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U.S. News & World Report: What's Behind the Research Momentum?

January 1, 2016
News Stories

U.S. News & World Report - Kimberly Leonard

Scientists have long lamented that inadequate funding prevents the kind of research that leads to treatments and cures for some of the most devastating illnesses. Washington appears to finally be listening.

Presidential candidates from both parties have talked publicly about the need to spend more on medical research, and Congress has for the first time in a dozen years significantly increased the budget for the National Institutes of Health, a U.S. Department of Health and Human Services agency that conducts research and awards grants to research institutions.

"Over the past year or more there has been so much momentum building for support for NIH and a recognition that the agency has really been neglected in terms of funding for a long time," says Jennifer Poulakidas, co-president at United for Medical Research, an alliance advocating for increased NIH funding.

The environment was ripe for the $2 billion increase in the budget approved by the House and signed into law by President Barack Obama in December. Congress didn't have to cut elsewhere to give more money to the NIH because an October budget deal raised spending limits in federal law. Still, the increase was double what the president had requested.

"We've heard from members of Congress that they do want to continue [increasing the funding]," says Poulakidas. "To hear that there's more to come is fantastic."

These developments follow a targeted lobbying campaign by Act for NIH, which in September 2014 joined the scores of patient groups, drug companies, scientific societies and universities that have been asking Congress to increase NIH funding for years. The group is funded by Jed Manocherian, a real estate investor and developer, who tapped the NIH director's top legislative aide, Patrick White, as president.

"This is the inflection point," says White, referring to the momentum he's helped create in Washington. "The funding situation has been so tight that bright, young people are leaving the field. That resonates with lawmakers."

Rep. Tom Cole of Oklahoma and Sen. Roy Blunt of Missouri, both Republicans and chairmen of the subcommittees in charge of NIH funding, were sympathetic to pleas for more funding.

The agency's director, Dr. Francis Collins, has met with more than 300 lawmakers in the past year, telling them about medical research and asking for support, according to his interview with STAT. He also turned to the media, giving interviews and writing op-eds. When Ebola led the headlines last year, Collins said a vaccine would already have been discovered if it hadn't been for budget cuts to the NIH.

The agency's budget headed into 2016 is $32 billion, compared with $30.4 billion in 2015. If the bipartisan 21st Century Cures Act the House passed in July becomes law, it will add another $8.75 billion over the course of five years.

Made up of 27 institutes, NIH is the largest financial supporter of research at U.S. colleges and universities, studying everything from cures for cancer to how to make condoms more pleasurable to increase use and prevent the spread of sexually transmitted diseases.

"Quite simply, medical research affects everyone," says Erin Heath, associate director of the office of government relations at the American Association for the Advancement of Science.

Some of the funding increase is earmarked for projects that the administration prioritized in 2015, including fighting drug-resistant bacteria. The spending bill also includes a $264 million boost specifically for the National Cancer Institute.

On the campaign trail, a number of presidential candidates have broached the subject.

GOP candidates Texas Sen. Ted Cruz, former Arkansas Gov. Mike Huckabee and former Florida Gov. Jeb Bush have called for greater federal investments in scientific research. Bush called for an increase in NIH funding in his health care proposal, though he didn't specify the amount.

Former Secretary of State Hillary Clinton, the Democratic front-runner, released a plan last week to increase funding for Alzheimer's and related diseases from $1 billion to $2 billion a year. Researchers are optimistic that at that rate over 10 years they could cure the disease that impacts more than 5 million Americans and a projected 15 million by 2050. Clinton will announce additional plans to boost medical research in the coming weeks, according to her campaign.

Running for the Democratic ticket in 2007, Clinton said cancer research would be one of her top priorities. "It's just outrageous that under President [George W.] Bush, the National Institutes of Health have been basically decreased in funding," she said at the time. "We are on the brink of so many medical breakthroughs, and I will once again fund that research."

In fact, NIH's budget increased during the early years of the Bush administration. The first cut to the agency's budget since 1970 came in 2006. ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

When he was running for president in 2007, Obama had pledged to double federal funding for cancer research in five years. Cancer researchers received a $1.3 billion boost over two years through the economic stimulus – a bill meant to jumpstart various parts of the economy – but the doubling never materialized. Before Obama took office, the NIH's National Cancer Institute budget was $4.8 billion a year. Going into 2016, the budget will be about $5.1 billion.

The NIH budget grew from $17.9 billion in 2000 to a peak of $31.2 billion in 2010, but advocates say funding hasn't kept up with inflation and the current 6.6 percent increase is the largest the agency has seen in 12 years.

"We doubled the [portfolio of] NIH then we had two wars and an economic crisis," White says. "We haven't been in a position to invest the way we should."

Funding began to decline after 2010, and has continued to fall slightly over the past four years, decreasing by 5 percent to $29.3 billion in 2013 as a result of the sequester, and increasing slightly to $30.15 billion in 2014. When setting those budgets, Obama was in the White House, Democrats controlled the Senate and Republicans controlled the House.

Despite the good news for researchers, the NIH funding increase could take a beating as campaign season heats up.

Kentucky Sen. Rand Paul, who is running for the GOP nomination, has been a consistent critics of the NIH, saying it has funded wasteful research and pointing to the private sector's investment in research and development. Billionaire Donald Trump, the GOP's front-runner, has said about the agency: "I hear so much about the NIH, and it's terrible."

Still, boosting NIH research is a compelling argument for curbing long-term government spending, and one Republicans have used.

"Advocates were successful in convincing many members of Congress … that diseases like Alzheimer's and diabetes and cancer would not only continue to claim lives and cause family heartbreak, but bankrupt the nation if we failed to put the full potential of science to work," Mary Woolley, president of Research!America, an advocacy organization, said in an email.

Advocates say the momentum is in place regardless of who wins the White House.

"One of the things I'll be working on is making sure that the nominees know everything they need and want to know about biomedical research," White says. "I'd like to see biomedical research made a priority with whoever our next president is going to be." 

Online: U.S. News & World Report