Although the massive 2015 spending agreement reached by Congress last night gives the National Institutes of Health (NIH) a flat budget, it contains modest increases for a few programs within the agency. An accompanying report also contains several directives that biomedical research advocates are eyeing warily.
The $150 million increase, a mere 0.5% boost over the $29.9 billion it received last year, still leaves NIH below its budget level in 2012 before sequestration took a 5% bite, note biomedical research advocates. It falls short of the $606 million increase that a Senate spending subcommittee had approved and is less than the White House’s request of $211 million. “We appreciate any increase, but it’s not getting the job done. We’re going backwards,” says Jennifer Zeitzer, deputy director of the Federation of American Societies for Experimental Biology’s Office of Public Affairs in Bethesda, Maryland.
The bill singles out a few areas for larger increases. The National Institute on Aging gets a $28.6 million increase, or a 2.4% raise to $1.2 billion. “[A] significant portion” of the new money should go to Alzheimer’s disease depending on the quality of grant proposals, says a report accompanying the bill. Some institutes also received a boost as part of a $25 million increase for the Obama administration’s BRAIN Initiative, which receives a total of $65 million.
The bill also tags $12.6 million for a new pediatric research initiative that Congress created earlier this year by passing the Gabriella Miller Kids First Research Act. The program is supposed to be funded through a checkoff box on tax returns that funds political conventions. But apparently Congress decided to get it started by including money in NIH’s budget, says David Moore, senior director for government relations at the Association of American Medical Colleges in Washington, D.C.
Separately, the bill gives NIH $238 million for Ebola research and vaccine development as part of a government-wide $5.2 billion emergency bill for Ebola.
One recent concern about NIH’s budget—that each year some money is skimmed off for other Department of Health and Human Services (HHS) agencies—is remedied in the bill. It says that the $700 million that NIH is set to contribute to the “tap” this year will come back as $715 million for the agency. (After this accounting maneuver, NIH still receives only a total of $150 million more than last year, however.) Other HHS agencies that previously received part of their budgets from this tap will instead get direct appropriations, Moore notes.
The report also directs NIH to pay more attention to the age at which new NIH investigators receive their first research grant, now 42 on average. NIH “is directed to develop a new approach with actionable steps to reduce” that age. The language echoes a controversial proposal from Representative Andy Harris (R–MD), a member of the House of Representatives Appropriations Committee, that would require NIH to lower the age of first R01 by 4 years within a decade, but lacks that specific target.
Lawmakers also address a perennial concern: that the amount NIH spends on specific diseases doesn’t take into account the burden that disease creates or death rates. The report “urges NIH to ensure research dollars are invested in areas in which American lives may be improved.” It also tells NIH “to prioritize Federal funds for medical research over outreach and education,” apparently a reference to a grant for making a nutrition video game that Harris has criticized as less important than disease research.
Biomedical advocates generally feel NIH should set research priorities based on the quality of research proposals, not disease burden or other criteria laid out by Congress. And although they worry about the aging of new investigators, they have reservations about Harris’s solutions. “What we’re seeing here is the committee expressing some concerns and setting some expectations,” Moore says. “It’s not certain what the next steps will be, but it’s something we will be watching very closely.”
NIH’s complementary medicine institute will get a new name. Now called the National Center for Complementary and Alternative Medicine, the bill replaces those last two words with “Integrative Health.” The report says this is because interventions such as dietary supplements and spinal manipulation therapy are now so widely used, they are no longer alternatives but instead are part of medical care.
The report advises NIH to follow an Institute of Medicine report this past June recommending changes to the design and leadership of the troubled National Children’s Study (NCS), a plan to track the health of 100,000 babies to adulthood. But the bill also says that $165 million allocated this year for the study could also be spent on “research related to the Study’s goals and mission” at NIH institutes.
The fate of the NCS will likely be decided later this week at a meeting of the NIH director’s advisory committee, where a working group will recommend whether to launch the full study.
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*Update, 11 December, 10:42 a.m.: The $25 million increase in the BRAIN Initiative has been added to this item.