41-34 Bypass Budget Calls for 7% More in 2017—and Doubling by 2026

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Bypass Budget Calls for 7% More in 2017—and Doubling by 2026

By Paul Goldberg

The NCI Bypass Budget for 2017 asks for a 7-percent increase over fiscal 2016, followed by a series of annual 7-percent increases that would continue through 2026, when the institute’s budget would double.

The Bypass Budget is submitted by the NCI director to the U.S. President under a unique authority given to NCI under the National Cancer Act of 1971. Over the years, the budgets have had different functions, which reflected the priorities—and styles—of the institute directors who submitted them.

Some viewed the Bypass Budget as a weighty scholarly and programmatic document, others as a glossy annual report. One former director saw it as a propaganda vehicle for delivering bombastic promises to end “suffering and death due to cancer by 2015,” and on some years occasion the Bypass Budget was skipped altogether.

The core of the 2017 Bypass Budget is brief: a two-page foreword from NCI Acting Director Douglas Lowy and a one-page table showing how NCI would spend additional $355 million that would boost its budget from the 2016 estimated level of $5.098 billion to $5.453 billion.

If the Lowy approach to the Bypass Budget sticks, he and future NCI directors would be able to avoid the headache of an annual exercise in creative writing and instead concentrate on their day jobs.

Lowy’s foreword and the table—arguably the principal components that advocacy groups and policymakers look at—are the only sections of the Bypass Budget available in the PDF format. This is the section that went to the White House.

Additional materials are available online.

“Communication is an important step in the scientific process, and NCI takes its responsibility to report about programs and scientific findings very seriously,” said Peter Garrett, director of the NCI Office of Communications and Public Liaison. “With the Bypass Budget authority, we have a vehicle for sharing our professional judgment directly with the Administration and Congress by highlighting the scientific opportunities and priorities for cancer research.

“The Bypass budget also gives NCI a way to share this information with the broader cancer community and generate a dialogue with stakeholders. This year, we hope researchers, health providers, and patients will add their perspective about some of the most promising areas for advancing cancer research.”

The Bypass Budget request matches the recommendations in the Cancer Progress Report prepared by the American Association for Cancer Research and published earlier this week (The Cancer Letter, Sept. 18).

In the 21st Century Cures bill, the House approved a $8.75 billion boost for NIH in mandatory funding over five years through the creation of a new “Innovation Fund.” On top of that, the bill authorized increased funding levels (through the annual appropriations process) for the NIH by $1.5 billion per-year for the next three fiscal years.

The text of Lowy’s Bypass Budget message follows:

When I speak with leading cancer researchers in the United States and around the world, I hear unprecedented optimism that we are on the verge of pivotal advances in oncology. This sentiment is based on progress in many important areas, including immune-based therapies, genomics, advanced imaging technologies, new laboratory models of human cancer, precision medicine, and more.

Key aspects of our understanding of and approach to cancer have been transformed based on years of investment in biomedical research. We are increasingly able to treat cancer with greater precision by identifying the molecular abnormalities that drive each person’s cancer and targeting therapies to each patient, ultimately improving outcomes and providing hope.

This promise of precision medicine has already been realized for treating some cancers, and we foresee greater progress in preventing, screening, and treating other cancers and even other diseases. Cancer research, therefore, offers a model for other fields of biomedical research that seek to leverage genetic and other molecular information to administer precise and effective interventions to treat disease.

At NCI, we are advancing precision oncology, while managing our resources to take full advantage of the most promising scientific opportunities. It is essential that NCI support the full continuum of scientific research—from basic biological research, to population-based studies, to cutting-edge clinical trials—as virtually all advances in cancer depend on many fields of science.

Although dramatic progress is being made, important scientific opportunities lie before us. With steady and sustained budget increases and a cadre of talented researchers, a new era of cancer medicine is well within reach.

Despite careful management of the NCI budget, many meritorious research proposals—including some bold concepts—must go unfunded each year due to the fiscal constraints we have been operating under for more than a decade. There is little doubt that budget constraints have resulted in missed scientific opportunities.

With the exception of the one-time increase allocated in the American Recovery and Reinvestment Act, federal investment in cancer research has been stagnant since 2003. During this same period, the costs of conducting research have escalated as inflation has substantially eroded NCI’s purchasing power. As a result, competition for NCI grants has been fierce, and some young researchers, frustrated by a lack of funding, have abandoned careers in medical research.

The current budget situation has hindered NCI’s ability to optimally fulfill its mission and promise to the American public: to foster rapid progress and reduce the burden of cancer.

Working closely with its advisory boards, NCI senior leadership has made difficult funding choices, reducing funding for some worthwhile programs and initiatives and curtailing funding altogether in some cases.

In the budget table that follows, NCI recommends a funding increase of 7 percent over the fiscal year 2016 level to pursue promising research opportunities that improve our understanding of cancer and reduce the burden of the disease. These research opportunities are among those for which additional funding would greatly speed the progress against cancer.

But a 7 percent increase can only be viewed as an initial down payment. Steady funding increases, sustained over time, are necessary to restore NCI’s purchasing power and accelerate scientific discovery in ways that significantly reduce the burden for people with all types of cancer. An annual increase of 7 percent for the next 10 years is necessary to achieve these goals. These steady increases will result in a fiscal year 2026 budget for NCI that is twice what it is today.

As NCI’s leader, I am continually inspired by the incredible dedication and passion of the institute’s staff and researchers, as well as the dedication and passion of cancer researchers across the country and around the world. We understand that patients and their loved ones expect and deserve continued progress and that we have an obligation

Douglas R. Lowy, M.D.

Acting Director, National Cancer Institute


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