Preventing the Extinction of the Clinical Research Ecosystem

THE 20th century has been termed "The Health Century" because of the near miraculous strides that have occurred in health care to increase the life expectancy and diminish the lifetime burden of pain and disability.¹At the beginning of this century, physicians could diagnose diseases and treat symptoms but often were unable to cure them. Aspirin was not even available. As Joseph Bloodgood, MD, said to a congressional hearing in 1929, "The practice of medicine leads to a good income, undoubtedly, but it does not lead to the control of disease. The cure for diseases is found in research laboratories.^"In 1930 the US Congress passed a law to establish the National Institutes of Health (NIH) in an era when the general population was beginning to see the importance of scientific research in human disease. During the same decade in Europe, German and French physicians succeeded in producing the