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UMR, ITIF Outline Strategies to Make NIH Funding More Predictable

NEW YORK (GenomeWeb) – A new report from United for Medical Research and the Information Technology and Innovation Foundation has laid out strategies they said would make funding for the US National Institutes of Health more predictable, especially in times of tight budgets and political battling.

In particular, the advocacy groups have called for changing discretionary spending caps, implementing multi-year budgets and advance appropriations, as well as considering making changes to mandatory programs, trust funds, and dedicated funding streams, strategies they argued would not only increase NIH funding but make it more stable and predictable.

"Science funded by NIH reduces government spending on health care, increases future productivity, and saves lives by delivering cures for some of society’s deadliest diseases," co-author Robert Atkinson, the president of ITIF, said in a statement. "The challenge for [Congress] is to find innovative means to provide the agency with sustainable and predictable funding to continue that mission."

While NIH enjoyed a doubling of its budget between 1998 and 2003, the rate of growth of its funding slowed between 2003 and 2010, and it has since fallen. In 2013, sequestration sliced a further 5 percent off the top.

Such cuts, research advocates have said, threaten the lead of the US in science and innovation, as countries like China pour $308.5 billion over five years into biotechnology.

Atkinson and his UMR co-author Joseph Kennedy noted in their report that there is widespread support for NIH across political party lines in Congress, but that its budget often becomes caught up in wider battles over discretionary governmental spending.

"Unfortunately, heated debates over the federal budget have led to flat funding at a time when greater investment is needed to further the medical breakthroughs of the last two decades," said Beth Felder from Johns Hopkins University and a UMR member.

In their report, Atkinson and Kennedy offered some approaches that they said could boost the NIH budget and shield it somewhat from those larger funding fracases.

For instance, they said the Budget Control Act could be amended to increase discretionary spending caps to enable more funds to go to the NIH. A similar approach, they noted, has been implemented for aspects of the Social Security program.

Additionally, they argued that removing the requirement that the NIH has to spend its funds by the end of the fiscal year or risk losing the remainder could allow the agency to smooth over funding gaps.

Developing and applying a multi-year budgeting or advance appropriation in which the agency receives its appropriation from previous years' bills could also provide some stability, the authors said. The Corporation for Public Broadcasting, they added, has received two-year advances since 1975. This, they noted, doesn't mean that the agency would receive any extra money, just that it would have some certainty about what its budget would be.

At the same time, making NIH a mandatory, rather than discretionary, program would offer greater stability, as its budget would not be subject to the annual appropriations process. Atkinson and Kennedy added, though, that this would only provide stability if the legislation making it a mandatory program didn't expire each year.

They further said that a dedicated funding stream similar to user fees could bring in added funds while the development of a tax-based NIH trust fund could offer additional budgeting certainty.

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