Jonathan Chen has a doctorate in computer science and could have his pick of lucrative jobs here in Silicon Valley today.
Instead, he pursued his medical degree and is working on ways to help physicians quickly mine clinical data to reach better diagnoses for their patients.
“I walked away from higher paying jobs because I was looking for a greater purpose in my work and a rewarding career,” said Chen, a physician-scientist at Stanford who was a VA Medical Informatics Fellow at Stanford Health Policy.
Future works like his — supported by a five-year grant from the National Institutes of Health — may be on the chopping block.
The Trump administration’s proposed budget intends to cut NIH funding by $7 billion over the next 18 months, which could severely compromise research grants that lead to major biomedical breakthroughs.
Chen is currently building OrderRex, a digital platform that data-mines electronic medical records that show clinical practice patterns and outcomes to inform medical decisions. He hopes it will one day be the Amazon of electronic medical records.
After more than 20 years of hard work — a college freshman when he was only 13 — Chen is finally poised to become a junior faculty member. But now he has to wonder whether he made the right choice.
“Seeing the proposed research budget cuts gives me pause,” Chen said. “And I’m considering whether it is foolish for me to even be joining the academic ranks now, chasing down grants that will be increasingly difficult to come by, amidst a political climate that does not seem to care for science.”
The administration has said it respects and would support the work of the NIH, which Secretary of Health and Human Services Tom Price recently called “very important.” But, he added, the American taxpayers should be getting “a bigger bang for the buck.”
About 80 percent of the federal NIH funding goes to grants for clinical and translational researchers at small businesses and academic institutions.
Here at Stanford Health Policy, the grants have funded research into everything from the epidemic of diagnostic errors to the economic harm of the tsetse fly on African economies; the impact of urbanization on obesity and chronic disease in India, to a global data analysis about whether foreign aid is directly linked to an increase in life expectancy in developing countries.
The National Institutes of Health — which has supported the research of some 148 Nobel Prize winners — has touched the work of nearly every SHP researcher.
“Cutting scientific research budgets could turn a generation of young minds away from the larger purposes of academic medical research and instead send them off into finance, tech, pharma — leaving behind the country’s talent pool in the decades to come,” said Chen.
Eran Bendavid, an assistant professor of medicine and core faculty at Stanford Health Policy, uses political science, economics, and epidemiology to study the prevention and treatment of infectious diseases in developing countries.
The infectious disease physician also depends, in part, on NIH funding.
“There is no substitute for NIH support for basic and applied research,” Bendavid said. “It has been a central actor in the progress of the biomedical fields and made the U.S. the global leader in innovation. It is also good diplomacy, promoting cooperation and partnerships across the globe.”
Bendavid and SHP colleague Grant Miller led the research that showed that declining use of safe contraception led to an increase in abortion rates in sub-Saharan Africa, a region in which family planning services are heavily financed by U.S. foreign aid. Their work was widely cited in news reports as a counterpoint to the Trump administration’s pledge to cut funding to international family planning organizations that also offer abortion.
“Even if many of the budgetary provisions are scaled back, this is an unfortunate place to anchor the negotiations,” Bendavid said of the proposed NIH cuts, which are so severe they are already facing opposition from some members of Congress. “This could signal real changes in what we do as individuals, as a division, and as an institution.”
House Speaker Paul Ryan was asked specifically about President Trump's proposed cuts to the National Institutes of Health. The speaker avoided criticizing the administration for that proposal — but indicated it was unlikely Congress would go along.
“I don’t try to get into making my opinion on this, on specific provisions,” Ryan said. “All I would say is perhaps the most popular domestic funding we have among Republicans is NIH.”
Michele Barry, director of the Center for Innovation in Global Health and senior associate dean for Global Health at Stanford University — as well as one of SHP’s key faculty members — wrote in this editorial on March 28 that such drastic cuts to biomedical research would make us more susceptible to global epidemics.
“We live in a time when pandemics cross borders faster than ever,” Barry wrote. “Yet to the horror of many of us working in global health, President Trump’s budget would completely eliminate the NIH’s Fogarty International Center — one of the most effective tools we have to fight global diseases.”