Challenges in the biomedical research enterprise in the 21st century: Antecedents in the writings of David Triggle
Delivery of Health Care
David Triggle's career as an educator, researcher, essayist and ethicist in many ways has paralleled the post WWII emergence of the "biomedical research ecosystem" that originated in the concept of the "Endless Frontier". In the ensuing 70 years biomedical research has irreparably changed the nature of society with vaccines, the birth control pill and new generations of drugs and biologics to treat infections, sexually transmitted diseases, psychiatric disorders and cardiovascular diseases. These have led to a shift in the population demographic to the elderly and the chronically sick leading to major issues in the provision of effective and affordable healthcare for much of the world's population. In the present article, in addition to providing a brief biography and an appreciation of David Triggle's contributions to science, the authors expand on three topics in which he has had a major interest: improving the quality, reproducibility and relevance of basic biomedical research; declining career opportunities for graduates in an era of decreased funding-the end of the "Endless Frontier"; and the dynamic between the provision for universal healthcare and the dysfunctional, wasteful and politicized systems of the current medical-industrial complex in delivering healthcare.