Following an extraordinary period of growth from 1998 through 2003, in which Congress doubled the budget of the National Institutes of Health by increasing its funding almost 15% per year on average, NIH budget growth decelerated in fiscal year (FY) 2004, increasing by only 3.2%. If the Presidents request for a 2.6% increase for FY 2005 sets the mark and advances this trend, advocates worry that gains made by the doubling could be lost.
Nearly 4 months after the start of the current fiscal year, Congress settled on a total program level (counting appropriations from all sources and all rescissions and across-the-board cuts) of $28.04 billion for NIH. Of that amount, the National Cancer Institute was allotted $4.74 billion, an increase of 3.3% over its 2003 budget. In determining funding levels, Congress stuck closely to the Presidents FY 2004 request for NIH.
On February 2, only 10 days after wrapping up the 2004 appropriation cycle, the biomedical research community got its first look at what the future is likely to bring for NIH funding when President Bush unveiled his FY 2005 budget request, which included $28.8 billion for NIH. $4.87 billion would go to the NCI for a 2.8% increase over the FY 2004 level. Both the President and some in Congress, contemplating the largest budget deficit in history, have vowed to strictly limit non-defense domestic spending. However, the Congress will be considering this budget during an election year in which many members may be particularly reluctant to cut spending on popular programs.
Impact on Biomedical Research
Many advocates are concerned that the relatively flat budget of FY 2004 and the potential for similar funding scenarios in FY 2005 and beyond could erode and even void the effect of the budget doubling. American Cancer Society National Vice President Daniel E. Smith said in a statement, "The Administrations proposed budget threatens to turn the past few years fountain of progress into a slow drip as the National Institutes of Health is slated for an increase that barely outpaces inflation for the second year in a row. This is unacceptable to millions of cancer patients, survivors, and their loved ones."
Howard Garrison, Ph.D., of the Federation of American Societies for Experimental Biology (FASEB) agreed. "This is an application of the brakes to the momentum," he said of the requested 2.6% increase for 2005. FASEB recommends a return to the historic annual average growth trend for NIH of 8% to 9% to sustain the increased research capacity built by the doubling. Garrison and colleagues described the effects of a much lower rate of growth in a 2002 Science article in which they compared the NIH appropriations, both recent and anticipated, with the average NIH growth rate since 1971. The authors demonstrated that, with meager increases following the doubling, not unlike those produced by the FY 2004 appropriation and the FY 2005 request, the "net effect of the 5-year doubling investment on the magnitude of the biomedical research enterprise would be extinguished" by FY 2007.
NIH distributes more than half of its budget every year in the form of research project grants (RPGs) to investigators across the nation. On average, such grants have agency support for 3.8 years, a time period referred to as out-years, so as the grant numbers rise, so do out-year commitments. For FY 2004 and FY 2005, NIH projects that the total number of RPGs, which has steadily increased for the past several years, will continue to increase, although slightly, and the number of new and competing grants will level off. Still, these numbers are expected to reach record highs in 2005.
To meet all of its out-year commitments and continue to fund new investigators, the modest budget increases will force NIH to spread its money a little thinner. Average annual award increases for the large number of grants will not grow at nearly the pace they have in recent years (see Stat Bite, p. 346). The Presidents request for FY 2005 provides a 1.3% increase in average annual cost, which NIH translates to cost increases of 1.9% for noncompeting grants and 1% for competing grants. Garrison pointed out that this does not keep up with the increased cost of doing research predicted by the Biomedical Research and Development Price Index, which is increasing at about 3.3% to 3.5% per year.
At the same time, success rates, calculated as the number of awards divided by the number of applications, are expected to fall from 30% in 2003 to 27% in 2004 and 2005. This implies that, although the number of grants awarded is expected to reach a record high in 2005, the demand for NIH research dollars will exceed the supply by a larger margin than it has in a decade.
Already, the post-doubling period may be looking like what Garrison calls "this awful period that we had in the 1990s where people were told they were funded, but then got a call from the institute for what became euphemistically known as downward negotiation."
At the NCI, Director Andrew von Eschenbach, M.D., said in the NCI Cancer Bulletin in early February that because of increasing research costs, out-year commitments, and commitments against the NCIs budget for centralized NIH initiatives, in FY 2004 the NCI is effectively operating at a $2.7 million loss compared with last years budget. "This means that every decision to fund something new requires a decision not to fund something else," he said. He described how NCI would meet that challenge: "NCI is committed in FY 2004 to maintain the pay line for the independent competing R01 investigator-initiated grant at the 20th percentile. The trade-off to achieve these targets is to reduce the recommended budget for competing RPGs by approximately 18% on average." He said that the NCI is also looking to reduce internal operating costs and staffing levels.
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