careers. In the United States, more than in other countries, high-school and college students have the opportunity to gain research and analytical experience by working in laboratories and attending specialized science programs.

The NIH has been the major federal funding agency for immunology research. The strength of this system is that it is largely an investigator-initiated, peer-reviewed, and merit-based system of awarding grants. Critically, it is the individual investigator–rather than the department chair or other research colleagues, as it often is in many European countries –that has the authority and autonomy to pursue a specific research interest. Unlike many foreign countries, the United States supports research institutions and medical schools through state governments and private foundations, and this allows the freedom and flexibility to develop innovative research programs.

5.3 Industrial Interests Have Fostered Many Striking Breakthroughs In Immunology.

Substantial funding of the biotechnology industry by venture capitalists and other investors has resulted in the successful generation of many products to sell in the international market. Venture-capital financing of the biotechnology industry increased by 11.7% from %697 million in 1996 to $790 million in 1997. (BIO, 1997; BIO, 1998) In addition to creating an economic benefit to the United States, the success of the US biotech industry has resulted in the creation of new jobs for immunology graduates. And, the collaboration between academic and industrial researchers has allowed scientific discoveries to be rapidly developed and commercialized, in contrast with what has been observed in many other countries.

5.4 A Scarcity Of Large-Scale Clinical Trials In Immunology Can Be Attributed To Shortages Of Funding And Of Qualified Personnel. In Addition, Increasing Dominance Of Managed Care Means That Fewer Patients Are Available To Academic Institutions For Clinical Trials.

The expense of a large-scale clinical trial often proves prohibitive, especially when there is fierce competition among institutions and between research interests for limited funding dollars. European countries, because of their centralized government control of medical schools and research institutions have been able to support large-scale clinical trials more successfully than the United States. Anecdotal evidence indicates a decrease in trained clinical immunologists to serve as principal investigators for such trials in the United States. Lack of funding and training opportunities has contributed to the growing scarcity. Furthermore, the advent of the managed care has decreased the patient base for this type of clinical research.

5.5 Shifting Federal And Industry Priorities, A Potential Reduction In Access To Domestic And Foreign Talent, And The Increasing Cost Of Maintaining Mouse Facilities Could Curtail US Ability To Capitalize On Leadership Opportunities.

Continued US leadership in the various subfields of immunology is not guaranteed. It depends on trends and sudden changes in the United States and abroad in funding, human resources, and infrastructure support. NIH has received increases in its annual budget from Congress, and the increases have resulted in the funding of more investigator-initiated grants in many fields of research, including immunology.

The trend of creating multidisciplinary graduate programs at large universities has resulted in competition for immunology graduate students and postdoctoral fellows. In



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