Israel is a country of science. An impressive 20% of its workforce have academic degrees; and 140 out of every 10,000 workers are scientists or technicians, who produce a disproportionate 1.3% of all the world’s scientific papers. Israel invests a record-breaking 4.53% of its Gross Domestic Product (GDP) on research and development (R&D), compared to the OECD average of 2.25%; and Israel’s academic (largely basic) R&D consumes about 0.6% of its GDP, compared to the OECD average of about 0.4%. However, the quality and impact of all this research, as measured by “citation index” (CI, the average number of citations for an Israeli research paper in a given field divided by the world average), is more mixed. In physics, chemistry, computer sciences and molecular biology, Israel is a world leader (CI = 1.29-1.34); in biology/biochemistry it holds its own (1.02); in clinical research (0.89), it does not. In fact, in 1993-2003, although Israel ranked fourth worldwide in the number of clinical research papers published per capita, it ranked only 31st in CI! Clinical research is unique in that most is done in a hospital setting; and that apparently poses special challenges for Israel’s physician-researchers.
 
In October 2006, the Israel Academy formed a special Committee for the Assessment of the State of Biomedical Research in Israel: Its Current Status and Future Needs to investigate all aspects of Israeli Biomedical Research (BMR). The Committee found that, although Israel is largely doing well in basic BMR, many researchers are seriously hampered by small budgets, antiquated laboratory infrastructure, and a lack of Israeli postdoctoral fellows (who mostly train abroad).
 
The Committee - and all three visiting expert committees - recommended that Israel create a well-funded new National Biomedical Research Fund (NBRF), not unlike the U.S. National Institutes of Health, devoted exclusively to competitively supporting innovative Israel BMR and clinical research, with an eye towards its eventual economic exploitation.
 
Israeli hospitals do conduct many clinical trials (for pay) to support the approval of commercial products, but the protocols used are those of the industrial sponsor, and they do little to promote original investigator-driven research. Indeed, physicians who want to do original clinical research have many hurdles to overcome, particularly a serious lack of: research time, research money, experienced mentors, proper physician-researcher career options, proper status, positive hospital research policies, and a supportive research environment. The Committee recommended creating a special unit within the new NBRF to promote clinical research through research grants, stipends (to reimburse hospitals for physician research hours), and other means.
 
Converting BMR laboratory findings into economically viable products is a long, expensive, multistep process. Thus, despite its sizable BMR base, Israel often lags behind in creating innovative biotechnologies and transforming them into a successful high-tech industry. The Committee found that one important bottleneck is the inability of Israeli universities to support the crucial, but expensive, proof-of-concept studies (PCS) required to attract private investment. The Committee recommended that Israeli universities take a broader view of their mandate, and that appropriate government agencies (such as the MITL) consider the visiting committee’s innovative suggestions for public-private PCS funding (e.g., floating special biotech bonds).
 
The Committee also recommended that the Israel Academy establish an ongoing mechanism for evaluating Israeli BMR in comparison with that of other countries. Areas of weakness and new fields of research underdeveloped in Israel should be strengthened. New legislation is also needed to encourage researchers in government-owned hospitals, by granting them patent rights (as in the U.S. Bayh-Dole Act of 1980). The Israel Academy has formed a high-level follow-up committee (Prof. Arnon, Prof. Alex Keynan, Prof. Howard Cedar) to monitor and ensure implementation of these recommendations. Israel’s potential in this area is too good to waste.