With tight budgets expected to continue for a while, the Senate urged NIH to explore creative ways to allocate funding. [© Bambuh - Fotolia.com]
Concerns by researchers that today’s austerity-minded budget climate will at the very least freeze NIH spending—and with it the agency’s funding of basic research grants—appear to have been well founded. For the federal fiscal year that starts October 1, NIH would see its funding cut by 0.6%, or $190 million, to $30.5 billion if a vote taken last week is any indication.
On September 22, the Senate Appropriations Committee approved a $758.7 billion spending plan for the Labor, Health and Human Services, and Education departments largely along the lines of the markup approved a day earlier by the panel’s subcommittee focused on those agencies, which is chaired by Sen. Tom Harkin (D-IA). “The Committee regrets that fiscal constraints prevent a higher recommended funding level for NIH,” Senate Appropriations stated in its report outlining the FY 2012 budget approved for the agency.
Harkin detailed some of those constraints in remarks to the committee: “Last year’s appropriations bill eliminated 46 programs totaling more than $1.3 billion. It cut all the fat and went into bone. In this bill, we get into the marrow.”
Marrow or bone, at least the Senate has some progress to show on deciding funding for NIH and the rest of HHS. The House of Representatives had yet to appropriate funds for NIH or any other part of HHS. Two attempts by House Appropriations to schedule a markup session fell through after it became clear the subcommittee lacked the votes to pass a Labor-HHS-Education markup.
No markup efforts are expected soon because both the House and Senate are supposed to be in recess. In truth, however, they continue to struggle with crafting a continuing resolution to maintain spending at current levels from October 1 through November 18, let alone come to terms on a new budget for FY 2012.
Battle for Money
At a time when President Barack Obama and Congressional leaders are talking about the need to end annual trillion-dollar budget deficits and reduce the $14.7 trillion-and-climbing national debt, the FY 2012 budget could have been much worse for NIH and its institutes. As GEN reported last week, House Appropriations cut as much as 11.6%, or $283.57 million, from FDA’s current budget, while Senate Appropriations trimmed NSF’s budget by 2.2%, or $120.875 million.
In approving a budget close to the amount sought by NIH, Senate Appropriations used its committee report to urge the agency to think hard about its spending. “With tight budgets likely to continue for the foreseeable future, the Committee strongly urges NIH to explore creative ways to rethink the way it allocates its funding. The alternative—continuing to nick away, little by little, at the success rate or the size of awards—will inevitably have a negative impact on young investigators who represent the nation’s future and on high-risk, high-reward research opportunities.”
The proposed NIH budget has drawn criticism from the American Association for Cancer Research (AACR). It contends that the spending plan is inadequate given the magnitude of the research necessary to bring cancer under control. AACR has called for lawmakers to approve a $33.3 billion budget for the agency, which is an 8.6% increase from FY ’11 and at least 5% above the biomedical inflation rate.
“Without sustained budget increases for research that also take into consideration inflation and other research expenses, we risk stalling the progress we have already made and compromise our ability to continue to transform cancer care for the benefit of patients,” AACR stated in its Cancer Progress Report 2011, released September 22.
As part of the $30.5 billion approved for NIH, Senate Appropriations put aside $582.362 million for the new National Center for Advancing Translational Science (NCATS). That’s nearly 17% less than the $700 million proposal by Francis Collins, Ph.D., when he first announced plans for this center, envisioned as focusing on moving treatments from bench to bedside as quickly as possible.
All but $20 million of the funds NIH would receive for NCATS comes from combining current budgets of existing centers within NIH that will be folded into NCATS. For example, the translational center’s budget will include the $485 million now spent on the National Center for Research Resources (NCRR); NCRR’s existing programs would be redistributed throughout NIH’s other institutes and centers.
The $20 million in new funding for NCATS will go toward a new Cures Acceleration Network (CAN), created to advance development of high-need cures through the reduction of barriers between research discovery and clinical trials. NIH initially requested $100 million for CAN, though.
“The future of NCATS is still very much a giant question mark,” Jennifer Zeitzer, legislative director for the Federation of American Societies for Experimental Biology, told GEN.
NIH’s three largest component institutes were left mostly flat by Senate Appropriations:
- National Cancer Institute: The panel approved $5.002 billion for NCI, down 1% from the $5.059 billion for the fiscal year ending this week and 3.7% below President Obama’s proposal. Senate Appropriations urged NCI to focus more on identifying melanoma biomarkers, spend more on pediatric cancer research, which now accounts for less than 5%, or about $1.5 billion, of NIH’s total budget, as well as spend more on breast and liver cancers, the latter by creating a Specialized Program of Research Excellence.
- National Institute of Allergy and Infectious Diseases: NIAID funding would drop 1% from FY ’11, or $50.68 million, to $4.725 billion, which is nearly 4% below Obama’s proposal. Senate Appropriations asked NIAID to “support a multicenter initiative with a companion data collection and analysis center” to facilitate the use of new desensitization protocols. According to the agency, these protocols have increased the number of cadaver kidneys suitable for transplantation for highly sensitized candidates.
- National Heart, Lung, and Blood Institute: The panel agreed to appropriate $3.036 billion to the NHLBI, down $33.5 million from FY ’11 and $111.8 million from Obama’s request. NIH noted that research spending on cardiovascular disease amounted to less than 8% of total NIH spending, or $2.455 billion. The Senate stated: “NHLBI is also encouraged to increase its attention to the impact of cardiovascular disease on ethnic minorities such as Native Hawaiians and Asians.”
Funding for the Centers for Disease Control and Prevention (CDC) would dip by 1%, or about $63.1 million, from $6.281 billion in FY ’11 to $6.218 billion; Obama proposed increasing CDC’s funding in FY ’12 to $6.393 billion.
CDC’s National Center for Emerging and Zoonotic Infectious Diseases would remain flat under the Senate Appropriations spending plan at $252.443 million. For the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Senate Appropriations approved freezing spending at about $1.116 billion in FY 2012.
A segment of CDC to see a significant increase was the National Center for Immunization and Respiratory Diseases, which in FY 2012 could see $50 million over the previous year. Spending would rise 6.7% from $748.257 million to $798.257 million. The boost reflects a $50 million expansion of the Section 317 immunization program.
Two centers within the Office of Noncommunicable Diseases, Injury and Environmental Health will see small increases under the Senate Appropriations plan, tied to increased data collection toward fighting disease. Funding for the National Center on Birth Defects and Developmental Disabilities would rise by $2 million, or 1.5%, to $138.072 million. Obama requested a 5.8% increase to $143.899 million. The entire $2 million increase will be spent to collect data on congenital heart disease.
CDC’s National Center for Chronic Disease Prevention and Health Promotion would see $4 million, or 0.5%, more in funds under the Senate panel’s spending plan, to give it $777.987 million. Obama sought to cut nearly $50 million from the office’s budget, proposing $725.207 million.
Much of the increase, $2.576 million, reflects an expansion of the National Lupus Patient Registry. Lupus registry funding will climb to $4.462 million from $1.886 million. The chronic disease prevention center would also fund data collection in two disease categories left unfunded during FY 2011: inflammatory bowel disease ($680,000) and interstitial cystitis ($654,000).
The panel approved a $10 million spending cut for the Office of Public Health Preparedness and Response to $1.405 billion in FY 2012 from $1.415 billion in FY ’11. Obama proposed raising the office’s budget by 2.6% to $1.452 billion. The $10 million cut comes entirely from State and Local Preparedness and Response Capability funds, and was actually an increase of $3.246 million from the $651.048 million proposed for that purpose by the president.
A major opportunity beckons the CDC, NIH, and Congress: a balancing act between continuing progress in the fight against cancer and other diseases and containing costs as promised by lawmakers on both sides of the political aisle who are scrambling to satisfy increasingly angry taxpayers and voters. Like the rest of the U.S., the agencies will be forced to make do with as much as last year if not less.