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Commentary

If Hospitals Close, Research Flat-Lines

Funding crisis in Los Angeles County threatens clinical studies.

September 04, 2002|KENNETH P. TREVETT | Kenneth P. Trevett is president and chief executive of the Research and Education Institute at Harbor-UCLA Medical Center.

Each day, tens of thousands of Americans discover their cholesterol levels are high, and their doctors recommend lifestyle and nutrition changes and perhaps medication that reduces the risk of a heart attack or stroke.

Each day, thousands of babies are born and are immediately tested to determine whether their thyroid glands are functioning properly; if not, they are given synthetic hormones that prevent devastating and irreversible developmental disabilities.

And each day, people who suffer from chronic obstructive pulmonary disease--the fourth-largest killer in the United States--will be enrolled in highly specialized exercise regimens so they can live more fully and freely with this debilitating condition.

These medical innovations and numerous others like them have one thing in common: They were developed at the Research and Education Institute, or REI, at Harbor-UCLA Medical Center, one of six public hospitals in Los Angeles County now threatened by a funding crisis.

Harbor-UCLA could be closed to in-patients or have services seriously curtailed under county health system scenarios being considered by the Board of Supervisors.

Although the REI is a free-standing biomedical research and training institution, its survival would be in question if the hospital closed. Its affiliation with Harbor-UCLA Medical Center is essential because most of the scientists who work at the REI also serve as clinicians at the hospital.

This year alone, $40 million will be invested by the federal government and pharmaceutical, biotechnology and medical instrumentation companies in research projects conducted at the REI. Taking advantage of a melting pot of different ethnic and age groups in the Torrance area, where it is located, the REI conducts an average of 125 clinical trials at any given time. Few research organizations in the country have that kind of diversity of human subjects--exactly the kind that the federal government seeks.

The research enterprise at the REI costs Los Angeles County absolutely nothing, and yet its very existence--after 50 years of highly productive activity--is jeopardized by the fiscal crisis.

Some of the projects underway may have to be moved elsewhere in the state or out of state or be stopped altogether. They include the development of a new generation of drugs to combat infections that are becoming resistant to existing antibiotics; applying to adult victims of emphysema and other respiratory disorders the technology now used to assist premature infants in breathing; the refinement of arterial stents used to repair ruptured blood vessels; research into new methods for treating Type I diabetes as well as for postponing the onset of, or preventing, Type II diabetes; the enhancement of imaging technology for more accurate diagnosis of breast cancer and pre-symptomatic heart disease; and studies examining a common pathway for such autoimmune disorders as multiple sclerosis, rheumatoid arthritis and lupus, thus creating the possibility of one therapeutic approach to several major illnesses.

Other hospitals within the Los Angeles County system also have ongoing, promising research into several different diseases and inherited conditions.

Like Harbor-UCLA Medical Center and the REI, these institutions face disruption or termination of their scientific and training missions as well as their clinical mission.

Once sacrificed, these programs will not be rebuilt.

It is too difficult and costly to reestablish research programs, recruit new scientists, develop relationships with patient volunteers and reconstitute the infrastructure that supports high-quality biomedical studies.

The victims of this funding crisis are not only the patients of today but our sons and daughters, our grandchildren and their children. These are the individuals who can realistically envision a world where cancer is not a death sentence, where pre-symptomatic heart disease can be identified and treated, where Alzheimer's is treatable and perhaps preventable.

Research now, results later. How much later is up to federal, state and county officials who control budget decisions, as well as each of us who can express our priorities for how these decisions are to be made.

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