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House Subcommittee Bill Would Raise NIH's Fiscal '08 Budget 2.6 Percent Over Bush Plan

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A US House of Representatives subcommittee has made its first moves toward giving the National Institutes of Health a 2.6-percent raise for over the fiscal 2008 budget allocation made by President Bush in February.
 
However, around 40 percent of that increase would go to the public-private Global Fund to Fight AIDS, Tuberculosis, and Malaria.
 
The House Subcommittee on Labor, Health and Human Services, and Education on June 7 set aside about $29.7 billion for NIH for the year beginning Oct. 1. The bill is one of 13 that will comprise the overall budget for the three agencies the subcommittee oversees.
 
The bill calls for NIH to receive $750 million more than the $28.9 billion proposed by President Bush. The full House Appropriations Committee is set to hold its markup meeting June 14, with the subcommittee’s counterpart in the US Senate set to start similar talks the week of June 18 or 25.
 
Bush’s fiscal 2008 proposal is $360 million less than the $29.2 billion Congress approved for NIH for fiscal 2007. This final amount included $99 million that NIH shifted to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In FY 2008, NIH would shift an additional $300 million to the fund, or 40 percent of increase proposed by the subcommittee’s bill.
 
Jon Retzlaff, director of legislative relations for the Federation of American Societies for Experimental Biology, said he was “disappointed” with the subcommittee’s bill because it is below the rate of inflation, which is projected to reach 3.7 percent in fiscal ‘08.
 
“We also recognize that this is the first step in a long process, and we hope to work with our Senate champions to improve on this initial number,” Retzlaff told BioRegion News last week.
 
FASEB and other advocates for higher NIH spending want at least enough cash to make up for the 8.2 percent in purchasing power NIH lost since 2003. The group’s short-term goal, which would increase NIH funding by 6.7 percent each year for the next three fiscal periods, represents the minimum needed to offset the effects of inflation.
 
State Capital
 
Between 1998 and 2003, NIH funding more than doubled from $13.7 billion to almost $27.2 billion, after which growth stalled due to spending on the wars in Afghanistan and Iraq and homeland security.
 
Funding for NIH plateaued at $28 billion in fiscal 2004, inched up to $28.6 billion in FY 2005, and dipped the following year for the first time in 36 years by 0.1 percent to $28.5 billion. NIH’s budget for the current fiscal year, which ends Sept. 30, is 2.3 percent higher than FY 2006.
 
California topped the list of states receiving NIH grants in FY 2006 with $3.1 billion, followed by Massachusetts at $2.2 billion, and New York at just under $1.9 billion. The top three states finished in the same order for number of grants awarded in 2006 (see Chart).
 
California’s success helped propel the Pacific region to the top among nine regions nationally when it comes to winning NIH funding. Between 1998 and 2006, the Pacific’s NIH funding grew 94 percent, compared with 90 percent for second-fastest-growing New England. New York and the rest of the Middle Atlantic region grew by the smallest amount at 77 percent, according to NIH. [see Chart 2 below]
 
Nationwide, the total number of research grants awarded by NIH has dipped 2.4 percent from a FY 2003 high of 39,279 to 38,313 in FY 2006. The number is projected by NIH to fall to 38,089 this fiscal year, and to 38,063 in FY 2008.
 
But the number of competitive peer-reviewed grants is set to rise 6.3 percent from the 9,622 projected this fiscal year to 10,188 in FY 2008. The House subcommittee wants an additional 545.
 
Political Science
 
The subcommittee’s proposed increase is a product of the shift in control that Congressional Democrats won over Republicans in the November 2006 elections. Yet the new majority has yet to say just how much more it will pursue for NIH.
 
The same is not true for at least one Democratic presidential candidate. On May 31, Sen. Hillary Rodham Clinton (D-NY), her party’s presidential front runner in most polls, proposed a 50-percent, five-year increase in NIH’s budget. She also called for doubling the NIH budget in 10 years.
  
“A culture that values and invests in ideas is part and parcel of the promise of America,” Clinton told the fourth annual CEO Business Climate Summit of the Silicon Valley Leadership Group. “And we have always supported that culture with public investment.”
 
Clinton’s NIH proposal surpassed the 20.1 percent, three-year hike sought by a coalition of five medical research advocacy groups called the Ad Hoc Group for Medical Research. In March, Clinton joined 47 other senators — including three of her challengers for the Democratic presidential nomination — in signing a “Dear Colleague” letter endorsing the coalition’s goal.
 
The three were Joseph Biden (D-Del.), Christopher Dodd (D-Conn.), and Barack Obama (D-Ill.).
 
But Clinton’s goal is easier said than done given budget constraints. Discretionary spending on domestic programs, of which the NIH budget is a part, has been squeezed as the costs of entitlement programs and the war on terror have risen.
 
US Regions
Mountain Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming
West North Central Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota
East South Central Alabama, Kentucky, Mississippi, Tennessee
West South Central Arkansas, Louisiana, Oklahoma, Texas
East North Central Illinois, Indiana, Michigan, Ohio, Wisconsin
New England Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
South Atlantic Florida, Georgia, North Carolina, South Carolina, Delaware, District of Columbia, Maryland, Virginia, West Virginia
Middle Atlantic New Jersey, New York, Pennsylvania
Pacific Alaska, California, Hawaii, Oregon, Washington
“Given the priorities the subcommittee had to wrestle with, and the amount of money that they had to deal with, I think [the 2.6-percent NIH funding increase] is a reasonable increase,” David Moore, executive director of the Ad Hoc Group for Medical Research, told BioRegion News.
 
The group is a coalition that represents more than 300 health, medical, scientific, academic, and research groups, including FASEB and the Association of American Medical Colleges, where Moore is senior associate vice president for the association’s office of governmental relations.
 
“This is the first at-bat, if you will, and I’m trying to encourage people not to get too disappointed with this go-around,” Moore said. “We’re still hopeful that in the end, after the House and Senate have conferenced this bill, that the [NIH] number will be closer to a least an inflationary increase, if not an above-inflationary increase.”
 
Other NIH advocates in the Senate include Edward Kennedy (D-Mass.), Orrin Hatch (R-Utah), and Richard Burr (R-NC), who circulated the Senate’s “Dear Colleague” letter. A similar letter in the House netted 182 signatures and was circulated by six representatives: Edward Markey (D-Mass.), David Reichert (R-Wash.), Henry Waxman (D-Calif.), Christopher Shays (R-Conn.), Janice Schakowsky (D-Ill.), and Christopher Smith (R-NJ).
 
Allocation Reformation
 
To some, the NIH is less in need of more money or more grants than of reform. Yuval Levin, a fellow at the Ethics and Public Policy Center in Washington, DC, and director of its Bioethics and American Democracy program, said the ‘98-’03 boom in NIH funding prompted many research institutes, universities, and other grant recipients to unwisely chase grants for costly long-term expansion projects, such as new labs and other facilities.
 
When the well dried, those institutions were forced to scramble for NIH grants to sustain those facilities rather than pay for new research projects, he said.
 
Today, Levin said, the NIH needs smaller but steady funding increases. It also need to consolidate its 27 research institutes into about a dozen broader entities focused on related diseases and disorders. He acknowledged that would be difficult given the constituencies in medical and patient circles seeking funding for each institute.
 
“The NIH has done an enormous amount of good, and it makes sense to spend the enormous amount of money we spend on medical research. But 27 separate institutes, each carving out its own channels, makes for multiple institutes doing the same thing when they really ought to be working together,” Levin said. “Since we spend so much money, we might as well do it in an efficient way.”
 

“This is the first at-bat, if you will, and I’m trying to encourage people not to get too disappointed with this go-around.”

Congress sought to address the efficiency issue last year when it reauthorized NIH, but stipulating that the agency not create any more institutes.

 
Levin also argued that research institutes and universities could pursue more private funding through foundations rather than rely on NIH. “Over time, it would be helpful if academic researchers looked more to private-sector and philanthropic support than they do now, rather than see themselves as wards of the state.”
 
That view is at odds with what biotech advocates and even many industry observers have long said publicly.
 
“I just have a plea to all of you,” urged Steven Burrill, CEO of Burrill & Company in San Francisco, speaking last month at BIO 2007: “We need to be active in trying to continue to support medical research on a global basis, or everything underlying our industry will wither away.”
 

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