I recently came across a fictional publication called the Not Yet Gazette with a front-page story dated November 10, 2025, entitled, “Demonstrators demand more money for arthritis research.” The fictional report gave details of a crowd of 100,000, “many in wheelchairs,” confronting the health secretary of that time. The genesis of this fictional article was the observed trend towards the aging of the population and slow growth in research funding. The article stated that, “ ‘Fiscal constraints caused by slow economic growth and resistance to tax increases have greatly reduced allocations for medical research grants in recent years,’ [the health secretary] told the delegates. ‘Unfortunately, in our current political climate, funding for health research is limited,’ she said to reporters after the meeting. ‘We have to devote our limited resources to diseases that are more immediately life-threatening.’ ”
While we cannot change the demographic trends of our time, we can surely address the issue of research funding. The kind of thinking in the above quote, even in fiction, should be disturbing to those of us who care for patients with chronic diseases. It highlights the perception that acutely life-threatening diseases are more worthy of research grant funding than conditions that merely affect quality of life. The patients who suffer from the pain, fatigue, and loss of function associated with arthritis and rheumatic diseases would surely disagree that these problems are less worthy of research.
I would argue that researchers in our field have the capacity to ask and answer questions that will have an effect far beyond rheumatology, and it is vital to position research in arthritis and rheumatic diseases in such a way that these questions are clearly applicable across diverse disciplines and within institutes at the National Institutes of Health (NIH). In aggregate, arthritis and other rheumatic diseases have an enormous impact on the health-related quality of life and productivity of our population; therefore, an economic argument based on the numbers of patients with arthritis and rheumatic diseases—with direct and indirect costs—should, and can, be articulated so the additional value associated with rheumatic disease research can be used to argue for increased funding.
How, then, do we avoid the fictional—but very possible—future describe in the Not Yet Gazette? We must work with our patients to educate Congress of the importance of research in the rheumatic diseases. As physicians and health professionals, we must arm our patients with the motivation and facts to view their diseases as important targets for research. Patients and providers must become advocates by contacting their current government representatives and voting for those who support biomedical research funding. In fact, this month your fellow ACR and ARHP members and their patients are attending the ACR Advocates for Arthritis advocacy visit in Washington, D.C., and are lobbying Congress for increased NIH funding and other issues important to the rheumatology community. I urge each of you, with your patients, to get involved.
To be able to answer the critically important research questions that affect our field, we must have rheumatologists trained in basic, translational, and clinical research. A cadre of physicians, health professionals, and basic scientists engaged in basic research and in the training of young investigators for the future are required to maintain the discovery pipeline. Well-trained clinician-scientists are vital to translational research, where their clinical skills are essential in moving new discovery to the bedside. Clinical scientists must be prepared to test the hypotheses generated by basic and translational research with the most rigorous of methodologies to determine their value to patients and populations. Young rheumatologists and health professionals must be able to look past the current funding environment and see an exciting future in research, and that future must be secured.
The ACR Research and Education Foundation (REF) recently completed a review of its core grants portfolio to assure that our young clinician-scientists with a strong desire for a research career will have a clear path toward becoming independent researchers. The chief emphasis of the REF portfolio review was to streamline the portfolio and application process and to incorporate real-time metrics to assure funds are awarded to those who are continuing in their quest to become independent clinician-scientists. Working together with the NIH and other funding agencies, the REF can achieve a goal of securing the future of research in rheumatology.
I hope you will all join me in providing support for the REF’s and the ACR’s efforts. The fictional article from the Not Yet Gazette may be all too real without attention to research funding now.
Leslie Crofford, MD is the president of the ACR REF and chief of the Division of Rheumatology at the University of Kentucky in Lexington. Contact her by e-mail at [email protected].