The Senate Appropriations Committee signed off on a $2 billion increase for the NIH earlier this year, for a total budget of $32 billion for fiscal year 2016. On the House side, Appropriations legislators called for a $1.1 billion bump, for a total of $31.2 billion. Negotiations for the omnibus could drag into the weekend. House Speaker Paul Ryan said Tuesday morning that his chamber will pass a short-term continuing resolution to fund the government past the December 11 shutdown deadline.
Congress has a long tradition of supporting biomedical research on a bipartisan basis, even if recent years have seen stagnant budgets. “No one is opposed to medical research,” said Patrick White, the president of the advocacy foundation Act for NIH. “The real challenge is what sort of priority do you give it.”
Advocates like White think members of Congress have, quite simply, shifted their priorities. White said the 2013 shutdown over Obamacare was a turning point in the NIH budget question. “I think that’s when people of all persuasions started to realize that not only were there some government functions that were absolutely worth supporting and keeping open,” White said, “but that NIH had first of all been neglected and second of all was something that was worth reinvesting in.” Members of Congress have also been spooked by significant biomedical investments in countries like China, White said, and conservatives in particular are receptive to arguments framing “public-health security [as] national security.”
The NIH has lost roughly 25 percent of its purchasing power since 2003 and just one in six grants sent to the NIH are funded; those are two metrics Director Francis Collins often cites as evidence of his agency’s ill health. Even after the 2013 shutdown, which hit the NIH’s operations hard and generated bad PR for Congress, there wasn’t an immediate funding reversal. In the 2014 budget, the NIH got a $1 billion bump, though that wasn’t significant enough to thrill research advocates. And last year, the NIH’s funds were bumped 0.5 percent, still below the pre-sequestration budget. “There’s no institute here that feels good about their ability to support the science that they’re asked to look at,” Collins said in an interview with Stat News late last month.
Researchers funded through the NIH are rattled not only because, in their view, the agency is funding an insufficient number of grants, but also because the constant budget battles in Congress generate uncertainty. That makes it hard to plan multiyear research projects, and it discourages young scientists from pursuing publicly funded biomedical research.
It wasn’t always like this. From 1998 to 2003, Congress doubled the NIH’s budget to $27 billion as part of a Republican-led, bipartisan push. In the last few years, Newt Gingrich, who was House speaker when the “doubling” began, has called for much more spending on the NIH:
[W]hen it comes to breakthroughs that could cure—not just treat—the most expensive diseases, government is unique. It alone can bring the necessary resources to bear ... And it is ultimately on the hook for the costs of illness. It’s irresponsible and shortsighted, not prudent, to let financing for basic research dwindle.
This year, congressional legislators have come around on some of those very ideas. Ronald DePinho, the president of the University of Texas MD Anderson Cancer Center and a member of Act for the NIH’s advisory committee, began to see signals in early 2015 that Congress was open to giving the NIH a bump. One was the House’s overwhelming support for the 21st Century Cures bill, which would boost funding for the NIH and the Food and Drug Administration, among other provisions. (The Senate is incorporating elements of the House bill into its own legislation, slated for next year.)