It’s early in the budget process. Almost always, the President’s budget is modified in Congress. The current proposal will not stand.
Nonetheless, it is still disheartening to learn of a budget that proposes a $5.8 billion cut to the National Institutes of Health—over 18% of its total. Over the years, NIH, which is the main source of federal funding for biomedical and behavioral research, has enjoyed bipartisan support. Of course the agency has not gone unscathed in the budget process – its funding has been nearly level since 2003, which culminated “the doubling,” a five-year effort that saw annual funding increases of 14% to 16%. As anyone on a fixed income knows, level is in fact a cut because of inflation. Fortunately, recent proposals to address cancer, brain health, and more—specifically Alzheimer’s disease—have augmented the NIH budget.
But until now, and despite occasional differences over priorities, an actual cut has been nearly unthinkable. In general, both parties have agreed that fundamental biomedical research and patient-based research not driven by industry are vital for the health and economic strength of America.
The country has seen vast returns on its investment in research conducted at or through the NIH. Eighty-three percent of NIH funding is distributed to over 300,000 researchers nationally at universities, medical schools such as Case Western Reserve, and hospitals; the remainder funds NIH investigators.
The list of progress and cures is long: four decades ago, childhood leukemia was a death sentence; now, more than 90% of its victims survive. Until the first CF centers were established, nearly all children with cystic fibrosis died before reaching school age; now the median survival age is in the 40’s, and for some genotypes, definitive treatment is on the horizon.
Pioneering work appears to have cured the first volunteers undergoing bone marrow transplant for sickle cell disease; death rates from cancer have been falling; paralyzed individuals can be assisted to use their arms and legs; infertile couples can have children.
We have made tremendous inroads against diabetes and high blood pressure.
Some disorders that used to require surgery and long hospital stays now are treated by minimally invasive interventions and surgical procedures, such as aortic valve replacement, gall bladder removal, and even cancer surgery. Patients with cataracts now get artificial lenses in a twelve-minute outpatient procedure rather than having to endure a two-day hospital stay with their head between sandbags, followed by use of coke-bottle glasses.
All of these life-saving and hope-giving advances benefitted from brilliant research funded in significant degree by the NIH. And the list could go on and on. Unquestionably, life is better for Americans because of the NIH.
The economy has benefitted as well. A few years ago, the NIH calculated that a single R01 research project grant, its basic funding mechanism, accounted for seven jobs with an average salary $52,000.
The federal government is no longer the largest source of funds for biomedical research – industry is. Today, the American pharmaceutical industry leads the world – and very few of our industries do, any more. But without the fundamental discovery research paid for by federal funds, there would be little or nothing to develop with industry money. The discovery research drives the entire enterprise. Clinical trials unencumbered by industrial goals teach us much about treatment of common diseases.
One enormously important example, which CWRU has played a part in, is SPRINT—the Systolic Blood Pressure Intervention Trial. This research study funded by the NIH is generating new blood pressure targets for treating hypertension. Such studies would never be conducted by industry – the primary drugs for treatment in this trial are off patent and dirt cheap. The findings will save taxpayers money through ultimately lower Medicare and Medicaid outlays for hypertension-caused diseases.
All of us need to keep close watch on the fate of NIH funding as the budget wends its way through Congress. We must speak up about the benefits of this investment. We must collect our arguments and have them immediately available, from sound bite to elevator speech to white paper. This is worth fighting for.
Pamela B. Davis, MD, PhD
Dean, School of Medicine
Senior Vice President for Medical Affairs, Case Western Reserve University
Arline and Curtis Garvin Research Professor
2109 Adelbert Rd. BRB 113
Cleveland OH 44106