By Vinay Prasad (The New York Times) – On Monday, the Nobel Prize in Physiology or Medicine will go to a few scientists for work that untangles the intricacies of the human body and may advance treatments for cancer, heart disease or other major illnesses. The prize comes with a sizable check and virtually ensures that the winners’ research will be well funded for the rest of their careers.
Every recent recipient has undoubtedly deserved the honor. But that doesn’t mean that prizes for medical research are a good idea.
The Nobel, along with the Dickson, Lasker-DeBakey, Canada Gairdner and other major awards, honors the scientists who are usually in the least need of recognition and funding, which squeezes out opportunities for other scientists.
More important, by emphasizing the importance of scientific breakthroughs — serendipitous occurrences that rely on decades of research — these prizes play down, and diminish, the way that great medical advances build on one another.
All scholarship is, to some extent, built on prior work — but this is especially true in scientific research. Consider James P. Allison, the winner of this year’s Lasker-DeBakey prize in clinical medical research. His work helped clarify one way cancer cells hide from the immune system.
Around 1990, a team of scientists found a protein on the surface of immune cells and proposed that it stimulated the immune system. Dr. Allison’s lab and a third group suggested that the protein put the brakes on immune responses. A fourth group confirmed that it halted the immune system, rather than stimulating it. Dr. Allison later showed that blocking this protein with an antibody could unleash an immune response in animals that could lead not only to rejection of but also immunity to many kinds of cancers. A decade later, similar antibodies to this protein and other related ones were found to prevail against several types of human cancers.
Dr. Allison’s work is surely impressive. But it occurred alongside and in dialogue with a number of related findings. Researchers analyzed the citations that led to Dr. Allison’s drug and concluded that it relied on work conducted by 7,000 scientists at 5,700 institutions over a hundred-year period. Yet only he was recognized.
The prize industry contributes to a deeper problem in scientific research: We throw resources at a privileged few who have already achieved enormous fame.
One study that tracked funding for university professors and researchers over an eight-year period found that about 80 percent of research funds in basic medical sciences were concentrated among the top fifth of researchers. This is bad for the long-term health of the discipline: After top scientists retire, who will replace them? We should be giving more support to midcareer scientists whose work will contribute to major advances in the future.