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February 27, 2007

Fact for the Day -- Research Funding for Diseases per Fatality

Michael Blowhard writes:

Dear Blowhards --

The following figures are a way of breaking down federal money spent on research into diseases. The number highlighted shows research money spent per fatality from each disease. The figures are from The National Center for Health Statistics and the National Institutes of Health. I found this set via, ahem, the AARP Bulletin. They reflect best estimates for 2007.

I'll go lowest to highest.

  • Stroke: $2143 are spent on research into stroke per person who dies of a stroke.

  • Heart disease: $3,649 are spent researching heart disease per person who dies of heart disease.

  • Lower respiratory diseases (such as emphysema and chronic bronchitis): $9,495

  • Alzheimer's: $10,164

  • Kidney Disease: $10,552

  • Diabetes: $13,474

  • Cancer: $14,006

  • Influenza and pneumonia: $58,315

  • HIV/AIDS: $212,330

Always interesting to see public research funds for health broken down on a per-disease / per-fatality basis, isn't it? Even though this exercise probably proves nothing definitive, it certainly whispers into my ear, "The funding of research on diseases is affected by, among many other things, politics."



posted by Michael at February 27, 2007


Your conclusion is obviously true, but comparing spending/death across these diseases is a bit misleading, since diseases have different death rates/diagnosis. It might be better to compare spending/case of disease, or even (research $)/(treatment $) for each disease.

Posted by: mike on February 27, 2007 11:08 AM

It does kind of blow the cover off the notion that the gay community is a political 98-pound weakling, doesn't it.

Posted by: Friedrich von Blowhard on February 27, 2007 11:09 AM

Recent US rather than wordwide fatalities are the denominator, right?

Also, cost/death ignores effective research; after
H. pylori was identified, but before treatment was specified, very few dollars had a very big impact.

I agree that things are skewed, but summaries this simple make lots of strong hidden assumptions.

Posted by: lw on February 27, 2007 11:13 AM

This has more impact than you'd think. For example, I believe that with folks living into their 80s and 90s now, and with the baby boomers starting to hit, government funding must go towards Alzheimers. Otherwise, we're going to be paying out a huge amount in nursing homes and long term care for folks who linger for sometimes decades. I've had personal experience with this, with my mom, and one of the things that galled me was that her death certificate stated cause of death as "Failure to thrive." After going through the heartbreak of this disease and seeing what it does to patients and families, I called several places to ask them to emphasize "Alzheimers" as the direct cause to be put down on death certificates when appropriate. How are we ever going to see the devastation from this disease, and ensure the funds necessary for research and care if it's not accurately reported?

Posted by: susan on February 27, 2007 11:20 AM

It seems that we spend more on infectious diseases, which makes a lot of sense if you think about it. If we cured HIV/AIDS, it would save not only all the people currently living with it, but all future people who catch it. Contagious diseases can spread geometrically, while things like cancer remain relatively constant.

Obviously, though, politics plays a role. Private spending on research is probably even more disproportionate. Some of the hereditary diseases common among Ashkenazi Jews, for example, get a ton of research compared to other diseases of similar severity and abundance.

Posted by: JewishAtheist on February 27, 2007 12:47 PM

The high status of diabetes in your listing is interesting too. I'd suspect that part of the reason it's so high is due to the increasing rate of diabetes. I.e., although the current cost to fatality ratio is high, when you account the predicted increase of incidence in the future, it may fall in line a little more reasonably.

Posted by: Brett on February 27, 2007 1:31 PM

This is an obvious criticism of the amount of spending on AIDS research. But of the diseases listed, only AIDS is both infectious and fatal. Only AIDS strikes down primarily otherwise-healthy young people. That makes it a very serious public health issue, and deserving strong public support.

Speaking of political motivations, what was your motivation for posting this article, while not mentioning these painfully obvious points?

Posted by: me on February 27, 2007 6:23 PM

Also, don't forget to consider the age at which the disease strikes. A deadly disease that strikes early in life will lead to more years of life lost than one that strikes late in life.

Posted by: Cedric Morrison on February 27, 2007 8:01 PM

"But of the diseases listed, only AIDS is both infectious and fatal."

Both influenza and pneumonia are infectious-one is a virus, the other a bacteria-and can often cause death.

Posted by: Peter L. Winkler on February 27, 2007 9:25 PM

Interesting list.. One other thing about HIV/AIDS in relation to the other items on the list that no one's mentioned yet: It's 100% PREVENTABLE!!

Posted by: Jim on February 27, 2007 9:40 PM

Of all these diseases, only AIDS is 100% preventable - interesting numbers!

Posted by: Jim on February 27, 2007 10:02 PM

I can think of many justifications for the greater spending on HIV.

1. HIV is a new disease, stroke an old disease.
2. HIV is infectious, stroke is not.
3. HIV is not a disease of aging, and thus is taken a bit more seriously since it cuts off people in their prime. (Note: I am 60).
4. HIV has been fairly successfully contained, which is one reason the dollar-per-death number is so high. In 2005 there were only 16,000 US deaths, which is not even in the top 10 categories of causes. (On the other hand, elsewhere the problem is more serious.)

So all and all, maybe the heavy spending on AIDS has been successful in keeping deaths down. Good.

Posted by: John Emerson on February 27, 2007 10:03 PM

The post compares federal research dollars to (US?) deaths.

The comments (and I) suggest other comparisons:
(b) world-wide deaths;
(c) number of expected life-years lost;
(d) cost to treat;
(e) suffering;
(f) opportunity to eliminate future deaths;
(g) likelihood of reducing deaths/costs per dollar spent.

Other concerns might be (a) issues in attributing deaths to a particular disease; (b) risks of pandemic outbreaks; or (c) what areas the private sector has incentives to work on.

Not that media exposure and politics doesn't have anything to do with how money is spent.

How about dollars spent per US death due to terrorism? ...that makes AIDS look cheap. (And how do you count US deaths in Iraq? deaths due to terrorism or a costs of preventing terrorism?)

One might also argue that research funds are not a zero-sum game. Groups organize and raise AIDS and flu funding. Other groups could organize and raise stroke funding without lowing AIDS funding.

Perhaps a problem for stokes and heart disease is that they can kill you too quickly; no time for the family to lobby congress.

Posted by: c&d on February 28, 2007 12:34 AM

Michael - A lot of people get stuck in the "target disease" model, a hold-over, perhaps, from the days of the March of Dimes anti-polio campaign, or the Jerry Lewis Telethon. The bottom line is that the most productive research is often non-specific basic research. The politics of research is such that a grant seeker has to mention a specific disease or field of research, but this is often irrelevant to the ultimately utility of the research itself.

If you think about it for even half a second, it should become clear that, for example, some AIDS research has gone into immune response research, which is just as important to cancer therapy and to organ transplants as it is to AIDS itself. Similarly, understanding how the AIDS virus attacks cells is generally important. On the other hand, you occasionally get folks who say stuff like, "if we spent all that AIDS money on cancer research, we would have a cure by now." Hmmm. Cancer involves cells gone wrong, or attacked, or which throw off misleading signals to body defense mechanisms, in some ways similar to how the AIDS virus attacks cells. So again, ultimately "AIDS research" or "Diabetes research" is really just medical research.

Also, of course, if you want to play the medical politics game, compare the amount spent for prostate cancer research vs breast cancer research.

Jim - RE: HIV/AIDS is 100% preventable.

So was/is syphilis. I suppose that all the money spent on VD research was money down a rat-hole. Also, are you against the recently developed vaccine that would immunize girls against HPV? With the vaccine, the disease is nearly 100% preventable.

As an aside, some gay men are requesting the HPV vaccine, on the chance that it might protect them against some HPV-related penile and anal cancers,

Posted by: Alec on February 28, 2007 1:56 AM

One thing I'd like to add as someone with a science background is that HIV is one of the first viral diseases we've been able to do something about. Sure there was acyclovir for herpes but that usually won't kill you (unless you're unlucky enough to get herpes encephalitis, and shingles hurts like hell).

Posted by: SFG on February 28, 2007 8:03 AM

Of all these diseases, only AIDS is 100% preventable - interesting numbers!

That's not always true. For example, a ton of women in Africa are not able to either refuse sex or to use protection. Similarly, way too many men in American prisons are unable to prevent HIV due to widespread homosexual rape. Also, kids who get it from their mothers are unable to prevent it.

Not everybody's a middle-class American.

Posted by: JewishAtheist on February 28, 2007 11:13 AM

I'm not too sure dollars/death is a particularly good ratio. What is important is the impact of the marginal extra dollar. Consider Africa. Africans spend nothing on AIDS research, and AIDS is the leading cause of death - by your metric, they're getting a much better deal.

Instead of presenting dollars/death, the number we ought to look at, and maximize, is the decrease in death per single dollar (derivative of the death(dollar) function evaulated at the current dollar amount.)

Posted by: secret asian man on February 28, 2007 12:15 PM

John Emerson and others==

Come off it.

This is shockingly disproportionate and shound END NOW.

There were reasons to respond this way initially.

Though there were far more rational reasons to quartine they overwhelimly gay aids sufferers who prsentented, a few years after recognizing the severity. Bath houses should have been universally shut down and so on. Why didn't it happen? Leftist PC media of course. (Not that I didn't and don't have sympathy. However extreme the lifestyle, before people know the risks, it's hard to blame them, and I don't wish to.)

Posted by: dougjnn on March 12, 2007 10:31 PM

Very interesting stats and input. About "the real" diseases"...we need to pay attention and money for them. About those, like: too much alcohol...unprotected boys with boys...too much McDonald's, etc....Darwin is alive and well. Get a clue you Bozos. It's not your right to get away with doing the wrong thing. AND, this is nothing about politics or religion. Bad behavior just doesn't seem to work in this world in the long run. The ladies don't do anything to contract breast cancer.....the boys can put a sandwich bag on the unit. THAT is the difference. Waves good and I'm out there tomorrow afternoon. Let's talk.

Posted by: billymax on March 14, 2007 10:38 PM

"Bad behavior just doesn't seem to work in this world in the long run."

That's why it's called bad, eh?
Question is whether non-judgmentalism works in the long run.

Posted by: James M. on March 15, 2007 9:27 AM

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