The American biomedical research enterprise is a national treasure. As such, biomedical research broadly, and the National Institutes of Health specifically, should be funded as a national priority. Sadly, as we enter the fiscal 2017 budget season, President Obama has proposed budget gimmickry over sustained investments, and the community should flatly reject this proposal.
Yesterday, Obama released his eighth and final budget, and, among other things, called for a nearly $1 billion increase to the NIH. However, this proposal comes with a catch. Reading beyond the headline of Obama’s request shows a shocking cut to discretionary spending at the NIH. In FY16, the NIH received a significant funding increase to $32.3 billion, a $2 billion increase over FY15, thanks to bipartisan congressional support for the agency. Obama’s FY17 request is for $30.3 billion in discretionary funding (a 6.2 percent drop in funding) and relies on Congress to provide a new, mandatory funding mechanism to make up the $2 billion difference between the president’s overall request ($33.1 billion) and the actual discretionary budget request. As FASEB Director for Legislative Affairs Jennifer Zeitzer said, “It’s an increase in the same way as saying, ‘I’m going to increase my household budget because I bought a Powerball ticket.'”
The biggest flaw in this proposal is introducing the use of mandatory funding as a means to funding the biomedical research enterprise. Look, we all know the appropriations process is far from perfect, and the boom-and-bust cycle of funding for the NIH is damaging to the enterprise as well. But, historically, the NIH has done well compared with other federal programs. The NIH budget doubled via the appropriations process during the late 1990s and early 2000s. Appropriators approved a $10 billion increase for the NIH in economic stimulus funding in 2009. And in December, the NIH received a $2 billion increase over FY15, again through the annual appropriations process. Furthermore, in the years in which the NIH budget was relatively flat, appropriators protected the agency from the budget cuts endured by other federal science agencies.
The call for funding the NIH by a mandatory mechanism is not new. Last year, the U.S. House of Representatives included a mandatory funding mechanism for the NIH in H.R. 6, the 21st Century Cures Act. That bill created a $1.75 billion per year mandatory funding stream for the agency for five years. These funds would be designated as an NIH Innovation Fund with various prescripted targets for this spending, such as accelerating translation of discoveries to treatments, funding high-risk/high-reward research grants and supporting young investigators. A number of organizations including the ASBMB did not endorse H.R. 6, in part out of a concern that a mandatory fund would encourage members of Congress to cut NIH discretionary funding by roughly $1.75 billion, rather than maintaining discretionary spending at the agency and allowing the mandatory fund to supplement baseline NIH appropriations.
Furthermore, recent history would suggest the path to forming a mandatory funding stream for the NIH is unlikely to come to fruition and should be opposed by the research community. Roadblocks to consider include:
- Obama’s proposal cuts the discretionary budgets of all 27 NIH institutes and centers and then replaces those cuts with mandatory funds. However, the mandatory funding mechanism for this plan does not yet exist, meaning the administration is essentially calling for cuts to the NIH and hoping for Congress to save the agency’s budget.
- The NIH Innovation Fund in H.R. 6 expires after five years, potentially leaving the agency with a funding cliff. If this is the model for Obama’s mandatory funding stream, this could severely damage the NIH by relying on funding that abruptly ends in five-years. Researchers and appropriators would be left to scramble to devise a plan beyond the expiration of the fund.
- Finally, the U.S. Senate will not bring up H.R. 6 for a vote, preferring to pass instead a series of smaller bills. And in its own innovation agenda, the Senate has deliberately not included increases in NIH funding, signaling a lack of political will to include funding for the agency outside of the standard appropriations process.
Beyond these roadblocks to establishing mandatory NIH funding, Obama’s proposal fails to build on growing bipartisan support for biomedical research and the NIH. Last week, ACT for NIH hosted a reception celebrating the $2 billion increase in NIH appropriations in FY16. The reception was well attended by bipartisan congressional champions for the NIH, including Senate and House Labor, Health and Human Services Appropriations Committee Chairs Sen. Roy Blunt, R-Mo., and Rep. Tom Cole,R-Oklah.; Sen. Patty Murray, D-Wash.; Rep. Rosa DeLauro, D-Conn.; House Majority Leader Kevin McCarthy, R-Calif.; and House Minority Whip Steny Hoyer, D-Md. There is the political will to fund the NIH through the normal appropriations process, as was proved just months ago with the FY16 omnibus spending package. This year’s budget was a wonderful opportunity for the Administration to build on this bipartisan support. An opportunity clearly missed by Obama’s FY17 budget proposal.
There is also one final major flaw to this budget request. Should the stars align and the funds become available, the president is flat funding 24 of the 27 individual institutes that make up the NIH. The National Cancer Institute, thanks to the President’s “cancer moonshot” that came out of his 2016 State of the Union Address, is poised to see a $600 million increase, as is the Office of the Director’s fund, which invests in the recent string of politically mandated research programs like the BRAIN Initiative and Precision Medicine Initiative. In fact, the National Institute of Dental and Craniofacial Research and the National Institute and Diabetes and Digestive and Kidney Diseases see modest cuts to their budgets. Heavy increases to one institute and flat funding for other institutes at the NIH is a recipe for slowing advancements in critical areas of biomedical research.
We aren’t the only ones who feel this way. American Association of Universities President Hunter Rawlings said in a statement that the AAU believes “this budget does not live up to the President’s long-time commitment to funding research.”
Biomedical research deserves to be treated as a national priority on par with national security. The biomedical research enterprise provides life-saving treatments to millions across the planet, creates high-paying jobs and has provided trillions to the U.S. economy. The administration seems to recognize the importance of biomedical research, as shown by its longtime support for the NIH. But the lack of a realistic funding proposal threatens the U.S. position as the global leader in biomedical research innovation. Anything less doesn’t provide our nation’s researchers with the support they deserve.