Medical Research Facing Federal Funding Crisis

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Brenda Russell, executive associate vice chancellor for research at the University of Illinois at Chicago Department of Physiology and Biophysics.Brenda Russell, executive associate vice chancellor for research at the University of Illinois at Chicago Department of Physiology and Biophysics.Physiologist Brenda Russell, a professor at the University of Illinois at Chicago, and her PhD students are looking at how heart tissue repairs itself after trauma.

Among other large sources of funding, Russell runs her laboratory on more than $350,000 in grants from the National Institutes of Health.

Recently, she submitted an application for an additional grant to augment existing funding. The application was peer reviewed and Russell was told that it was “much improved” over the original application. Paradoxically, the score was lowered and the grant denied.

“Nobody has ever done that before,” she said.

These are tight times for the NIH and Russell isn’t the only one feeling the squeeze. Work that was good enough to receive an NIH grant five years ago now faces a far steeper hill to climb.

Scientists and doctors who applied for a grant from the National Institutes of Health in 2001 had a 32 percent chance of success. Since then, their chances have dropped below 20 percent, according to Research!America, an advocacy organization based in Washington, D.C.

Rex Chisholm, the dean of research at Northwestern University's Feinberg School of Medicine (right) with a student. (Courtesy of Feinberg School of MedicineRex Chisholm, the dean of research at Northwestern University's Feinberg School of Medicine (right) with a student. (Courtesy of Feinberg School of Medicine)

The grants support research in cancer, heart disease, diabetes, genetics - virtually every branch of medical science. And the funding impact is likely to be felt for decades to come.

“Protecting the health of the U.S. public is one of the most important jobs the U.S. government does,” said Dr. Rex Chisholm, dean of research for Northwestern University's Feinberg School of Medicine. “We’re not doing that right now."

Scientists are uniting to raise awareness. A group of university presidents, Nobel laureate scientists, business and government leaders and other interested public figures have signed a petition to bring the presidential candidates together for Science Debate 2008.

The debate has been scheduled for April 18 at the Franklin Institute in Philadelphia, four days before the Pennsylvania primary, a potentially decisive contest for the Democratic presidential nomination. All candidates, including Sen. John McCain, have been invited to the debate; no candidates have as of yet committed to appearing.

The debate would focus exclusively on science-related issues and the declining federal budget for science grants would be a central topic for the debate.

“I think the crisis is in what we’re doing to our junior scientists,” Russell said. “People are leaving the profession.”

Those who do receive grants find that NIH has cut funding at the margins. In fiscal year 2008, the average research grant from the NIH is projected to be about $408,000, according to the American Association for the Advancement of Science. That number in 2003, when adjusted for inflation, was $434,970. Where grants had previously covered five years, now they frequently only cover four.

The proposed fiscal year 2009 budget is the same as 2008 – not one dollar is added to the $29.5 billion the NIH is receiving in the current fiscal year – and a zero percent increase means an actual drop in funding when adjusted for inflation.

The numbers are more ominous when taking into account “biomedical inflation” – the inflation of materials for scientific research – which far outpaces consumer inflation.

Using the NIH calculations for biomedical research inflation, NIH funding has, in effect, fallen 13 percent since 2004.

When fewer proposals are accepted, grants most frequently go toward more experienced doctors and scientists, often leaving younger professionals without a research lifeline.

“I think we’re going to see bright young scientists saying, ‘I can’t do this, there’s not a career for me,’” said Chisholm. As a prominent and established scientist; his applications for research grant proposals to the National Institute of Health are usually just a formality.

For younger researchers, nothing is certain.

Currently, the average age of grant recipients for applicants with a PhD or an MD is 44. “There’s no doubt that investigators at a younger age have a tougher time breaking into the NIH grant system,” said Stacie Propst, vice president for science policy and outreach at Research!America.

“Reaching job security at 44 is not anyone’s plan for a good life," Propst said. “A whole generation of scientists could be lost, literally.”

For young professors, applying for an NIH grant can be especially frustrating. “Most major universities require such a grant for tenure,” Russell said.

The NIH falls under the U.S. Department of Health and Human Services. Its research priorities and funding are largely set by Congress and the White House.

In a statement February 4, the day his fiscal year 2009 proposed budget was released, President George W. Bush was unapologetic about the cuts in domestic agencies and programs.

“We must do more to restrain spending,” Bush said. “My budget proposes to keep non-security discretionary spending growth below 1 percent for 2009.”

Yet the Bush Administration’s 2009 proposed fiscal year budget totals more than $3 trillion (a record in American history) and runs a $400 billion-plus deficit.

And the proposed budget includes big increases in defense spending. Excluding the wars in Afghanistan and in Iraq, the Bush Administration has increased defense related spending 39 percent from 2001-2008, even after taking inflation into account, according to the Center on Budget and Policy Priorities, also an advocacy group based in Washington, D.C.

The NIH budget is a small piece of the pie – less than one percent of the entire federal budget.

The impact of even small NIH budget cuts is severe: The agency funds about 30 percent of all medical research in the U.S., according to the Journal of American Medical Association. The cuts likely will mean fewer research grants from an already increasingly parsimonious agency.

“One hundred million taken out of the NIH kills us,” said Dr. Alan Leff of the University of Chicago Medical Center, who heads pulmonary and critical care medicine. “I know some of my colleagues have closed their labs. What are you going to do? You’re out of money.”

The National Institute of Allergy and Infectious Diseases, one of 20 sub-agencies under the NIH, was able to fund 38.3 percent of applications submitted in 2001. In 2006, they funded only 20.6 percent.

The National Cancer Institute estimated that it lost 12 percent of their purchasing power – for equipment and research materials – since 2004. “You have to shut down research that’s close to delivering,” Propst said.

President Bill Clinton pledged to double the NIH budget in 1998 from 13.6 billion. Then Texas Gov. George W. Bush, on the campaign trail, pledged to complete Clinton’s pledge.

It was a promise he kept when Bush first came to the White House. But after that, the NIH budget precipitously dropped, Propst said. “The increases have either been below inflation or been flat-out cuts.”

The cuts reflect a major change of direction historically. Increases to the NIH budget have typically hovered around 8 percent annually since the Nixon Administration.

The 2006 fiscal year budget was the hardest for the NIH. For the first time in 36 years, the agency received less money in real dollars than the year before. All but two of the 20 NIH sub-agencies were hit with a funding cut.

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