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NIH funding plans decried as paltry; 575 medical organizations ask for more

Health groups voice concern that Congress' budget will undermine progress in medical research.

By Joel B. Finkelstein, amednews staff. Sept. 22/29, 2003.

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Washington -- Bills that call for relatively scrawny fiscal year 2004 increases in National Institutes of Health funding have spurred medical groups to push Congress for more. They say the added money is needed to ensure progress in medical research and discovery.

In a letter to the Senate, 575 groups asked lawmakers to support an amendment to the appropriations bill for the Depts. of Labor, Health and Human Services, and Education that would boost the NIH budget $1.5 billion above the nearly $28 billion already included in the Senate package. The House bill would increase funding by 2.5%, to $27.7 billion, which matches the Bush administration's budget request.

At press time, the Senate was still debating the appropriations package, and proponents of the amendment were seeking more co-sponsors.

The amendment, which was proposed by Sens. Arlen Specter (R, Pa.), Tom Harkin (D, Iowa) and Dianne Feinstein (D, Calif.), would increase NIH's budget by 9.2% over this year's level. Specter, who is on the Appropriations Committee, also introduced the original Labor/HHS appropriations bill.

Regardless of whether the amendment passes, the House and Senate will have to agree on a final number. Proponents hope that passage of a higher funding level in the Senate would boost the chances of a more generous final appropriation.

On the House side, a group of lawmakers is attempting to secure an agreement to raise NIH funding by 10% during negotiation that eventually will take place between the House and Senate.

Sustaining research progress

The currently proposed funding levels are disappointing in light of past increases, said proponents of the effort to boost NIHfunding for fiscal 2004.

In 1999, Congress committed to doubling the NIH budget within five years. Since then, the institutes' budget has grown by nearly 15% on average each year, up until this year, when that effort officially ended.

"The five-year commitment to double the NIH budget was a huge statement by this nation that we believe in the promise of medical research," said Wendy Selig, vice president of legislative affairs for the American Cancer Society.

It has yielded extraordinary results, she said.

"We now look at cancer as a chronic disease instead of a death sentence," Selig said. "There are over 9 million people living with cancer today who are surviving and going on with their lives."

Physician organizations were among the groups that signed on to the letter in support of beefing up the NIH's funding.

"Investment in research is one of the ways America has achieved the best health care in the world," said J. James Rohack, MD, AMA chair-elect. Physicians, as scientists, recognize the importance of research and how study findings lead to better care for patients, he added.

W. Michael Scheld, MD, president of the Infectious Disease Society of America, said, "We wouldn't be where we are today, in terms of understanding, preventing and treating infectious diseases, had it not been for the wise investment in research."

Flattening out funding

The 2.5% increase in the House bill and the 3.7% rise in the Senate bill would hamper continued progress, the health groups said.

"With only minimal budget increases proposed for fiscal year 2004 ... ongoing research will be stalled and pathways of discovery will not be explored," according to their letter to the Senate.

When inflation is taken into account, a 2.5% increase is basically flat funding, Selig said.

She pointed out that appropriate funding is needed to encourage young, bright people to go into the research field and that they need to be reassured that the funding will be available in the future.

"Medical research is not like a light switch. You can't flip it on one year and flip it off the next and expect to make progress," she said. "Some of the greatest discoveries in medical research people spent decades studying. So you really have to keep the pipeline open."

Even with the recent increases, the National Cancer Institute can afford to fund only 25% to 30% of peer-reviewed research.

"The inverse of that is that three-quarters to two-thirds are not getting funded, and each one of those is a potential breakthrough on a treatment or a cure," Selig said. "There is plenty out there that is meritorious that could be funded if we had the resources beyond what we have had. If we ... cut back on our focus, we will lose ground."

Research has brought the medical community to the brink of some phenomenal discoveries, she said. Continuing reasonable increases in research funding is important to seeing a return on that investment.

"If the funding were just to go off a cliff, you would stop a lot of this progress in its tracks," she said.

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