What Should School Do As NIH Funding Slows?

From 1997 through 2003, the government doubled the National Institutes of Health’s budget. Two years later, with the NIH up for reauthorization, Congress is less enthusiastic. While in the doubling period, NIH funding had been increased every year by an average of 15 percent, funding for 2004 was increased by only 3.2 percent; in 2005 funding was increased by 2 percent; and President Bush has requested that in 2006 the agency’s budget be increased by only 0.5 percent. Because the agency has ongoing commitments to projects started earlier, these slight increases in its budget mean that new grants are fewer and smaller.

On Nov. 16, HMS convened a panel of four speakers at the NRB to discuss the state of the NIH budget, how it will affect HMS researchers, and how the School plans to tackle new funding-related challenges.

The Down Side
David Moore, senior associate vice president in the Office of Governmental Relations at the Association of American Medical Colleges (AAMC), explained in detail the state of the NIH’s budget and how changes in it would affect researchers. “2006 represents the third year after the doubling and also represents the third year where NIH has failed to achieve inflationary growth,” he said.

The NIH’s financial problems are not only caused by smaller-than-hoped-for budgetary increases, Moore continued. Increasingly, the agency’s funds are being tapped for special projects, leaving less funding for routine grants.

Additionally, Moore said that some of the agency’s monetary troubles were caused by the accomplishments of the earlier doubling. “One of the successes of the doubling of the NIH budget was it created a whole cadre of new ideas and new people competing for money,” he said. The increased budget led to more applications, however, there is no longer a corresponding increase in funding to match this level of interest.

The decrease in available funds will have implications for researchers, warned Moore. There will be fewer grants available, and awards will be smaller. The NIH’s budget for building extramural research facilities has “essentially disappeared,” he said. Competing grants, which require peer review, are decreasing at a faster rate than noncompeting grants, and about a thousand fewer competing grants are projected to be awarded in the next year than were awarded in 2003.

New researchers will have a harder time receiving grants than established researchers, warned Moore, a trend that has already become evident.

The NIH still has tools for funding innovative research, said Moore. “The Road Map is one of our best weapons on Capitol Hill—it’s a vision about where medicine needs to be in the future,” he said, and visions are effective lobbying strategies. In addition, the agency is trying to transform clinical and translational research through the Clinical and Translational Science Awards.

Counterpoints
Kevin Casey, senior director of federal and state relations at Harvard, described the budgetary considerations as a “dark cloud,” but reminded listeners that “this isn’t the first time there have been difficulties in budgets in Washington—these things do go in cycles.” Casey represents one arm of Harvard’s defense against cuts in spending, lobbying politicians in Washington, D.C., on the University’s behalf. Along with lobbyists from other universities and a professional pollster, Casey crafted a message to use on Capitol Hill that links funding for scientific research with domestic job growth and Americans’ ability to compete globally. Aimed at Republicans and Democrats who are looking for campaign themes for the 2006 and 2008 elections, the document urges Congress to “create a long-term strategy to keep jobs here” by strengthening science and math education as well as providing more funding for basic science research.

Don Gibbons, HMS associate dean for public affairs, presented a second set of approaches the School is using to counter projected cuts in funding. “We’re not going to take this lying down,” he said. “We may not be completely successful in reversing all of these trends, but at least we’re going to try.” Part of Gibbons’s efforts involve organizing the Fulfilling the Promise campaign, a collaboration of administrators from medical colleges who educate political players and the public about the NIH’s work, justifying the increases in the NIH’s budget. Polling shows that four out of 10 voters have never heard of the NIH, Gibbons said, and 41 percent of Congressional staffers do not know how the NIH’s budget is allocated. To educate politicians about health care spending, the campaign started organizing lunchtime informational sessions for Congressional staffers and put together a website with a searchable database of medical breakthroughs that were made possible by NIH funding.

The fourth person to speak was Cynthia Walker, HMS executive dean for administration, who added more optimism to the discussion. Although “we know that we’re going to be in a period of some uncertainty,” she said, the School is taking measures to counteract the effects of the NIH’s new budgets. “We’re looking for different sources of funding,” she said, mentioning agreements with philanthropies and private foundations. In addition, the School will give a 30 percent subsidy in animal care per diem to help make HMS-based research that uses animal models more competitive. HMS will also be investing in more technology, because “we think that having leading-edge technology will be helpful to you,” Walker said.

But, she said, there is a challenge in all of this for the HMS community as a whole. “The question for you is this, what else should we do?” She encouraged students, faculty, and staff to contact her with ideas.

—Rebecca Tinkelman

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