No stone unturned

But such a change raises a potential problem. Support for what we will no longer call basic research has, for quite some time, piggybacked on the support for what we will no longer call translational research, which was what scientific leaders presented to governments and laypeople as the raison d'etre for public support of biomedical research. Generally, they didn't talk much about basic research at all, believing that the public wouldn't understand it very well and therefore wouldn't support it. They understood its importance themselves, so they paid for it, but they didn't advertise it. National Institutes of Health (NIH) director Francis Collins's now-famous remark that "We're not the National Institutes of Basic Sciences" is but one example of this mentality. If we now are to talk about all research using the same language, how do we justify the support of projects that don't have an obvious clinical relevance, and may never have one?This problem is becoming more acute because we have oversold some big science projects in order to gain the huge financial support they require. The human genome sequencing effort, which was really a basic research project, was presented as a faster route to diagnosis and cures for a host of diseases, although it typically takes decades for research results to lead to clinical advances. Congress and the public, having bought the original sales pitch, are now asking, "So where are the cures?"Three articles in the 17 March issue of the Journal of the American Medical Association (JAMA) highlight this increasing impatience. They concern the War on Cancer, a huge increase in both funding and responsibilities for the US National Cancer Institute (one of the institutes that make up the National Institutes of Health) that was started by President Richard Nixon in 1971. Ignoring the fact that the language of the legislation implied that cancer was one disease, which it most assuredly is not, and therefore should have one cure, which it mos