Researchers decry flat NIH budgets, fear delays in treatment advances

Washington -- Some of tomorrow's breakthrough medical treatments are going to take longer to develop -- if they happen at all -- thanks to years of stagnant National Institutes of Health budgets, researchers and patient advocates warn.

The NIH budget doubled between 1998 and 2003 to $27.1 billion, but for the last three years Congress has kept funding at about $28 billion. Biomedical research inflation has averaged 4% annually since 2004, so in effect, NIH finances have slipped.

"Flat funding of the NIH, combined with inflation, is eroding research budgets," states "Within Our Grasp -- Or Slipping Away?" a report by a coalition of eight medical schools, including Johns Hopkins and Harvard University, and unveiled March 19 on Capitol Hill. "Scientists are being forced to downsize their laboratories and abandon some of their most innovative and promising work."

The funding problems come at a time of heightened interest in research, driven in part by the sequencing of the human genome. In 2002, the NIH funded 31% of 30,068 grant applications. In 2006, it funded 20% of 45,688 applications, found an analysis by the Federation of American Societies for Experimental Biology. Approvals remained stalled at about 9,000.

Budget pressures have forced NIH review panels to reject high-quality grant applications and to fund research seen as less risky, states the "Within Our Grasp" report.

"No wonder so many of the best and brightest stars are leaving the research field," said Edward Miller, MD, dean of the Johns Hopkins University School of Medicine and CEO of Johns Hopkins Medicine.

Scientists are beginning to follow research dollars to Europe and Asia, the report said. This talent migration will take years to reverse, said John Buse, MD, PhD, president-elect of medicine and science at the American Diabetes Assn. and director of the Diabetes Care Center at the University of North Carolina.

Young researchers are frustrated with flat budgets, scientists and patient advocates said. Today about 20% of experienced researchers have their NIH grants funded, compared with 40% traditionally, said NIH Director Elias Zerhouni, MD, at a March 19 Senate Appropriations subcommittee hearing. However, as little as 5% of first-time grant applicants might be successful now, whereas 15% was normal a few years ago.

Alan Schneyer, PhD, believes his research grant likely was denied because his proposal was viewed as too risky. He serves as a senior faculty member of the Reproductive Endocrine Unit at Massachusetts General Hospital in Boston and is an associate professor of medicine at Harvard Medical School.

Dr. Schneyer and his associates modified mice to be infertile, but they weren't. They then found the mice had more insulin-producing beta cells and could process more glucose. This suggested a new diabetes treatment. He presented a paper at the Endocrine Society in June 2006. He says it was well-received, but he was unable to get an NIH grant to characterize the beta cells or study the mice.

Dr. Schneyer and "Within Our Grasp" authors -- including scientists on selection committees -- say the panels are more likely to fund research that appears likely to deliver some results, however incremental, over a proposal seen as riskier but that may deliver a breakthrough.

Life insurance for flies

Susan Gerbi, PhD, the George Eggleston Professor of Biochemistry at Brown University in Rhode Island, just took out a life insurance policy to benefit her fungus flies. If Dr. Gerbi dies, there will be $1 million to maintain four incubators full of vials of the flies, known as Sciara. She has the world's only repository of Sciara, useful for studying DNA replication. It costs $100,000 yearly to keep up the stock, in existence since the 1920s.

Dr. Gerbi has been using the flies to study amplification of breast cancer-causing genes. But she has not been able to obtain federal funding for her research in the last two years. She was diagnosed with breast cancer and her illness prevented her from publishing, an unofficial NIH prerequisite.

Today she's in remission but her lab is having a tough time recovering. She's reapplying for a $250,000 NIH grant in July. "If no money were to come in, then things would be extremely tight by the early fall," said Dr. Gerbi, who has begun using her own money to support the lab. She said she hasn't seen such a tough NIH climate since she began her career during the Nixon administration.

NIH-employed scientists also have suffered under the flat budgets, said Michael Gottesman, MD, PhD, NIH deputy director for intramural research. The institutes employ about 1,200 researchers whose work is examined every four years.

When Dr. Gottesman joined NIH in 1994, intramural programs accounted for 11.3% of the budget. Now they represent 9.6%. Also, NIH has closed at least 50 intramural labs -- about 5% of its total -- and reduced funding for others in the last three or four years.

The same goes for programs funded by intramural grants. For example, RIOS Net, a three-year-old electronic network of 275 primary care clinicians in New Mexico, is losing its intramural NIH support at the end of September, said its director, Robert Williams, MD, MPH, a professor in the Dept. of Family and Community Medicine at University of New Mexico. The consortium had been conducting collaborative research on 10 health care topics in traditionally underserved populations.

Researchers and advocates are calling on lawmakers and President Bush to renew their funding commitment. The Democratic Congress included a $615 million boost for the NIH in the 2007 continuing budget resolution it passed in February. President Bush proposed a status quo fiscal 2008 NIH budget. The congressional appropriations process for fiscal 2008 has not yet started; however, Senate Appropriations Committee Chair Tom Harkin (D, Iowa) and ranking member Arlen Specter (R, Pa.) have vowed to push for an increase.

The experimental biology federation said annual 6.7% increases from 2008 to 2010 would put NIH back on track. If increases aren't possible, the "Within Our Grasp" report says, NIH funding should at least outpace inflation. Last year the American Medical Association called for enough funding to sustain the research momentum created by the NIH budget doubling.

The institutes expect to receive more than 51,000 grant applications in 2008, Dr. Zerhouni said. The difference between funding 20% versus 30% of those grants could be "exponential," said Wendy Selig, vice president for legislative affairs at the American Cancer Society. Each discovery leads to new ideas and other discoveries.