Jin Nakahara: Win-Win-Win

The decline of Japan's basic scientific strength and the decrease in graduate students are frequently in the news. Fortunately, I have not yet felt this in my laboratory, but I feel the decline in the acceptance rate for public research funds deep in my bones. When the acceptance rate for public research funds drops and one becomes "strapped for cash," it becomes impossible to secure not only one's own research but also the free research activities of graduate students. Without financial independence, there is no academic independence; poverty dulls the wit. As someone responsible for dozens of medical staff members, I spend my days scrambling for funds.

Since I can do nothing about the state of public research funds, I have no choice but to collect private research funds. As student tuition fees are affected by the declining birthrate, it is also difficult to ask for an increase in research funds within Keio. Looking abroad, it seems that billionaires provide research funds partly as a tax measure, but in Japan, a society where everyone once considered themselves middle class, there is unfortunately little hope for that. In our world, pharmaceutical companies with financial power used to distribute "scholarship donations"—transparent research funds—from their operating expenses. However, perhaps due to drug prices being lowered every year, or perhaps because it was discovered that they have almost no effect on doctors' prescribing trends, recently we cannot even get a "pittance." After all, they have shareholders, so providing expenses that do not lead to an increase in corporate value is practically a breach of trust. Therefore, we turn to various "string-attached" research funds.

Pharmaceutical companies are in the business of selling drugs. In other words, they think of measures to increase doctors' prescriptions. If the effect of "donations" is weak, they try to improve doctors' prescribing trends through "differentiation of drug efficacy." When that is paired with "string-attached" research funds, it becomes the breeding ground for the "distorted clinical research" seen at a certain university. It is only natural that the patients who were used as pawns would be angry. As a result, the Clinical Research Act was enacted this spring, and clinical research using "string-attached" research funds is now subject to depressingly rigorous reviews. In the world of medical sciences research, the future is unpredictable.

What is needed now is not Win-Win, but Win-Win-Win. This means that not only the pharmaceutical companies, which are the source of research funds, and we researchers, but above all, the patients must be happy. For whom does medical sciences exist? The price paid for forgetting this obvious fact is high. Speaking of private research funds, unlike national and public universities that are tied down by conflicts of interest, the Juku is a private institution. This pinch might be an opportunity. Thinking that way makes my heart leap. Today, while searching for the seeds of Win-Win-Win, I maintain my pride even in the face of adversity.