"Da cure is coming..." Sometimes, I feel like I am singing the refrain of a church hymn. I believe that the cure is coming but I don't know when. I don't know when because the obstacles to a cure are not scientific but sociological and economic.

Many people have been posting their frustration with how long it is taking for treatments to get to clinical trial. Some people have called out for restricting certain avenues of research to pursue ones that are more likely to yield immediate results. Some people have opposed certain types of research (embryonic stem cells, for example) that many scientists consider to be promising not only for spinal cord injury but for other conditions. A few have blamed scientists for the slow progress.

I would like to urge people to consider the following:

First, spinal cord injury research is not and should not be a zero-sum game. A zero-sum game refers to a situation where all the resources are limited and if you shift resources to one area, it takes it from another. We must understand that spinal cord injury is a small part of a large research enterprise that is attempting the reverse the age-old dogma that the central nervous system cannot be repaired or regenerated, or recover from injuries. The CNS restoration field is in turn part of a much larger neuroscience effort. The neuroscience effort is part of a huge biomedical science effort. Stopping research in one arena (such as embryonic stem cell work) does not mean that the saved funds will be diverted into spinal cord injury research. Nor does it mean that having such research will steal money from spinal cord injury research.

Second, think not of just yourself but also future generations. To say that we should eschew research that does not benefit the current generation but that is likely to benefit future generations is an unacceptable position to take. We must not allow society to force us into that choice. We must demand that research funding be adequate for both the current and future generations. Incidentally, the spinal cord injury community is divided regarding the possibility of a cure that will come in time to benefit the current generation. Almost everybody, however, agrees that the research will benefit future generations. To oppose research that will benefit future generations because it will not benefit yourself is ultimately selfish.

Third, we must understand the obstacles to progress of therapies to clinical trial. The obstacles are not scientists or their attitudes, as suggested by some in these forums. The scientists are doing what they should be doing... delivering data from animal studies, trying to convince the world that these are promising treatments that should be taken to clinical trial, and working very hard to ensure that the data is as reliable and predictive as possible. The obstacles are:

• Lack of funding for clinical trials. The government and companies are not investing. Charitable foundations do not have enough funds. This is a serious problem and this is problem that the spinal cord injury community can and should solve.

• Slow clinical education. Many of the doctors in the field are not up on the latest in spinal cord injury research. They do not come to the meetings or read the journals. Even worse, they may not understand or believe what is happening when they do come into contact with the information.

• Fractured spinal cord injury community. While many members of our community belies and supports a cure, this is not the case for most people with spinal cord injury. It is frightening to me how many people and families with spinal cord injury are totally silent when it comes to research. Some even openly oppose research funding. If you don't believe this, just look at how much the National Institutes of Health is spending on spinal cord injury research... less that $100 million per year.

As I have said time again, we are behaving like a wagon train that has circled but all the guns are pointing inward. Until we start addressing the real reasons why therapies are taking a lot time to develop, it will take a long time.

Wise.