Scientists Warn NIH Funding Squeeze Hampering Biomedical Research

Abstract

THE UNITED STATES’ PREEMINENCE in health care research and its scientists’ ability to conduct the basic and clinical studies necessary to create innovative treatments for a variety of diseases and conditions could be severely damaged if Congress continues to fund the National Institutes of Health (NIH) at recent levels. So warned members of several major research universities on March 19, during testimony before the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education. “To be frank, my 3 decades in clinical neurology and basic neuroscience research at Yale, Harvard, and Johns Hopkins have convinced me that the recently flat NIH budget is stifling creative, high-risk research endeavors,” testified Stephen M. Strittmatter, MD, PhD, professor of neurology at Yale University School of Medicine in New Haven, Conn. Strittmatter’s comment came during the first of 6 hearings regarding the upcoming NIH budget scheduled by subcommittee chairman Tom Harkin (D, Iowa) and ranking member Arlen Specter (R, Pa). According to the American Association for the Advancement of Science, although the NIH budget almost doubled from $13.7 billion in fiscal year 1998 to $27.2 billion in fiscal year 2003, funding since then has remained relatively flat and currently stands at an estimated $29.2 billion for fiscal year 2007 (http://www .aaas.org/spp/rd/health08p.pdf). When inflation is considered, NIH funding has actually fallen 16% since 2003. Further cuts may be looming: President George W. Bush has proposed trimming the agency’s budget by $328 million for fiscal year 2008 (which begins October 1, 2007). “Thatcutthreatenstosquanderournation’s investment inbiomedical research, delaynewcuresandtreatments, anddiscourage thenextgenerationofyoung investigators fromentering the field,”Harkinsaid.TheIowasenatoraddedthat the cut is even $200 million deeper because the President’s budget calls for the NIH beingresponsiblefortheentirecostof the Global AIDS Fund instead of sharing financial responsibilitieswiththeStateDepartment,asitcurrentlydoes.Harkinand SpecterhaveproposedincreasingtheNIH budget by 6.7% per year for 3 years to make up for the real-dollar cuts in funding when inflation is considered. The NIH, comprising 27 institutes and centers, is the major engine powering US medical research. More than 83% of NIH funding is awarded through nearly 50 000 competitive grants. An estimated 325 000 researchers at more than 3000 universities, medical schools, and other research institutions receive these grants. Another 10% of the NIH budget covers research by about 6000 scientists at its own laboratories. The stagnant NIH budget has changed the research landscape. During his appearance before the subcommittee, NIH Director Elias A. Zerhouni, MD, said that historically, the NIH funded 3 grants for every 10 applications, compared with only 2 grants for every 10 applications funded today. The odds are even longer for new grants; only 10% of first-time submissions receive support. “I’m concerned that 20% is too low,” Zerhouni said. “It’s discouraging future research.” Budget constraints are also skewing a greater proportion of NIH funding toward basic research rather than clinical trials, as a cost-containment measure. Zerhouni noted that clinical trials, which can take years to complete, are often subject to higher costs as they occur in health care settings facing higher inflationary pressures. “The purchasing power in clinical trials is 35% less than 4 years ago,” he said. Coinciding with the subcommittee hearing was the release of a report by a group of concerned universities and research institutions hoping to raise awareness of the NIH’s flat funding (http: / /hms.harvard.edu/public/news /nih_funding.pdf). The report was coauthored by the University of California system, Columbia University, Harvard University, Johns Hopkins University, Partners HealthCare, the University of