publication date: Jul. 21, 2017

Guest Editorial

Medical research funding: Why we must keep our foot on the accelerator

By Michael A. Caligiuri

President of the American Association for Cancer Research, and director, The Ohio State University Comprehensive Cancer Center and chief executive officer of the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

Michael_Caligiuri

 

It’s been a long time since we’ve seen the kind of strong national commitment that exists today to support medical research.

Of course, this enthusiasm is more than justified because of the large number of unprecedented research opportunities that are at the ready to propel us toward defeating cancer and the numerous other diseases that afflict so many Americans.

Congress underscored this commitment in April when it passed the fiscal year 2017 Omnibus Appropriations Bill, which provided the National Institutes of Health with its second consecutive $2 billion annual funding increase.

The prior year’s funding increase represented the largest annual funding boost the agency had received in a decade.

Additionally, the Beau Biden Cancer Moonshot Initiative, one of the key initiatives of the 21st Century Cures Act, was funded at $300 million in FY 2017.

These recent Congressional actions signal an awareness of the critical role that NIH-funded research plays in preventing, detecting, diagnosing, and treating cancer and other diseases.

Four passionate and determined champions for medical research have been leading the charge to make the NIH a national priority:

  • Senate Appropriations Subcommittee Chairman Roy Blunt (R-MO),

  • House Appropriations Subcommittee Chairman Tom Cole (R-OK), and

  • the two respective Ranking Members, Sen. Patty Murray (D-WA) and Rep. Rosa DeLauro (D-CT). 

Their actions are allowing our nation’s researchers and physician-scientists to significantly accelerate the pace of progress against cancer, as well as any number of the hundreds of other diseases that afflict millions of Americans.

Both Chairman Blunt and Chairman Cole have led in a bipartisan fashion and talked repeatedly about the importance of robust, sustained, and predictable annual funding increases for the NIH ever since they assumed leadership of their respective subcommittees in January 2015.

Since then, funding for the NIH has increased by a total of 13.3 percent. In the decade prior, stagnant funding levels had resulted in the NIH losing approximately 25 percent of its purchasing power, when adjusted for inflation.

In addition, Sen. Murray’s leadership as the Ranking Member on the Senate Health, Education, Labor, and Pensions Committee, was instrumental in her securing an additional $4.8 billion for targeted initiatives at the NIH, including the Beau Biden Cancer Moonshot Initiative.

This funding was authorized over a period of 10 years in the 21st Century Cures Act, a bipartisan law that is changing the way we treat disease. For example, the FDA Oncology Center of Excellence, a key component of the 21st Century Cures Act, will expedite the development of novel combination products and support an integrated approach to tackle this devastating disease that touches so many American families.

The center is the first disease area (in oncology) at the FDA to have a coordinated clinical review of drugs, biologics and devices across the agency’s three medical product centers.

Given the widespread bipartisan support for the NIH, as well as the astonishing progress NIH-funded researchers are currently making to improve our nation’s health and save lives, we were shocked when President Trump’s FY 2018 budget proposed cutting the NIH budget by $7.2 billion, a 21 percent reduction from its current funding level.

The National Cancer Institute’s budget is also slated for a significant cut of $1.2 billion, a 20 percent reduction from its current funding level.

The president’s irresponsible proposal would risk irreversibly harming our nation’s ability to further understand the complexity of cancer and other diseases and postpone the development of lifesaving therapies for patients. 

United for Medical Research, an advocacy group based in Washington, D.C., estimated that the President’s budget would mean 5,000 to 8,000 fewer grants, and the elimination of nearly 90,000 jobs.

Fortunately, the president’s FY 2018 budget proposal was roundly criticized by members of both parties on Capitol Hill, many of whom vowed to vehemently oppose his proposal for the NIH.

Chairman Cole expressed concern that the president’s proposal would “stall progress and potentially discourage promising young scientists from pursuing biomedical research.”

Cole also stated that the “NIH will remain a priority in my budget, and we’re going to do everything we can to stay on the course we’re on.”

Chairman Blunt also affirmed his commitment for the NIH because “the investments we make in NIH research will not only save lives, they’ll lead to new frontiers in drug and device development that are critical for reducing health care costs, growing our economy, and maintaining America’s competitive edge in innovation.”

Even one of President Trump’s most trusted advisors, former Speaker of the House Newt Gingrich, penned an Op Ed a couple of years ago in which he stated, “We are in a time of unimaginable scientific and technological progress. By funding basic medical research, Congress can transform our fiscal health, and our personal health, too.”

Although we are growing increasingly confident that Congress will reject outright the president’s FY 2018 budget proposal for the NIH, the medical research community is also facing a complicated and worrisome challenge in the form of the spending caps that are currently in place for FY 2018.

These shortsighted and restrictive spending caps were set in the 2011 Budget Control Act, also known as the sequester.

If the NIH, NCI, the FDA, and other vitally important scientific agencies are to receive the resources that are necessary to drive advances across the clinical cancer care spectrum and save an increasing number of lives from cancer, it’s going to require that Congress negotiate a bipartisan budget deal to raise the discretionary budget caps for FY 2018.

There’s an effort to break the caps on the defense side of the budget, while leaving the non-defense side of the budget caps in place. With regards to this proposal, we agree with Rep. Nita Lowey (D-NY), the top Democrat on the House Appropriations Committee, who said, “It is clearly time to lift the budget caps in FY 2018, but for more than just the Pentagon.”

As Rep. Lowey has stated, the non-defense discretionary side of the budget ledger should grow at a comparable rate in order to support vital research and patient needs, as these and other programs “need attention just as badly as we need new jets, tanks, and ships.”

As Congressional leaders approach the final two months before the beginning of FY 2018 on October 1, we encourage the entire medical research community to make your voices heard by asking your respective members of Congress to:

  • Continue to support robust, sustained, and predictable growth for the NIH budget by providing an increase of $2 billion for the NIH in FY 2018, for a total funding level of $36.2 billion;

  • Ensure that funding designated through the 21st Century Cures Act for targeted initiatives such as the Beau Biden Cancer Moonshot Initiative is fully appropriated in FY 2018;

  • Increase the FDA budget in FY 2018 to $2.8 billion, an $80 million increase above its FY 2017 level, and fully fund the FDA Oncology Center of Excellence, to ensure support for regulatory science and to accelerate the pace of development of medical products that are safe and effective; and

  • Negotiate a bipartisan budget deal to raise the discretionary budget caps for FY 2018 and beyond, which would allow our nation’s policymakers to continue to invest in priority areas, such as biomedical research funded by the NIH.

By continuing to pursue an appropriations strategy that provides annual funding increases that are robust, sustained, and predictable for the NIH, NCI, and FDA, and by ensuring the funds available for the Beau Biden Cancer Moonshot Initiative and the FDA Oncology Center of Excellence are fully appropriated, Congress can continue to help us transform cancer care, spur economic growth, and maintain our position as the global leader in science and medical research.

Most importantly, we can continue to bring hope to the millions of people everywhere who are touched by cancer.

Copyright (c) 2017 The Cancer Letter Inc.