P&S Journal: Spring 1997, Vol.17, No.2
Research Funding: No Longer Just Government Dollars

By Devera Pine and Sally McLain

 Faced with greater competition for government funds for research, scientists will increasingly turn to alternatives for financial support of their work. One alternative is the private donor--the individual, family, or group willing to offer a helping hand in the form of a grant or donation. In the 1996 fiscal year, non-government contributors--individuals, foundations, and corporations--contributed more than $50 million to Columbia Health Sciences. Although that sum also includes contributions for education, training, and treatment, it is significant for marking the first time in the history of fund raising on Columbia's medical center campus that the $50 million mark has been exceeded.

 "Private giving has existed for a long time," says Dr. Kenneth A. Forde, professor of clinical surgery and vice chairman of external affairs for the surgery department. "I myself have been supported by private giving for 20 years or more. But it didn't have the same prestige as NIH funding, so one didn't mention it unless it was a major gift."

 A variety of factors motivate individuals to donate money for research. Some individuals donate funds because they are grateful for medical treatment they received from P&S physicians. In other cases, donors are motivated when they, family members, or close friends are touched in a dramatic way by a disease or condition that needs to be researched and eradicated.

 "In general, people give money for research because it hits an emotional spot," says Anke Nolting, associate dean and executive director of development and alumni relations. "Donors often become involved in funding research because they themselves have experienced a debilitating disease or they have a family member who suffers or who has died from diseases, such as cancer." These days more people are donating money for research because institutions are making a better case for the need for funds and because people are becoming more aware of changes in health care financing, she says.

 People also give money because press coverage increases public understanding of research, notes Dr. Georgiana Jagiello, professor emeritus of genetics and development. These press reports show that science is coming through, she says.

 Although in one article it would be impossible to include all the factors that motivate people to donate or to profile all the individuals who have donated money to P&S over the years, the following profiles represent a small sampling of P&S donors--and what motivated them to give.

In the Family
 JoAnn and Joseph Murphy are good examples of individuals who became donors because of a medical condition affecting their family. In the 1970s, two of their five children were diagnosed with diabetes and they became involved in supporting diabetes research and helping establish a local chapter of the Juvenile Diabetes Foundation, among other accomplishments. The Murphy children are now in their 30s and continue to face the medical complications of diabetes. This chain of events has led the Murphys to not only give funds for diabetes research, but also to participate in raising funds. As co-chairs of CPMC's Diabetes Advisory Committee, the Murphys are helping to plan a new diabetes center.

 "I never thought that 25 years down the line I would still be talking about a cure, with all the funds we raised and the research that is going on," says JoAnn Murphy. The new diabetes center will be the only New York metropolitan area center to support research, education, and teaching. The Murphys have pledged a major gift for the center.

From Basic Science to Clinical Advances  It's not always possible to see the potential for clinical use in basic research. But some current P&S research has clear potential: Researchers discovered a direct link between a new herpesvirus and Kaposi's sarcoma, a cancer common in people with AIDS. The finding may improve diagnosis and treatment of Kaposi's sarcoma. P&S researchers have shed light on a naturally occurring defense system within cells that can be used to inactivate harmful genes. This may allow scientists to develop treatments for AIDS and cancer. Researchers identified a molecule in the digestive system that inactivates secreted serotonin, a discovery with implications for controlling gastrointestinal side effects of drugs aimed at serotonin receptors in the brain and for developing new drugs to treat ailments of both gut and brain. The research suggests that many drugs aimed at the brain also may affect the GI tract. Knocking out the cyclic GMP phosphodiesterase gamma gene in mice results in the degeneration of the retina shortly after birth. Researchers have found a molecular mechanism in the brain that may explain nicotine's potent physiological effects. The discovery may pave the way for the development of anti-addiction treatment. An artificial enzyme has been developed as a potential treatment for cocaine addiction. Photo by Jonathan Smith

By Association
 Some donors support research indirectly by contributing to associations dedicated to a particular cause. One of the most successful examples of this is the National Alliance for Research on Schizophrenia and Depression (NARSAD), formed in 1986 as family members and friends of the mentally ill responded to emerging neuroscience research and its potential for better treatment. In its 10 years (as of December 1996), NARSAD has awarded $43 million to fund 1,120 grants to 619 scientists in 110 universities and medical research institutions. At Columbia, NARSAD has funded more than 62 investigators who focus specifically on treatments and explanations for schizophrenia and other forms of mental illness.

 "Columbia University has been an outstanding recipient of research awards because NARSAD's scientific council has found such remarkable breadth and talent with creative research ideas on the faculty," says Constance E. Lieber, NARSAD president and a member of the Columbia-Presbyterian Health Sciences Advisory Council. Mrs. Lieber and her husband, Stephen, have been active in NARSAD since the beginning of the organization. Their daughter was diagnosed with schizophrenia 20 years ago.

 "The Lieber family also funds research at P&S through the Essel Foundation, a family foundation. For instance, the foundation supports the M.D.-Ph.D. program and research in the Department of Psychiatry. "I want to push research," says Mrs. Lieber. "I want to stir the whole field up so that research can help overcome the suffering from these disorders."

The Alma Mater Connection
 Private donations also played a key role in the establishment of and subsequent research by what is now known as the Columbia Genome Center. Although the university provided some funds, private donations were critical in getting the center started, says Dr. Isidore S. Edelman, director of the center and the Robert Wood Johnson Jr. Professor Emeritus of Biochemistry and Molecular Biophysics. "To qualify for NIH funds, you have to have personnel and a track record," he says. That, of course, takes funding. The money the University provided was not enough, so private donations made the difference and enabled the program to lay the foundation for greater things.

 In 1990, Dr. Judith P. Sulzberger and Mr. and Mrs. Frederic A. Bourke provided the additional funds needed to initiate the P&S genome program, under the joint direction of Dr. Argiris Efstratiadis, the Eugene Higgins Professor of Genetics and Development, and Dr. Edelman. Both Dr. Sulzberger and the Bourkes, who have contributed annually, have long-standing ties to the University. Dr. Sulzberger is an alumna of P&S, and Mr. Bourke did graduate studies at the School of Business Administration. The Bourkes' commitment to biomedical research at P&S actually began in the early 1980s, with annual contributions to the Department of Biochemistry and Molecular Biophysics.

 Once the P&S genome program was established, private donations were again important to the transition of the program into a Universitywide center. "One of the major problems is the lack of flexibility in the use of federal funds," says Dr. Edelman. For instance, when high output DNA sequencing began to gain importance as a technique, the center was still using its federal grants for mapping of chromosomes. "We were locked into a path that would not allow us to go to the next step--the analysis of genes and disease states. The support provided by Dr. Sulzberger and the Bourkes was critical in allowing us to make that transition," he says. Dr. Sulzberger continues to be an important part of the genome center, serving as assistant to the director for special projects.

 Research in urology also has been well-funded by contributions from private donors. Patent attorney S. Leslie Misrock, for example, has supported the work of Dr. Paul B. Fisher, Chernow Research Scientist in pathology and urology and professor of clinical pathology. And David H. Koch of Koch Industries made a three-year, $1 million pledge to P&S through the CaP CURE Foundation to fund research on the molecular staging of prostate cancer and the role of various genes in the disease. Mr. Koch's donation is helping to fund the work of Dr. Aaron Katz, assistant professor of urology; Dr. Ralph Buttyan, associate professor of pathology; Dr. Thambi Dorai, senior staff associate in urology; and Dr. Cy Stein, an Irving Associate Professor of Medicine and associate professor of pharmacology.

ALS, Lou Gehrig, and Baseball Cards  Some private donations are funded in unusual ways. When Eleanor Gehrig died in 1984, the widow of the legendary New York Yankees first baseman, Lou Gehrig, left $100,000 for CPMC, where the Eleanor and Lou Gehrig MDA/ALS Center is located.  "She was not charitably inclined," recalls George Pollack, a New York trial attorney who was executor of the Gehrig estate. "But she was favorably inclined to Columbia-Presbyterian because a doctor there had taken care of Lou."  The death of Eleanor Gehrig, however, did not end the public's abiding fascination with the man still remembered more than 50 years later as "The Pride of the Yankees." Pollack says he began receiving queries about licensing rights about a year after Eleanor Gehrig died. At the time, there was no licensing of Lou Gehrig's picture or name.  Gehrig, "The Iron Horse" who batted behind Babe Ruth, played 2,130 consecutive baseball games--a record that lasted 56 years. He was elected to the Hall of Fame and was twice named the American League's Most Valuable Player. But Gehrig succumbed to amyotrophic lateral sclerosis, or ALS, on June 6, 1941. Even today, the degenerative nerve disorder is better known as "Lou Gehrig's disease" than by its formal name.  The Gehrigs had no survivors, so Pollack signed a licensing agreement with the Curtis Management Group of Indianapolis. The agreement covers any merchandise with Gehrig's name or likeness, such as baseball cards and calendars, with the proceeds allocated in accordance with the charitable contributions Eleanor Gehrig had specified in her will.  Over the years, that arrangement raised a substantial amount of money for CPMC. "There's a plan to dedicate a whole floor of the hospital [the Neurological Institute] to Eleanor and Lou Gehrig. It would be dedicated to ALS patients," says Pollack.  "My hope is that his name and picture can provide the money that someday provides a cure," he says. "That would be simple justice." -- Bruce V. Bigelow, staff writer for The San Diego Union-Tribune

A Few Problems
 Although private donations are playing more of a role in funding research, problems remain, especially in basic science departments, where research-only donations are still relatively rare.

 "There are only two government agencies that fund our research--the National Institutes of Health and the National Science Foundation," says Dr. Claudio Stern, professor and chairman of genetics and development. But the NIH is currently funding only 10 percent of all grant applications, as opposed to 30 percent a few years ago. In addition, the duration and the amounts of the grants are less than they once were. "It's now almost impossible to get a five-year grant," says Dr. Stern. "So you have to write grants more often and do less research. It takes nine months between submitting a grant and getting news of the outcome and therefore nine to 18 months for a project to be funded. So you have to write grant applications that are time-insensitive. And at least one year before the end of the grant, you have to start writing to get a continuation. So what used to be a five-year grant is now really about three years."

 The advent of managed care also has had an effect on funding for research, decreasing revenues from clinical service and research capacity and activity and decreasing the numbers of scientists, faculty, fellows, and residents.

Basic science researchers would like to be able to support their work with more donations from private individuals, but they have less contact with patients so they are less likely to form the kind of lasting relationship with a patient--and potential donor--that clinicians form. "We don't see a lot of [private donations] in basic science research. It lags behind clinical research," says Dr. Robert S. Kass, professor and chairman of pharmacology. "This is somewhat understandable in that it is easier for people who benefit from medicine to want to donate to clinical research, which may have, in their minds, more immediate relationship to their personal experience. It is more difficult to appreciate the long-term benefit of more basic research investigations."

 As Dr. Herbert Pardes, vice president for Health Sciences and dean of the Faculty of Medicine, explains, "Basic sciences have a funding problem because people feel they do not die from biochemistry or microbiology."

 But research in biochemistry, microbiology, and other basic science departments is actually directed toward diseases. Research in genetics and development, for instance, touches on Huntington's disease, fragile X syndrome, breast cancer, blood disorders, genetically linked psychiatric disorders, and more. There is insufficient basic knowledge about the mechanisms causing some diseases and how they can be corrected, says Dr. Stern. "The real progress in understanding these can only come from basic research."

 In addition, he says, basic research can unexpectedly open up new areas of science and medicine. "I think that throughout history most of the really major advances have been through non-goal directed research that led to approaches that were not foreseen," says Dr. Stern. The discovery of penicillin is one example.

 CPMC is taking several approaches to help raise funds for basic science. One is to foster collaboration between basic and clinical researchers. Dr. Forde is a case in point. When Dr. I. Bernard Weinstein led the cancer center, he and Dr. Forde were co-principal investigators on a major grant (from 1987 to 1992) from the Aaron Diamond Foundation to study the molecular biology and the epidemiology of colon cancer. The research team consisted of surgeons, gastroenterologists, epidemiologists, and basic scientists. Most of the funds went to basic research in colon cancer. "To me, that is a classic example of collaboration," says Dr. Forde. "Basic and clinical researchers are going to have to team up more closely on projects to obtain funding. It's not happening to a large enough extent now."

 Another example of collaboration between clinical and basic researchers is so-called translational research, which seeks to apply technologies developed in the research lab to a clinical setting. This type of research also sends clinical findings and insights to the lab, where investigators study the fundamental mechanisms behind them. Translational research brings physicians and researchers together, encouraging cross-fertilization of ideas. One recent example is the creation, several years ago, of the oncology division of the pathology department. The division has CPMC's largest concentration of basic scientists bridging clinical cancer issues.

 The entire CPMC community needs to be more sensitive to the needs of projects and departments, says Dr. Forde. "If we share, it will eventually help us all."

 While that may be true, it's not the whole picture, says Dr. Stern. P&S already has many collaborative projects between basic and clinical researchers and more projects along these lines won't necessarily solve the basic science funding problem, he says. "It would be good if there were a more efficient way of conveying to donors the real value of basic research and how it can contribute in a tangible way." Donors should be encouraged to give to the medical school, and not necessarily to the doctor who treated them, he says, because clinical research won't lead to a paradigm shift in the same way basic research can. "Most of the giving today is to clinical departments. Basic science departments have never benefitted from private giving the way clinical departments have."