Alexis Carulli is one of those terribly bright grad students in universities across the country who face an equally bright future. Maybe.
She's been working on two doctorate degrees, one in medicine and one in scientific research, for six years now and she should be able to see the light at the end of that long tunnel.
But the light is dimmer than it used to be, and it's getting even dimmer. She's worried enough that a couple of months ago she poured out her concerns in a letter published in a professional journal.
Funding for biomedical research in this country has declined so much in the past few years that the United States could lose the global dominance it has held for decades. So even with all she has to offer, Alexis can't be sure there will be a job waiting for her when she wraps up her academic career.
"The decreased funding levels for science aren't just affecting research right now," she said in her letter, published in the American Journal of Physiology: Gastrointestinal and Liver Physiology. "If this situation lasts longer, it will have very long-term consequences because the scientists won't be there."
Where will they be? Quite possibly in other countries that are ramping up their funding for biomedical research even as the U.S. reduces its own funding. One of them may be Carulli.
This shouldn't be dismissed as the whining of a student who is worried about her own future. It's backed up by research from many institutions -- including her own university -- showing a national trend that could affect every American.
Here's a few troubling facts in a paper authored by experts in both research and economics, published in the New England Journal of Medicine, documenting global changes in biomedical research funding from 2007 through 2012:
Just a bunch of numbers, so why should anyone care?
"There are many reasons we should all care," Reshima Jagsi, associate professor of radiation oncology at the University of Michigan Health System and coauthor of that study said in a telephone interview.
"But why should we care about our own expenditure in the U.S.? Because biomedical research is critical when we think about the economy and economic health" as well as the health of Americans and people all over the earth who are dependent on progress led by this country for so many years, she said.
So much depends on further progress, especially at a time when so many doors have been opened -- including the sequencing of the human genome that many hope will lead to treatments that are directed at personalized solutions to specific issues for each individual.
That's the hope, but it won't be cheap.
On paper, the numbers look like the federal government has been fairly consistent over the years in its support, but with the rising cost of research and inflation, the real purchasing power has dropped precipitately, Jagsi said, possibly as much as $1 billion over that six year period.
Surprisingly, the biggest drop in U.S. funding has come from industry, not agencies like the National Institutes of Health. From 2007 through 2012, public funding went from $48 billion to $48.9 billion while industry's investment dropped from $83.3 billion to $70.4 billion.
"That surprised us," Jagsi said.
She and her coauthors think that could be because biomedical research is looking for the cheapest labor, like everything from autos to textiles. Companies that face enormous costs in moving their potential products from the lab to the pharmacy may be shipping more money to Asia, in particular. Higher government subsidies, and less bureaucratic hassle, may also contribute.
There's no question about it. Biomedical research leading to drugs and new treatment technologies is really expensive. Just getting a drug through clinical trials and into the marketplace can literally cost billions, although the journey is so difficult to predict that no one knows exactly how much it's going to cost.
A team of Canadian scientists spent years trying to come up with a "gold standard" for the cost of getting a new drug to market, but the result was baffling. They found 29 studies over the past 10 years that estimated costs ranging from $161 million to $1.8 billion, including the cost of actually producing and marketing the product.
That's a huge difference, and the fact is that most drugs fail to get that far. One leading study found that nine out of 10 drugs fail somewhere along the way, so even a billion-dollar investment doesn't guarantee success. And the pharmaceutical industry is heavily dependent on government funding for research institutions because that's where most of the work begins that could eventually lead to new treatments.
Much of that work is basic research -- just trying to understand disease, not necessarily treat it -- but it is a critical element in the pharmaceutical pipeline. One study estimated that more than half of the drugs begin first in universities and institutions supported by government grants.
"We need the federal government to support the kind of research that industry may be less likely to support during those early stages of discovery," Jagsi said. The reward may not be immediate, she added, "but it can have dramatic, long-term downstream effects."
It may even help stem a reverse-brain-drain, so we won't have to watch promising young scientists like Carulli pack up her bags.