This week ASPET has offered written testimony in support of a $37 billion FY 2011 NIH budget to the House Labor/Health and Human Services Appropriations Subcommittee. The following article by Jim Bernstein provides the background to this testimony, clearly depicting the difficult political and economic environment under which we will be operating in the near future. It makes for interesting if sometimes depressing reading. Now, more than ever, it is important for ASPET members to make themselves heard by their Congressional Representatives. Please take the time to read this piece and consider what action you can take.
Brian Cox
President
Hope and Glory: Forecasting NIH’s Difficult Future in FY 2011
Jim Bernstein
ASPET Director of Government & Public Affairs
ASPET members have received from many national media sources what seems to be a relentless barrage of bad and pessimistic news concerning the nation’s economic plight, a partisan political process seemingly at an impasse over a variety of important policy issues, and little optimism that federal funding for biomedical research will see any real growth. Given this state of affairs, it might be a good time to look at how economics and politics can be the difference between being awarded that grant you spent so much time writing – or not. How did the NIH go from doubling its budget over a five year growth period (1998-2003) to losing roughly 15% of it purchasing power in the latter part of the past decade? This is not intended to be a class in civics or economics that you might have founded so tedious in high school or college. But hopefully it will inform some and cause others in our community who never cared to look up from the bench at the issues impacting their laboratories to become not just scientists but scientist-advocates for biomedical research.
For the moment, the $10.4 billion appropriated in 2009-2010 to the NIH through the American Recovery and Reinvestment Act (AARA) as part of the economic stimulus package passed by Congress helped to restore much of the purchasing power that NIH had lost. Sen. Arlen Specter (D-PA) was the originator and prime advocate for NIH ARRA funds. At the time, there was considerable debate and concern within the biomedical research community over how NIH would manage such a huge increase in funding. Perhaps the more critical issue was what would happen in FY 2011 without continued support to maintain the infrastructure that ARRA would build? The Administration seemingly recognized this “falling off the cliff” scenario. Kathleen Sebelius, Secretary of the Department of Health and Human Services initially acknowledged that researchers would be in trouble, “We certainly need to begin working on what happens in 2011 and 2012.” However, her additional comments were troubling. She stated that because of ARRA funding, NIH “didn’t need additional resources.” Shortly thereafter, President Obama released his proposed FY 2011 budget recommendations for federal programs and recommended a 3.2% increase for NIH above its FY 2010 budget. This increase will not even account for inflation, effectively extending more than half dozen years of relative decline in the NIH budget’s purchasing power. FASEB has recently completed models showing that if President Obama’s NIH budget proposal were adopted, the purchasing power of the NIH would decrease from $36.4 billion in FY 2010 (taking into account ARRA funding) to $32.2 billion, a 14.3% decline and research capacity would shrink by 11%. View: http://www.aspet.org/PolicyUpdatesNews.aspx?id=1631
However, all President’s budgets are only recommendations and almost always declared “dead on arrival.” While President Obama’s proposed budget disappoints, keep in mind that all President’s recommendations for NIH always disappoint. The doubling began under the Clinton Administration, who, like all presidents offered similar anemic budget increases for NIH. What is sometimes overlooked and often forgotten is that the origins and push for the doubling came not from the White House or Congressional Democrats, but from fiscally conservative Republican leadership. Former Representatives Newt Gingrich (R-GA) and John Porter (R-IL) - who chaired the appropriations subcommittee that makes the programmatic funding decision for NIH, were instrumental in helping NIH achieve the doubling. In the other chamber, former Senators Mark Hatfield (R-OR) and Connie Mack (R-FL) were prime movers, along with current Senator Arlen Specter who was a Republican at that time (Specter switched party affiliation last year). Why is this important? Well, notice that all but one of the above mentioned are retired. Sen. Specter remains but finds himself in a tough political fight to keep his seat. In fact, the reason he switched from Republican to Democrat was that he concluded he would not be able to win the Republican primary in Pennsylvania. Senator Specter aside, the fact is that the NIH’s most vocal, supportive, informed and passionate supporters in Congress are not there anymore. And no one has replaced them. Yes, every one is in favor of biomedical research and all rational people want cures for diseases that touch everyone. But that does not mean that the current Congressional makeup has anyone who has taken up NIH as their own cause. With no true congressional “champion” NIH will have a harder time making satisfactory gains.
Deficit Politics
Congress has a “deadline” of April 15 to finish the FY 2011 budget resolution. But that obviously was not met and in any event it is nonbinding. Congress has failed to adopt a budget four times in the past 35 years: 1999, 2003, 2005, and 2007. But Congress does not need to pass a budget resolution anymore than you need to adopt a budget for yourself. You can spend as much as you want but maybe a budget would give you some much needed discipline. Same with Congress. So what is the big deal if Congress does not get its act together for FY 2011? This is an election year and all House seats are up for reelection as are many Senate seats. With a record $1.4 billion deficit and soaring national debt, the Republican minority in Congress is sure to make the majority party pay politically for not passing a responsible budget that will address these twin problems. The Democrats also are not in any rush to pass a budget that will have to contain some cuts to key programs and/or raise taxes, neither of which is appealing to the public. In fact, a recently released Economist poll indicated that 62% of respondents said they wanted to reduce the budget deficit via budget cuts instead of raising taxes. However, when asked what area of federal spending they would be willing to cut, only foreign aid received a majority at 71%. Cuts to Social Security and Medicare – which have by far the largest impact on the federal spending – were opposed by 93%. Take a look at the pie below. It shows where all federal spending went in FY 2008. Social Security, Medicare, Medicaid are all entitlement programs with growing costs and account for approximately 40% of the budget. Throw in defense spending (20%) and the interest we pay on the national debt (8.5%) and almost 70% of our federal spending is consumed. Now look at all the remaining 30% that get funded. Funding for NIH and other life science research is embedded among these areas. This also would include spending for dozens of other programs that people care about, provide critical support to individuals or otherwise provide valuable services to our country. This would include funds for programs like mine safety, school lunch or milk programs for underserved populations, FBI, bridge and road repair, etc.
NIH must compete with other labor, health and education programs within the Appropriations Labor/HHS Subcommittee’s jurisdiction. There are 12 Appropriation Subcommittees and each has a finite amount of money to spend. The NIH is already the largest program under the Labor/HHS Subcommittee purview. Somebody always gains at someone else’s expense. Any significant increase in the NIH budget will likely have to come from another program. And any increase in other programs would mean less for NIH.
Recently, Ben Bernanke, the Chairman of the Federal Reserve, stated that the federal government will have to get serious about reducing debt either through increased taxes, cuts in spending, or combination of both. There is a general consensus to begin to bring the budget deficit and federal debt down. How to do this is the problem, and the tired maxim of the “devil is in the details” certainly applies here.
Many ASPET members might recall the Republican led “Contract with America” in the mid 1990s that would restrain the growth of programs. There was even a failed Congressional effort to cut – not limit - the NIH budget. And yet, it was during this time that the move to double the NIH budget began. As mentioned above, it was because of the Republican leadership that the doubling came about. Republicans viewed NIH as an entrepreneurial and successful federal agency worthy of being well funded. So, in FY 2011, could NIH fortunes take a similar and favorable turn? There are two significant differences however between the mid-1990s and present day events. One is that the current economic environment is more difficult than the mid-1990s. Budget deficit and debt projections in future years are dismal without major tax and spend policy changes. Several economic studies have indicated that the interest we will pay on the debt will more than double by the end of the decade (creating greater pressure to reduce domestic discretionary spending). Politically, the environment is much more polarized than in the Contract with America days. It is not clear how many, if any, of the Tea Party movement’s followers would view NIH as a federal program that works and is an important asset. Whatever the movement’s long-term impact and outlook is, it will likely have some influence on spending decisions in FY 2011.
Our FY 2011 “Ask”
ASPET has submitted testimony to the House Labor/HHS Appropriations Subcommittee that recommends a FY 2011 NIH budget of $37 billion [link to testimony]. The $37 billion recommendation is consistent with the NIH’s own program justification and consistent with the recommendations of other societies in the FASEB community. View ASPET’s testimony here: View:http://www.aspet.org/PolicyUpdatesNews.aspx?id=1633
The FY 2011 mark was determined by taking the FY 2010 budget ($30.7 billion) and adding half of the ARRA funding -$4.2 billion. ($8.4 billion of $10.4 billion was for research). We then added 6.3% -$2.2 billion, accounting for half of that amount as an inflation adjustment.
$37 billion is an ambitious mark for NIH. It will be difficult to achieve. Congressional Appropriators are looking at the FY 2010 NIH budget of $30.7 billion as the base in determining the FY 2011 budget. They are viewing the ARRA funds as supplemental appropriations. Our community must take into account that ARRA funding was significant, has helped to build up infrastructure and manpower, and needs to be added to the FY 2010 base when making final FY 2011 funding decisions. We hope each ASPET member will take the time in the coming months to contact their Members of Congress and educate them about NIH’s needs. It is critical that ASPET members leave the message that we need a new national commitment to the NIH for sustained and predictable growth over the long term. We need to sustain momentum for medical progress and build and expand the capacity of NIH to improve health, power economic growth and innovation, and advance science. Make the case by pointing to how ARRA money has contributed to your institution or provided grant money for your own research. The AAMC has surveyed institutions on their ARRA success stories: http://www.aspet.org/PolicyUpdatesNews.aspx?id=1480.
For information on how to contact your Member of Congress, as well as ASPET’s Advocacy Outreach Program, view ASPET’s Grassroots Congressional Education web page at: http://www.aspet.org/Page.aspx?id=172.
There likely has never been a more difficult time for NIH. The pressures on Congress to limit growth in the NIH will be extreme. In response to this difficult economic and political climate we have already seen several bipartisan proposals to cap discretionary spending by Members of Congress. While none have been successful, future attempts could be. Scientists have an obligation as stewards of public monies to speak out about how your research is conducted and the reasons why a robustly funded federally funded biomedical research enterprise makes sense. Everyone in Congress is supportive of biomedical research and many do understand what NIH has contributed to public health and local economies. The public is overwhelmingly supportive of biomedical research. But focus groups conducted in the past year indicate that the public really does not have any idea what the NIH is nor what it does. To the extent they have heard of the NIH, they tend to think of it as a mouthpiece for public health messages, similar to the Surgeon General’s Office. So the bottom line is that we really cannot do enough to educate the public about what NIH is and what it does. And we need to continually make the case to Congress relentlessly.
Despite what you have just read here, our intention was not to be morbidly pessimistic, but we must be realistic. These are tough times but the many forecasts predicting a dire economic future might not be realized either. The environment won’t turn suddenly for the better but it might improve slowly enough and that is still another reason to become actively involved in advocacy for NIH. If our community of scientist-advocates is not making its case in tough times, it won’t have credibility when the funding environment starts to improve.
The 2010 World Congress in Pharmacology to be held in
Copenhagen in July is organized around a series of focused conferences each
integrating recent basic and clinical research on a discrete topic in 2 or 3
day program within the main Congress schedule. The topics for all the
conferences look very interesting, but one that caught my eye is on ion
channelopathies (FC12: Ion channelopathies: new windows on complex disease and
therapy). 
The date for submission of abstracts for the International Union of Pharmacology (IUPHAR) 2010 World Congress in Pharmacology is fast approaching (the last date for abstract submission is 15 January 2010); now is the time to start planning to attend what promises to be a very interesting meeting. A message (see below) from Sam Enna, former ASPET President and current IUPHAR Secretary-General, outlines plans for the meeting, which will be held in Copenhagen in July..jpg?n=4106 "beach")
The International Union of Basic and Clinical Pharmacology (IUPHAR) will hold its 16th World Congress in Copenhagen, Denmark, July 17-23, 2010. Designated WorldPharma2010 (www.WorldPharma2010.org), the meeting is organized and hosted by the Danish Society for Pharmacology. This is the first IUPHAR Congress to cover both the basic and clinical aspects of the discipline. Highlights of the meeting include 18 focused conferences, each of which lasts from 2 to 2 ½ days. Focused conference topics include ion channels in analgesia and anesthesia, transmembrane transport, simulation and data modeling in drug development, pediatric clinical pharmacology, and G protein-coupled 7TM receptors, to name a few. In most cases, the focused conferences emphasize the translational nature of the work, illustrating how information gleaned from basic laboratory research can be exploited clinically. Among the focused conference speakers are Randy Blakely, Jane Mitchell, Jean Philippe Pin, Michelle Bouvier, Marc Caron, William Catterall, Frank Gonzalez, Peter Kalivas, George Koob, and Paul Vanhoutte. Another feature of the meeting includes two dozen plenary lectures. Speakers in this group include Salvador Moncada, Trevor Sharp, Brian Kobilka, Sue Duckles, Shizou Akira, Peter Barnes, and Olavi Pelkoknen. Poster sessions, workshops, satellite meetings, and sponsored symposia round out the meeting. 
Scheduled social events are an opening reception, a reception at Copenhagen City Hall, and a dinner at Tivoli Gardens. Beyond this, Copenhagen and the
surrounding Danish countryside offer a wide range of activities from castle tours, to cycling, to art museums, and seaside activities.
First, the Convention Center has been completely
redone—as in adding a whole new front and two stories up. What was the old center is now just the
exhibit hall and the new foyer with a full glass front is light and
welcoming. The meeting rooms, part of
the addition, are convenient and modern.
Each of the Societies meeting at EB has its own mini-corridor
perpendicular to the foyer where its session rooms are located. These are wide enough to provide seating and
space for people to congregate and network in between (yes and even during) sessions
but short enough to still let in the light from the foyer. The Anaheim Convention Center is now one of
the nicest and best laid out convention centers we will have met in.
Mentoring Breakfast. Don’t miss the annual WIP Into Shape
Networking Walk on Sunday morning, an informal opportunity to network and walk
in the beautiful Southern California weather.
As for all the other things that you would like to do in
Anaheim if you weren’t going to be at the meeting the whole time, the perennial favorites are still
there—Knott’s Berry Farm, the Crystal Cathedral, and of course,
Disneyland. Only now it is Disneyland,
Downtown Disney, and Disney’s California Adventure. Disneyland is directly across the street from
the Convention Center so there is no need even to ride the bus. Because Anaheim is, above all else, a family
vacation destination, the prices are much more reasonable than in many of our
other meeting cities. In addition, the
service people are pleasant and glad to have you there. Anaheim has recently completed building the
Garden Walk. A short walk from the
Convention Center, this is a lovely pedestrian mall with lots of outdoor shops
and restaurants and entertainment. The
winning Los Angeles Angels of Anaheim baseball team and stadium can also be
found in Anaheim. In nearby Santa Ana is
the Discovery Science Center housed in a building shaped like a cube poised on
one corner. The Honda Center in Anaheim
is home to the 2007 Stanley Cup winning Anaheim Ducks. There are lots of beaches within easy driving
distance (let’s not forget whence came the inspiration for The O.C.)!