From time to time, Congress asks federal science agencies to prepare an expert “bypass budget” that lays out the funding the agency thinks is necessary to meet an important goal. Usually such budgets are purely aspirational, and aren’t included in the White House’s formal budget request to Congress (hence the name; they “bypass” White House budget officials). But lawmakers see the documents as an opportunity to get straight talk from an agency without White House interference. And, occasionally, bypass budgets have helped build political support for shunting new money toward research in areas such as cancer and HIV.
Yesterday, the National Institutes of Health (NIH) released the first such bypass budget proposal for Alzheimer’s disease, which is projected to triple in prevalence by 2050. Distilled from discussions at a series of NIH meetings and consortia, the new document requests $1.06 billion for Alzheimer’s research in the 2017 fiscal year that begins 1 October. That’s $323.5 million more than the $737 million the president requested in the formal budget request. The new request, which NIH expects to update yearly, identifies 66 separate “milestones” for the Alzheimer’s community, ranging from research projects into the molecular pathogenesis and physiology of Alzheimer’s to new clinical trials, and studies aimed at caregiver support.
The request falls far short of the roughly $2 billion annual government investment in Alzheimer’s research that advocacy groups such as the Alzheimer’s Association believe is necessary to meet the goals of the National Plan to Address Alzheimer’s Disease. It calls for effectively treating and preventing Alzheimer’s and related dementias by 2025. However, NIH plans to steadily ramp up its Alzheimer’s spending requests, says Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke, once it has established the basic infrastructure for new clinical trials and other projects. The first year “might be fairly low expense,” he says, “because it’s mostly planning.”
NIH's best known bypass budget is prepared annually by the National Cancer Institute.