Spinal Cord Injury Progress, Promise, and Priorities (2005) / Chapter Skim
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8 State Programs in Spinal Cord Injury
8 State Programs in Spinal Cord Injury
Pages 205-242
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That section examines the unique strengths of New York State's institutions and researchers in neurological, basic, clinical, and translational research on spinal cord injuries and offers recommendations on what distinctive contributions New York's spinal cord injury research program can make to accelerate the search for improving the outcome after a spinal 205
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The states can learn much from one another to develop and strengthen their spinal cord injury research programs. STATE PROGRAMS AND LEGISLATION Since 1988, 14 states have passed legislation that has resulted in annual funding for spinal cord injury research of about $27 million (Table 8-1)
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The concept behind most state legislation can be traced back to a pioneering 1988 Florida law that designated a set percentage of revenues from fines for unsafe driving for spinal cord injury care and research. Today, the amounts and the percentages vary, but the majority of the 14 states each spend at least $1 million each year for spinal cord injury research.
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Several states have developed or contribute funding to extensive research centers, including the Miami Project to Cure Paralysis and the Kentucky Spinal Cord Injury Research Center (see below)
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Since 1995, when the survey was conducted, a huge infusion of state funds to life sciences research has been obtained from a new source: state tobacco settle Other Sciences 7.4 23.9 State Agencies Psychology and Social Sciences 5.28.7 Academia Physical Sciences 3.9 7.9 Mathematics and Computer Sciences 3.85.9 Environmental Sciences 12 7.4 Engineering 10.7 10.9 Biomedical and Medical Sciences 54.8 37.5 0 10 20 30 40 50 60 Percent of State R&D Expenditures FIGURE 8-2 State government research and development expenditures, by performer of the research and field, 1995. SOURCES: Battelle Memorial Institute/SSTI, 1998; Jankowski, 1999; National Science Foundation, 2004.
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. In New York State, for example, Governor George Pataki spearheaded several research and development initiatives worth more than $500 million, including the formation of the New York State Office of Science, Technology, and Academic Research (NYSTAR)
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. In contrast to earlier efforts, which were more broad based, states are now targeting specific niches within biomedical research, such as spinal cord injury research.
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Advantages of State Programs for Studying Spinal Cord Injuries Testimony to the committee and interviews with scientific directors of state programs showed that state-sponsored spinal cord injury research programs offer several advantages to researchers: flexibility; the capacity to leverage more funding, especially for renovation or new construction; a steady form of financing (e.g., from motor vehicle surcharges) ; and a strong investment in the regional economy.
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Examples include endowed faculty chairs (see the description below of the Kentucky Spinal Cord Injury Research Center) , lecture series, and special fellowships.
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MODELS OF STATE-SPONSORED SPINAL CORD INJURY RESEARCH PROGRAMS The following sections profile the efforts of three states to support state spinal cord injury research programs (Kentucky, Florida, and California)
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The New York City Council launched the program in 1997 by allocating $15 million over 5 years to the New York Academy of Medicine. The program was confined to grant support for new assistant professors or postdoctoral fellows in eight research-intensive New York City institutions, six of which were academic medical centers.
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. These funds were competitively awarded to researchers BOX 8-3 Kentucky Type of Program: Centralized program in two universities State Trust Fund Revenues: $1.5 million to $3 million per year from vehicle sur charges Trust Fund Use: Research, endowed chairs, graduate student and postdoctoral support, and a visiting lecture series Estimated Annual Research Budget: $3.5 million plus salaries from endowed chairs for faculty at the Kentucky Spinal Cord Injury Research Center (see Figure 8-3)
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. Kentucky Spinal Cord Injury Research Center Over the past decade, the trust fund has been used to transform a small laboratory at the University of Louisville into a nationally recognized program of research in spinal cord injuries.
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The center uses trust fund revenues in several ways, most commonly to fund competitively awarded research proposals and to endow faculty chairs. Driven by a commitment to collaboration the center has a research agenda that encourages translational research and that seeks out collaborations to extend the impact of the center (see below)
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from the NIH Cen ters of Biomedical Research Excellence 2002 Designation as the Kentucky Spinal Cord Injury Research Center Department of Neurological Surgery at the University of Louisville. The endowed chairs have been used to recruit four senior investigators to the Kentucky Spinal Cord Injury Research Center or to endow laboratories to which outstanding junior faculty are recruited.
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The Miami Project to Cure Paralysis has historically used state funding BOX 8-5 Miami Project to Cure Paralysis Type of Program: Centralized in one facility State Funding: Variable, but ranges from $750,000 to $1.4 million each year (2000 to 2004) Use of State Funds: Primarily salaries and equipment for new faculty to perform the pilot research needed to obtain federal grants Estimated 2005 Budget: $15.8 million (see Figure 8-4)
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. The Miami Project to Cure Paralysis The Miami Project to Cure Paralysis was founded in 1985, and is the nation's largest single program devoted to spinal cord injury research.
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them generate results from pilot studies, which are highly advantageous in gaining NIH grant funding. The state funding for new faculty has been the engine behind garnering more NIH grants.
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California History and Role of State Funding In 2000, California Governor Gray Davis signed The Roman Reed Spinal Cord Injury Research Act of 1999, which is devoted to finding treatments for spinal cord injuries. The Act is named for Roman Reed, who sustained a spinal cord injury while playing college football.
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Its decentralized structure is similar to that of the center to receive the first grant from the New York State Spinal Cord Injury Research Program (see below)
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; 9 are for investigators new to the spinal cord injury research field NIH and foundation grants: $3.7 million in Roman Reed Research Program funding to state researchers (the total over the first 3 years) has led to $18 million in other grants and 24 new jobs in California Researchers: between 2001 and 2004, more than 180 California researchers have participated in 57 Roman Reed Research Program research projects experiments that can be performed with animals.
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The proposition explicitly prohibits human reproductive cloning research. Proposition 71 is likely to benefit spinal cord injury research, one of the commonly named conditions identified to benefit from stem cell research.
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. NEW YORK STATE SPINAL CORD INJURY RESEARCH PROGRAM In 1998, New York State passed legislation to establish a new program whose ambitious mission is to support research "towards a cure for [spinal
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Legislation to establish the spinal cord injury research program was originally proposed by Senator Vincent Leibell and Assemblyman Edward Griffith and was signed into law by Governor George Pataki on July 14, 1998.6 This legislation is often referred to as the Paul Richter Bill, after a New York state trooper who was shot while on duty in 1973. Christopher Reeve was also a strong advocate.
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Using the Scientific Advisory Committee's recommendations as a starting point, board members review the proposals and rank the applications according to their consistency with the Spinal Cord Injury Research Board mission, potential impact, and scientific feasibility. Applications that meet these criteria are forwarded to the commissioner of health for review and approval.
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This grant does not support "program projects, research centers, or large scale clinical trials" (New York State Spinal Cord Injury Research Board, 2002)
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. The year 2001 grants were also awarded for basic research, including research on neuron regulation, axonal guidance, myelination, repair and protection, and glial cells (New York State Spinal Cord Injury Research Board, 2002)
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SOURCES: CRPF, 2000; Times Newsweekly, 2001; New York State Spinal Cord Injury Research Board, 2004. Challenges Facing New York State's Program Expanding the Number of Spinal Cord Injury Researchers in New York In 2003, only six principal investigators in New York State received NIH grants (R01 grants)
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The greatest challenge for the New York State program will be to attract new researchers to the spinal cord injury research field, either by collaboration with or recruitment from researchers in related fields of neuroscience or neurology and bioengineering. It is hoped that over the next 3 years the number of researchers in New York focused on fundamental and translational studies related to spinal cord injuries will at least double.
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Delays are highly disruptive and discourage investigators from getting involved in spinal cord injury research with the New York State program, which is exactly the opposite of the program's intent. Furthermore, issues regarding board members' appointments and attendance remain.
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SOURCES: NIH, 1999; New York State Spinal Cord Injury Research Board, 2002; AAMC, 2004; NIH 2004a,b; Personal communication, F Johnson, Society for Neuroscience, November 19, 2004.
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. All of the states except Pennsylvania have state spinal cord injury programs (Table 8-1)
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The abundance of researchers in fields that overlap the spinal cord injury research field makes it possible for the New York State Spinal Cord Injury Research Program to expand by cultivating collaborations and by sharing core facilities, equipment, and other resources. Opportunities to increase the focus on spinal cord injury research and draw talented researchers to New York could be enhanced through the funding of two to four endowed chairs in spinal cord injury research at New York universities.
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. Strengthening the Research Infrastructure in New York State As demonstrated in this chapter, state spinal cord injury research programs can make a significant contribution to the research endeavor to find a cure for spinal cord injuries.
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RECOMMENDATIONS Further development of the New York State Spinal Cord Injury Research Board should build on the recommendations presented in this report, with additional focus on the following recommendations. Recommendation 8.1: Build and Strengthen New York State's Re search Infrastructure The New York State Spinal Cord Injury Research Board should in crease its research infrastructure to meet the program's mission.
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2000. New York State Spinal Cord Re search Trust Fund Awards $3.6 Million in Grants.
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Albany: New York Department of Health. New York State Spinal Cord Injury Research Board.
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2001. Research of Spinal Cord Injury Gets State Funds.
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