Journal Highlights

NIH Advocacy in Need of Critical Care

Better late than never.  Congress, unable to reach agreement on the FY’11 budget that began October 1, finally completed legislation that funds programs for the remaining 6 months of the fiscal year.  NIH will receive $30.7 billion, a 1% reduction from its FY’10 spending level.  We won’t torment you by rehashing how that happened or why because you are probably tired of hearing about it.  And in any event, you can expect more of the same as Congress reconvenes early May to hash out a FY’12 budget and deal with raising the federal debt limit ceiling.  How these two issues are addressed and ultimately resolved has profound funding implications for the NIH. 

It is a measure of how significantly the expectations of the biomedical research community have been reset that a 1% cut from the previous year’s budget is viewed by some with relief that NIH was not cut more.    

Déjà vu

So, for better or worse, the FY 2012 budget season has begun.  Almost certainly, any agreement, whenever we ultimately arrive at one, will entail additional cuts to domestic discretionary programs.  The Republican-led House has passed its FY 2012 budget resolution that calls for significant cuts to discretionary spending, tax cuts for the wealthiest Americans, and changes to Medicare and Medicaid. The Democrat controlled Senate will almost certainly resist this plan, but will have to agree on many spending cuts.  So you can expect more of the same debate and rhetoric emanating from Washington in the weeks and months ahead.

To compound an already difficult FY 2012 funding situation, the above scenario is also influenced by Congressional debate over raising the federal debt level ceiling, which currently stands at $14.3 trillion. To lift the debt ceiling sometime this summer, Republicans and some Democrats will use additional cuts in spending as a bargaining chip to increase the debt ceiling limit.  Polls show that the public is against raising the debt ceiling limit so many in Congress will vote against raising the limit at least once before they vote for it to avoid the country going into default.

None of this means that NIH will be cut.  But in this economic and political environment, it becomes difficult to imagine any scenario where the funding situation for NIH moves modestly forward from its current FY’11 level.  As the recently completed fiscal year spending bill revealed, NIH may “succeed” only relative to other programs.  

NIH and other domestic discretionary spending programs total about $450 billion of federal spending, about one-eighth of total spending.  Interest payments alone totaled $197 billion in FY 2010.  Interest debt payments in 2021 are estimated to total over $790 billion.  So unless this country gets it deficit and federal debt under control, the U.S. will pay more money to foreign governments than it pays collectively for biomedical research, repairing bridges, improving food safety, etc.  Here is another way to view it:  NIH currently supports approximately 50,000 research grants across the country, at an average of about $400,000 per grant.  If the U.S. did not need to make those interest payments in 2010, those interest payments could instead have funded about 490,000 grants; and in 2021 NIH would be able to fund 1,980,000 grants.

New Paradigm

It is not just Republicans but Democrats too who have embraced austerity and deficit reduction measures.  The Obama Administration has called for increases in investments in science and technology and yet NIH funding is going backwards. What are others saying about NIH?  Early this spring, the Congressional Budget Office (CBO) issued a report, Reducing the Deficit: Spending and Revenue Options. (http://www.cbo.gov/ftpdocs/120xx/doc12085/03-10-ReducingTheDeficit.pdf) that outlines 100 options and policy implications lawmakers could consider as they look to address deficits and debt.  The CBO report is only intended to provide options and makes no recommendations.  Yet it is instructive to look at what options the CBO lists to “Reduce or Constrain Funding for the National Institutes of Health (see page 121 of chapter three: Discretionary Spending Options).”

CBO offers two options and you won’t like any of them.  One is to restrict the rate of growth at the NIH to 1% per year and option two is to cut funding for NIH to its FY 2003 level and only then allow it to grow with inflation.  CBO notes that these options would force NIH to focus on research that would provide the most significant benefits.  CBO does acknowledge that cuts to the extramural research programs would disrupt funding for programs already under way and discourage innovation that would improve people’s health.

All this means is that for the remainder of the year, it is more critical than ever that ASPET members make the case to Congress that investing in the NIH should be a national priority.  If you think that your Representative or Senator is especially difficult, that is even more reason to speak to them and their staff on what NIH does and what it means to your community and the nation. A collective effort by all in the biomedical research community can make a difference in preventing cuts, and possibly seeing the NIH budget move forward.  We can’t predict what will happen or where help may come from.  In 1995, NIH faced cuts and prolonged freezes in its budget.  Yet, it was Republican leadership that ultimately increased the NIH budget and was the catalyst behind the doubling effort that ended in 2003.  If you would like more information on how to meet with your Congressional delegation, how to prepare for a meeting, and the many advocacy resources available to scientists, contact me at jbernstein@aspet.org.