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Funding the U.S. National Institutes of Health

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#1 Dr. Joseph Lorenzo

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Posted 01 December 2015 - 12:10 PM

Funding is the bedrock of all biomedical research. In the United States there are a number of agencies that support scientific biomedical research. However, far and away the largest single source is the National Institutes of Health (NIH). Since 2003 funding for the extramural program of the NIH has declined in inflation-adjusted dollars by 22% (see Figures 1 and 2, which were created by Federation of American Societies for Experimental Biology, FASEB). In turn, this decrease in inflation-adjusted support has decreased the number of research project grants that NIH can fund in any given year by over 3000 (roughly 10%) during this same period.
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Fortunately, it now appears that the trend of decreasing fiscal support by the U.S. Federal Government for biomedical research may be reversing. For fiscal year 2016 President Obama’s budget proposed a one billion dollar increase in NIH funding, which would be only the third time since 2003 that the annual NIH budget increased at a rate greater than inflation. Even more hopeful for researchers, changes to the Budget Control Act of 2011 (the so-called “Sequestration”) allowed more discretionary funding in the Federal budget. Recently, a group of 100 members of the U.S. House of Representatives signed a letter urging the House to increase NIH funding above the Presidents request for fiscal year 2016 by another 700 million dollars to 32 billon dollars per year (roughly a 6% increase over last year). This is also the level of NIH support that the U.S. Senate Appropriations Committee approved last August.

The U.S. Congress has also become aware that the wide swings in fiscal funding for the NIH have had significant negative effects on the number of investigators who can pursue biomedical research. This is probably most important for early stage investigators who are the most dependent on the successfully funding of their research to advance their careers. In July the U.S. House approved the “21st Century Cures Act” with strong support from both major political parties. This bill would provide $8.75 billion in new funding for the NIH over five years ($1.75 billion in additional funding per year). However, this measure needs to pass the Senate where it may run into opposition because of limited ways to pay for the new NIH funding. The additional NIH funding would. be distributed in the following areas: biomedical research, cures development, an accelerating advancement program, high-risk high-payoff research, and special funding support for early career researchers. The U.S. House bill also sought to accelerate the process by which the U.S. Food and Drug Administration (FDA) approved new treatments for disease. This would include relying on results from biomarker studies rather than more definitive trial results. It is unknown whether changes to the FDA approval process will be included in any final legislation.

All this news brings some hope to U.S. biomedical researchers that the decline in inflation-adjusted funding of the NIH that has occurred over the last 12 years may be reversing. However, FASEB estimates that even with an increase in NIH funding of 5 percent per year, which is approximately what the 21st Century Cures Act proposes, it would take 10 years to restore NIH funding to its fiscal year 2003 inflation-adjusted level.

Joe Lorenzo

Farmington, CT, USA.

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