NIH sees reversal of fortune with proposed funding boosts
【LWBS 2015 06 21 A】(SpringRain Edited from POLITICO/Sarah Karlin )
It is suddenly NIH’s moment on Capitol Hill, with even the lawmakers whose usual mantra is fiscal restraint and less government spending now among the medical research agency’s most vocal cheerleaders for greater funding.
After a dozen years in which the institutes’ budget has remained flat — representing a 23 percent loss in purchasing power — appropriators in both chambers are planning to give it a boost in spending. A House subcommittee agreed Wednesday to increase NIH resources by $1.1 billion, more than the president requested in his budget, and the Senate is expected to top that amount. The 21st Century Cures legislation, now targeted for a House floor vote in July, would add another $10 billion over five years.
A host of other factors has also played into the turnaround — the credibility of NIH Director Francis Collins, a highly respected and well-liked presence on the Hill; a strong and persistent grassroots push from cancer and Alzheimer’s advocacy groups; and the emergence of key research-driven efforts like the president’s Precision Medicine Initiative and the House’s 21st Century Cures Act. Plus recent groundbreaking therapies, not necessarily from NIH, have spotlighted the advance of science worldwide.
Collectively, these elements have made the point that the institutes’ work is invaluable medically as well as economically and have offered lawmakers a rare opportunity to show their constituents that Congress can work in a bipartisan manner. It’s why the Republican Moran can simultaneously call himself a “fiscal hawk” intent on a balanced budget and explain that making the case for NIH funding is “so easy.”
Republicans now talk about curing disease as a way of also curing government spending. “We can’t solve mandatory health spending problems without finding cures for Alzheimer’s, heart disease, cancer and diabetes,” said Maryland Rep. Andy Harris.
Collins himself sounds alternately pleased, confident and somewhat surprised. He notes recent high-profile support from “unpredictable voices” like former House Speaker Newt Gingrich as well as tea party-backed Rep. Matt Salmon of Arizona, who told a cancer advocacy meeting that balancing the federal budget on the backs of NIH was a mistake. Salmon then proposed “to go well beyond anything anyone in his party had been talking about in terms of dollar figures,” Collins recalled.
“It has been a lot of effort on the part of many voices — advocates, scientists, our colleagues in the private sector — to make a case that whether you are interested in advancing human health or stimulating the economy or encouraging American competitiveness, every dollar you put into medical research is a really good investment,” Collins said during a break last week at the BIO International Convention in Philadelphia.
“To see this growing momentum this year, finally, is really gratifying. It even gives one hope that it might translate into actual votes and knowledge,” he added with a chuckle.
The major research work being done in other countries has also been a definite “wake-up call” for some people, Collins believes. China, for example, filed more patents in the life sciences than the United States did last year.
“That ought to be a cause of considerable concern if you are thinking about our future economic health,” he said. “What we had considered to be a given, that is America’s dominance in biotech, in pharma, is now really being eroded.”
The House’s proposed increase would bring NIH funding up to $31.4 billion in fiscal 2016. In adjusted dollars, that amount would still be $4.8 billion less than 12 years ago. Even the $10 billion in Cures funding won’t solve all of NIH’s catch-up needs, Collins said.
But NIH’s readiness to work closely with Republicans on exactly how its money is spent should bode well for additional funding increases in coming years.
“Dr. Collins has shown a willingness to take steps to increase the efficiency and effectiveness of money spent at NIH, and Congress is willing to provide more funds as a result,” Harris said. “Congress has made clear that if NIH is willing to make some internal reforms, Congress will be willing to provide more money for lifesaving research. ”
The internationally known geneticist has been an unflagging ambassador for the agency he’s led since 2009. In the past few years, he says he’s met one on one with 300 lawmakers to talk about his agency. It’s the largest supporter of biomedical research in the world, with 27 separate institutes and centers.
“I can’t remember a single one of those [meetings] that went badly, just because the case is so strong,” Collins said. Not just in terms of the nation’s economic health but — he pounds his hand over his heart for emphasis — “it also gets you where you live.”
“This is a way we can try to eliminate suffering; this is a noble enterprise,” he continued. “This is one of the greatest things the government does, and the track record over the decades is stunning.”