Robert F. Kennedy younger talked about an “existential threat” who said he could destroy the nation.
“We have the highest load of chronic illness of any country in the world,” Mr Kennedy said in a hearing in January before the Senate confirmed him as Secretary of Health and Human Services.
And on Monday, a tour of the southwest begins to promote a program to combat chronic illness, emphasizing nutrition and lifestyle.
But since Mr Kennedy took his place, the basic grants and contracts directly addressed to these diseases, including obesity, diabetes and dementia that experts agree are among the nation’s leading health problems.
These programs range on scale and expenses. Researchers warn that their collapse could mean missing opportunities to address a aspect of public health that Mr Kennedy said is his priority.
“This is a huge mistake,” said Dr. Ezekiel Emanuel, co-director of the Institute of Health Transformation at Perelman University of Perelman Medical School.
Decades of Diabetes Research is Interrupted
Since its beginning in 1996, the diabetes prevention program has helped doctors understand this deadly chronic disease. The situation is the most expensive, affecting 38 million Americans and burdening $ 306 billion in a last year at direct cost. With about 400,000 deaths in 2021, it was the eighth cause of death.
The program has been terminated and the reason has nothing to do with its advantages. Instead, it seems to be a matter of a leading researcher who works in the wrong place at the wrong time.
The program began when doctors in 27 medical centers received funding from the National Institutes of Health for a study asking if type 2 diabetes could be avoided. The 3,234 participants had a high risk of illness.
The results were a huge victory. Those who were commissioned to follow a healthy diet and practice routine regularly reduced the chances of developing diabetes by 58 %. Those who received metformin, a drug that reduces blood sugar, reduced their risk by 31 %.
The program entered a new phase, led by Dr. David M. Nathan, a diabetes expert in Harvard Medical School. The researchers followed the participants to see how they went without the constant attention and support of a clinical trial. The researchers also examined their genetics and metabolism and examined the measures of weakness and cognitive function.
A few years ago, the researchers had an idea. Some studies indicate that people with diabetes had a higher risk of dementia. But scientists did not know if it was vascular dementia or Alzheimer’s or what were the exact risk factors. The diabetes program could renew its focus on investigating this with 1,700 aging participants.
The team added a new main researcher, the expert of dementia Dr. Jose A. Luchsinger. For administrative reasons, including the new catering on dementia, the program decided that its money should flow through the Dr. Luchsinger, Columbia University and not through the University of Harvard or the University of George Washington, where a third lead researcher works.
On March 7, the Trump administration cut off $ 400 million to grants and contracts in Columbia, saying that Jewish students were not protected from harassment during protests for the Gaza war. The grant of diabetes was among those ended: $ 16 million a year that Columbia was divided into 30 medical centers. The study ended abruptly.
Asked about the termination, Andrew G. Nixon, Director of Communications in the Department of Health and Human Services, gave a statement from the Organization’s General Advisor, saying that “anti -Semitism is clearly incompatible with the core values that must be informed of its liberal education”.
At a time when their grant ended, the researchers had begun advanced cognitive examinations for dementia in patients, followed by brain imaging to search for amyloid, the characteristic of Alzheimer’s disease. Planned to complete the tests over the next two years.
Subsequently, Dr. Luchsinger said, the team was to examine the biological indicators of amyloid and other signs of dementia, including brain inflammation. For comparison, they planned to perform the same tests on the blood samples of the participants from 7 and 15 years ago.
“Very few studies have been collected and stored and stored so far behind,” Dr. Luchsinger said.
Now much of the work cannot start, and the place where it had started remains incomplete.
Another alarming question that researchers hope to answer was whether metformin increases, decreases or has no effect on the risk of dementia.
“This is the largest and largest study of metformin never,” Dr. Luchsinger said. Participants assigned to take the drug in the 1990s took it for more than 20 years.
“We thought we were able to support this question about metformin,” Dr. Luchsinger said.
The only ways to store the program, Dr. Nathan said, are for Mr Kennedy to agree to restore Columbia funding or transfer the grant to a main researcher to another medical center.
Researchers in the study are attractive to the conclusion of diabetes in Congress, hoping that it can help make them health and human services.
“We hope that Congresses and Senators could prevail and say:” This is crazy, this is the chronic illness, that’s what you wanted to study, “Dr. Nathan said.
So far, there has been no change.
Include diversity. In fact, this is a very variety.
Compared to the diabetes prevention program, a program for pediatric education to become scientists is tiny. However, pediatric researchers say the Pediatric Science Development Program helps to ensure that chronic childhood diseases are included in medical research.
It began 40 years ago, when the presidents of the Pediatric Departments called for the creation of the program, which was continuously funded by the National Institute of Health and Human Development of Children.
Participants are clinicians who have been trained in sub -businesses such as endocrinology and nephrology, who are practiced as clinical doctors and inspired to go into research to help young patients with first -hand diseases.
The extremely competitive program pays for seven to eight pediatricians to train university medical centers for one year, combining them with consultants and giving them time away from clinic in research conditions, including obesity, asthma and chronic kidney disease.
In retrospect, the fate of the program was sealed in 2021 when its leaders applied for renewal of their grant. Seemed pro form. This was his eighth renewal.
This time, however, an external committee of grant reviewers told the researchers that the greatest weakness of their proposal was the lack of diversity. The program had to look for pediatricians who represented a variety of ethnic attributes, financial backgrounds, states, research supplies and pediatric specialties.
Criticism said, for example, that “attention should be paid to the recruitment of applicants from a different background, including groups that have been shown to be under -customized at biomedical, behavioral, clinics and social sciences”.
Thus, the program leaders sprinkle diversity through a re -registering grant application.
“The diversity, in its broader sense, was throughout the grant,” said Dr. Sallie Permar, professor and president of the Weill Cornell Medical College and Program Manager. “It was exactly what the reviewers appreciated when we downgraded again.”
The grant was renewed in 2023. Now it is terminated. The reason? Variety.
The finish letter from officials at the National Institute of Health and Human Development of the Child said it made no sense to try to rewrite the grant request. The inclusion of diversity has made the implementation off the line that “no modification of the project could align the project with the priorities of the service”.
Mr Nixon, a spokesman for the Ministry of Health, did not answer questions about the cancellation of the pediatric program.
Participants in the program are disappointed.
Dr. Sean Michael Cullen had studied childhood obesity at Weill Cornell in New York. It has been explored because male mice supplied a high fat diet that produced offspring that became fat, even when these descendants were supplying a standard diet.
He hopes that his findings would help to predict people whose children are in danger of obesity so that pediatricians would try to intervene.
Now the funds are gone. It may seek private or charity funding, but it has no clear prospects.
Dr. Evan Rajadhyaksha is in a similar situation. He is a specialist in children’s kidney disease at the University of Indiana. When she was a resident, she cared about a little girl who developed kidney disease due to a condition in which some urine rinsed by the bladder in the kidneys.
Dr. Rajadhyaksha has an assumption that completing vitamin D can protect children with this condition.
Now, this task has to stop. Without funding, he expects to abandon the research and return to clinical work.
Dr. Permar said he had not left. The program costs only $ 1.5 million a year, so her colleagues are looking for another support.
“We ask for the foundations,” he said. “We are starting to ask the industry-we did not have funding in the industry.
“We are literally under each sofa pillow,” Dr. Permar said.
“But,” he said, federal support for the program “was the institution and cannot be replaced”.
