K M Venkat Narayan: Health Sciences Research: Is the United States Getting Complacent?

venkat narayanAs the knowledge-driven, post-industrial global economy of the 21st century evolves, the role of research and training for research will become increasingly important. China seems to have heard that message. 

During a recent visit to China, I had the pleasure of interacting with investigators and doctoral students at the Institute of Nutritional Sciences (INS) of the Chinese National Academy of Sciences in Shanghai. INS is a young institution.  Established in 2003, it has already spawned twenty-one laboratories, focusing on nutritional research – spanning from diabetes to food safety. Each laboratory has a number of core investigators and several doctoral and post-doctoral students. 

What struck me was the long-term vision with which the Chinese government is actively supporting and helping build research infrastructure. All the twenty-one laboratories at INS are directed by experienced and talented investigators, who have returned to China after several years in the United States and/or other developed countries.  The reasons for their returning to China were easy to understand. The government provides stable core and start-up research funds for senior investigators (whose mentoring time is also supported), and doctoral students are fully funded for five years.

The environment for inter-disciplinary research at INS is excellent and one could feel the excitement and ambition among the investigators for cutting-edge science.  There is also ready eagerness within INS leadership for interaction and research collaboration with other countries.  Many of their doctoral students told me how keen they were to go to the United States for post-doctoral training, and almost all of them wanted to return to China after a stint in the US.

The Unites States, by any stretch of imagination, is still the envy of the world in terms of research infrastructure and in its ability to attract talent from all over the globe. The culture of research in the United States is something that truly fosters independence, openness, collegiality, and innovation among researchers. Most of those who come to the country end up staying because of the exciting and welcoming environment that it offers.  It is no wonder that the United States dominates the world of science in terms of Nobel prizes, publications, and patents. 

Will the United States retain this edge or is there a danger that the country might risk losing its preeminence as the dream and innovation machine of the world? 

How organizations and institutions react to acute stress often give a clue to what their perceived priorities might be.  During the recent downturn in the US economy, a number of major universities (especially, those reliant on endowment incomes) showed a distressing tendency to increase enrollment of fee-paying undergraduate and masters’ students, while reducing support for doctoral students or shifting the financial responsibility of doctoral students onto their already over-burdened mentors.  Some of the Deans and senior administrators even told me that research and doctoral training were “expenses” (I had thought they were “investments”) and therefore, needed to be cut, whereas undergraduate and masters’ students were “income generators” and therefore, their intake needed to be increased – even if it meant greater strains on already stretched teaching resources or lowering of the bar for admissions.  That is a sort of “business model” akin to continuing the pernicious reliance on middle-east oil for energy, while ignoring research investment into futuristic green technologies.

In an inter-connected and digital global world, the competition for highly skilled talent is fierce.  That is why China is investing strategically in higher education and research training.  Many European countries, Australia, Singapore, etc. are also building research human infrastructure, often by recruiting seasoned overseas investigators, and attracting foreign students into their doctoral programs with fee waivers and full stipends.  Strangely, however, not only is the US making it challenging for talented native-born students to pursue higher education and training, it is also making it hard for foreign students, at least in health sciences, to come to the US for doctoral education. 

The vast majority of NIH-funded individual or institutional doctoral training grants remain restricted to US citizens or to permanent residents.  This policy seems to somewhat miss the point that the “war for talent” in today’s world is global and not national anymore.  The US should be actively competing to attract the best young minds from anywhere in the world, and offering training grants and other incentives for such talented foreign doctoral and postdoctoral students to pursue high quality training and health research in the country. A high proportion of them will likely stay on after their training and make their careers in the country. These immigrants will also bring connectivity with other parts of world, something so much needed for collaborative global research.

On my flight back from Shanghai to Chicago, I read in a little book called “100 Pearls of Chinese Wisdom” a very wise quote: “One generation plants trees under whose shade another generation rests”.  The present generations of Chinese clearly seem to be planting and nurturing large numbers of saplings for the future of their health sciences research. 

At a time of paradigm changes with the rise of several Asian and other growing economies, is there a danger that the United States may be getting complacent about its health research and training infrastructure?  In a rapidly changing world, past and present glory is never a guarantee for a stake in the future.

The US has a rich and fertile soil for health sciences research. But it needs to imbibe some of that ancient Chinese wisdom and plant and nurture a lot more saplings – US-born and/or foreign-born doctoral and post-doctoral students – quickly and fast.

This would need some serious conversation and systemic changes.

K.M. Venkat Narayan is Ruth and O.C. Hubert Professor of Global Health and Professor of Epidemiology and Medicine at Emory University Atlanta. He is a product of three continents, having lived and worked in India, United Arab Emirates, United Kingdom, and United States of America.