is dean of Weill Cornell Medicine and provost for medical affairs of Cornell University. He argues that declining spending on research is threatening the country’s technological and intellectual lead.

— Susan Svrluga  

If a serious public health crisis were to strike the United States that tests the limits of our abilities, one of the first calls U.S. leaders would make would be to China.

That’s because China has among the world’s best genomic sequencing technology allowing for a rapid molecular identification of an outbreak to guide a public health response. In short, China’s expertise could be essential for turning the tide in such a crisis and saving American lives.

As the genomic sequencing advances suggest, China is within striking distance of surpassing the United States as the global leader in innovations that protect public health. And it’s not just the technological lead that the United States is losing. The lure of ample research budgets — in China and elsewhere — while U.S. research spending is in decline is threatening a biomedical brain drain from our shores.

The American Society for Biochemistry and Molecular Biology polled its 12,000 members and found that a decade of reduced research spending here is having a toll on U.S. innovation while also stoking a willingness among scientists to move overseas. The organization concluded that nearly 20 percent of respondents were considering moving to another country to continue their scientific careers.

The failure that this represents — both in terms of public health readiness and the ceding of scientific primacy — cannot be underlined enough.

“This means the federal government would invest in the training of young scientists only to have them move to another country to compete against American scientists for the breakthroughs of tomorrow. Such a scenario would be a major blow to our national scientific enterprise,” the organization said.

Far more important than private or university sources of funding, the National Institutes of Health historically has been the essential engine for biomedical study and breakthroughs by sponsoring discoveries focused on addressing specific diseases. In addition, the agency supports and conducts basic science that is applicable to a wide spectrum of research areas. But from 2003 to 2015, federal support for biomedical research declined precipitously — by over 25 percent in real dollars, with NIH approving half as many proposals as before.

Unfortunately, the Trump administration’s budget blueprint for 2018 would make a bad situation much worse. While the 2017 budget recently worked out with Congress boosts research at NIH, the White House is seeking a huge cut the following year — a nearly 20 percent reduction, along with big cuts to research budgets in other federal agencies.

Darrell G. Kirch, chief of the Association of American Medical Colleges, warned that the proposed cuts would “set back progress toward critical advancements that could take decades to regain, prevent new ideas from being explored, and have a chilling effect on those who would potentially enter the biomedical research workforce,” he said.

The long and short of it is that a new generation of U.S. researchers is coming of age in the most unfavorable climate in decades.

“This is the issue that wakes me up at night when I try to contemplate the future of where biomedical research can go in the United States,” Francis Collins, chief of NIH, warned last year. U.S. researchers “are finding themselves in a situation that is the least supportive of that vision in 50 years.”

“They look ahead of them and see the more senior scientists struggling to keep their labs going and suffering rejection after rejection of grants that previously would have been supportive. And they wonder, ‘Do we really want to sign up for that?’ And many of them, regrettably, are making the decision to walk away.”

The inevitable result of the grinding decline in research is that scientists are struggling to retain grant money and younger scientists are struggling to get grants, while universities are in danger of losing scientists who may take their talents abroad where they can get their research funded. For example, several Asian countries are increasing biomedical research spending by double-digit annual growth rates, led by China.

We used to be worried about the university laboratory across town poaching our best and brightest. Now we are worried about other countries poaching them.

Thousands of Americans recently took part in the March for Science in Washington, where participants called for “robustly funded and publicly communicated science as a pillar of human freedom and prosperity.”

But as Congress considers the Trump administration’s funding cuts for next year, lawmakers should recognize a corollary of the march’s aim: The next big medical breakthroughs, the treatments for the untreatable, all require sustained NIH funding to nurture a new generation of researchers — and to keep them firmly anchored in this country.