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NIH Director Dr. Collins to Senate: “NIH Needs a Stable Trajectory of Inflationary Increases and Growth”

Legislative Update
April 2, 2014

Sen. Tom Harkin (D-IA)
Sen. Tom Harkin (D-IA)
Today, just a week after he appeared before the House Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee, National Institutes of Health (NIH) Director Francis Collins, M.D., Ph.D. testified before the companion Senate Subcommittee to address the Administration’s Fiscal Year (FY) 2015 NIH funding proposal—a modest $200 million or 0.7 percent increase over FY2014 for $30.1 billion. Dr. Collins, who was accompanied by several Institute Directors (see box below), provided brief comments about major NIH initiatives, based on his written testimony.

The Senate’s NIH hearing had a very different feel than that in the House for several reasons, not the least of which is that it was the last for Chairman Tom Harkin (D-IA), who is retiring at the end of this session. “Since 1989, I have either served as Chair or Ranking Member of this Subcommittee, trading the gavel with the late Senator Arlen Specter for most of those years, and I have seen a transformation of the NIH campus—as well as the transformation of science and the opportunities it holds for the future,” he said. “Congress is being penny-wise and pound-foolish for not adequately funding NIH, as its future is in doubt,” he added. Senate Appropriations Chair and Subcommittee member Barbara Mikulski (D-MD) recognized Senator Harkin’s leadership and recounted the past bipartisan leadership that resulted in the NIH doubling and the creation of the NIH Office on Women’s Health, for which she was a champion. She not only lamented the NIH funding decrease due to the sequester but also cited the 16-day government shutdown last year and its negative impact. “We need to get the NIH back on track with steady growth so we can fund the folks who do the research, especially young investigators,” she said. She announced that the Senate Appropriations Committee will hold an April 29 hearing on the nation’s “Innovation Deficit.”

Sen. Dick Durbin (D-IL)
Relating to Senator Mikulski’s comment about getting “NIH back on track,” Dr. Collins displayed a new graphic demonstrating that, if NIH funding had continued on the trajectory prior to the doubling of 3.7 percent annual growth, its funding would now be at a level $10 billion greater than it is now. “Although we thank Congress for the NIH doubling, the combination of flat budgets and lack of an inflationary increase since FY2003 has resulted in a deficit from the past trajectory.” When asked by Senator Dick Durbin (D-IL) whether “Manhattan Project-type” funding or sustained growth was preferable, Dr. Collins responded that, “Nothing is worse for biomedical research than uncertainty. NIH needs a stable trajectory of an inflationary increase and growth.” Senator Durbin noted that his bill, S. 2115 American Cures Act introduced on March 12, would ensure a five percent per-year increase over a cost-of-living inflationary factor for a ten-year period to get NIH back on track. “As we short-change the NIH, we add to the cost burden of our other health programs,” he concluded.

In this regard, the Democratic-led Senate hearing differed from the Republican-led House hearing in that the former focused on ways to increase NIH funding while the latter focused on NIH doing more within current spending by prioritizing research. While Ranking Member Jerry Moran (R-KS) lauded the NIH and agreed that it is at a critical juncture, he questioned the Administration’s commitment to biomedical research, especially since it proposes to transfer funds from NIH biomedical research to broad Department of Health and Human Services (DHHS) programs through the Program Evaluation Transfer, or TAP, slated to increase from 2.5 percent to 3 percent. (The TAP is imposed on NIH and other DHHS agencies to fund cross-cutting programs, such as the National Center for Health Statistics). This comment echoed that of House Republican Subcommittee members at the March 13 hearing with DHHS Secretary Sebelius and the March 26 hearing with Dr. Collins that this TAP increase would reduce NIH’s $200 million funding increase by $150 million. Senator Moran also asked several questions about NIH’s priority-setting process, that is, how and where it decides to focus funding. Dr. Collins noted that although it is a combination of numerous factors-including public health burden and scientific opportunity—it is primarily driven by insights from the investigator-initiated grants. “NIH priorities are very much driven from the bottom up versus the top down,” he said, emphasizing that the Institute and Center (I/C) Directors also actively balance peer review of grants with programmatic need to determine portfolio funding.

Dr. Collins provided answers about NIH initiatives for several diseases. While responding as he did at the House hearing that “no NIH program has been untouched by budget cuts,” he did focus on how NIH was maximizing its efficiencies through I/Cs working together and with other government agencies, industry, private funding foundations, and advocacy organizations.

NAEVR will submit written comments to the Senate hearing file by the May 23 deadline, as it did with the House’s March 28 deadline. The House and Senate Subcommittees will now proceed to develop bills and hold Subcommittee markups, expected in the May-June timeframe.

Accompanying Dr. Collins:
Christopher P. Austin
National Center for Advancing Translational Sciences

Anthony S. Fauci, M.D.
National Institute of Allergy and Infectious Diseases

Gary H. Gibbons, M.D.
National Heart, Lung, and Blood Institute

Story C. Landis, Ph.D.
National Institute of Neurological Disorders and Stroke

Harold E. Varmus, M.D.
National Cancer Institute