|
August
2002
The Opportunity
Cost of Time
Twenty-eight
million lives would be saved worldwide over the next eight years
if proven prevention methods were put into practice, according to
two recent studies released in conjunction with the World AIDS Conference.
This evidence,
shocking in itself, got me thinking about the many other instances
where the benefits of health research are, at best, only partially
effective:
- Because
not all health care professionals wash their hands when they are
supposed to, as many as 75,000 hospitalized Americans die each
year.
- Because
physicians do not always examine the feet of their diabetic patients,
40,000 amputations occur every year.
- Because
not all patients at high risk of heart disease are prescribed,
or take, aspirin, 40,000 of them die worldwide every year.
This is a terrible
loss: People are suffering and dying unnecessarily. Resources are
being squandered here and around the world because in so many cases,
important discoveries falter on the journey from basic research
to effective practice.
Where is the
sense of urgency that will keep them on course and might shorten
the accepted 20-to-30-year trajectory from idea to public benefit?
While there
is a growing awareness among professionals of the need to focus
more on the translation of research from policy to practice, efforts
to address it remain piecemeal. The basic research enterprise at
the National Institutes of Health remains largely detached from
the demands and contingencies of health care delivery and public
health policy. The federal agencies with responsibility for application
of new knowledge have no mandate and few resources to succeed.
The successful
effort to double the budget of the NIH was driven by the promise
of a flood of exciting innovations that will expand the possibilities
to prevent, cure and manage disease. But if the backlog of effective
practices that languish in the file cabinets in Bethesda are any
example, we will be fortunate if our children see the benefit of
our investment.
This is not
good enough. Whatever our assumptions have been about how new scientific
knowledge naturally makes its way into effective policy and practice,
they need to be revised and acted upon. We need a groundswell of
enthusiasm and commitment - resources and will - to ensure that
the billions spent on generating new knowledge about health will
be put to daily use in improve the prevention, treatment and management
of disease. The lives and future health of all of us are at stake.
|
