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Thread: NIH priorities from 2003 to 2007

  1. #1

    NIH priorities from 2003 to 2007

    As many people from CareCure are going to Washington DC to lobby Congress for increased spinal cord injury research funding, I thought that it would useful and important for people to know and understand the NIH budget and what the Christopher Reeve Paralysis Act will do. NIH web site has a very interesting page that lists budget amounts for different research areas from 2003 (FY03) to 2007 (FY07). NIH had not published breakdowns of funding by disease, conditions, and fields since 2001. The new information tells a fascinating story of how biomedical research has fared under the Bush administration since 2003, which is the end of the doubling of NIH budget mandated by Congress in 1997. I recommend that people save this page because such politically sensitive information have a tendency to disappear.

    In another topic, there is much discussion of stem cell research. According to the NIH figures, NIH funding for all stem cell research (human, non-human, embryonic, non-embryonic) rose from $517 in FY03 to an anticipated $608 million in FY07, an increase of about 18%. This seems to be a lot of money. However, if we correct for inflation, this is not much of an increase. An annual 3% inflation rate adds up to 12.5% over 4 years. Therefore, stem cell research funding has really increased only 5.1% over 4 years. This is a remarkably small increase, given the importance of stem cell research and the almost universal belief by scientists and clinicians that stem cell research represent the most important area of biomedical research since the discovery of DNA.

    An analysis of the funding of different stem cell research categories reveals several surprising trends. Human embryonic stem cell research increased from $20 million in FY03 to $39 million in FY07, an increase of 95% or 82% if one adjusts for inflation. It is true that an increase of $19 million is paltry but it is one of the few research areas at NIH that has increased under the Bush administration. However, non-human embryonic stem cell research fell from $113 million in FY03 to $96 million in FY07, a decline of –27.6% when corrected for inflation. In short, the increase in human embryonic stem cell funding came at the expense of non-human embryonic stem cell research.

    Even more shocking is the story that these numbers tell for human non-embryonic stem cell research, i.e. human adult and umbilical cord blood stem cell research. Despite all the talk about bone marrow and umbilical cord blood stem cells curing hundreds of diseases, human non-embryonic stem cell research only slightly increased from $191 million in FY03 to $200 million in FY07. Corrected for inflation, this represents a –7.8% change in funding of human non-embryonic stem cell research. Interestingly, non-human non-embryonic stem cell research went from $192 million in FY03 to $273 million in FY07, an inflation-adjusted increase of 29.6%. In other words, much of the NIH research dollars in stem cell research switched to basic laboratory studies of adult stem cells. This movement is of course driven by the excitement over discoveries of stem cells in various tissues, including brain, skin, liver, pancreas, and muscle.

    For several years, I have heard bone marrow stem cell researchers complain about how terrible the funding situation is for them. My initial response was incredulity. How can they be cut, with all the right-winged religious groups trumpeting how bone marrow and umbilical cord blood stem cells are curing diseases? However, when I heard from Jim Battey (former head of the NIH Stem Cell Task Force) last year that NIH spent only $200 million on human non-embryonic stem cell research in 2004, I was stunned. How could this be? Bone marrow and umbilical cord blood stem cells are the mainstay therapy for most hematopoietic and immunodeficiency diseases and they are now being touted as the cure for failing hearts. The NIH has been cutting back on human non-embryonic research while the Bush Administration has been touting its value.

    A look at the fields that received the most funding increases is interesting. I took selected categories of funding and calculated inflation-adjusted changes in funding from FY03 to FY07, and then ranked them in order of percent change of funding. A snapshot of the spreadsheet is attached. It is worth studying. Percentage-wise, influenza research received the largest increase of 237%. The second highest increase went to human embryonic stem cells at 82% but was only $19 million. Vaccine-related research was third with an increase of 30.5%. Surprisingly, non-human non-embryonic stem cell research was fourth on the list with a 29.6%. Emerging infectious diseases was fifth with an increase 20.6% and biodefense was sixth with a 9.1% increase. However, the amount of increase for biodefense and related fields tells a different story. The combined FY03-FY07 increase of funds for vaccine-related, emerging infections, and biodefense add to to $1248 million, easily eclipsing everything else.

    The list gives a sordid story of how biomedical research has fared under the Bush Administration. From 2003-2007, almost every major disease or condition has had a decline in funding except for slight increases for traumatic brain injury, diabetes, and spinal muscular atrophy. The analysis only encompasses selected conditions but the list suggest that the following fields have had cuts in research support: chronic pain, multiple sclerosis, HIV/AIDS, neuroscience, stroke, amyotrophic lateral sclerosis, cancer, trauma (head/spine), autoimmune diseases, Alzheimer’s disease, and spinal cord injury. There will be 15% less spinal cord injury research going on in FY07 than in FY03. Is it at all surprising that the United States is falling behind in the race for the cure of spinal cord injury and many other diseases?

    To be fair, NIH funding depends on grants that are submitted by scientists and the decline in some of the fields may not be the fault of the administration but simply because scientists are not applying for grants in those areas. On the other hand, as a member of the NICHD Council from 2000 to 2005, I saw the funding level of NIH grants fall from 25% of applications to now close to 10% of applications. Also, NIH can make a big difference by allocating funding for training programs, research centers, and young investigator awards to encourage research in the field. Finally, it is clear where the money has gone. It has gone into biodefense research and related fields such as vaccines and emerging infectious diseases.

    By adding $100 million per year to paralysis research with an emphasis on paralysis research, the Christopher Reeve Paralysis Act should have a significant effect on the field. It is important to bear in mind that only a third to half of the funds will be going to NIH and it has to address all causes of paralysis, rehabilitation, and quality of life. It is not very much but every little bit helps. An increase of even $30 million for spinal cord injury research and the establishment of clinical trial centers would be enormously helpful for the field.

    Last month, the Bush Administration and Congress proposed draconian cuts of the FY07 NIH budget. As is evident from the above FY07 analysis based on the President's budget, the only fields that received substantial increases were influenza, vaccine-related research, and biodefense funding. Everything else was flat-lined or cut back. Given the already intolerable 10% funding of NIH applications, i.e. only one out of 10 applications is receiving funds, this latest budget proposal will be devastating for many fields, including spinal cord injury research and related fields.

    The U.S. Senate responded to the budgetary cuts by passing the Specter-Harkin amendment (see http://carecure.org/forum/showthread.php?t=60366) to restore NIH funding to 2005 levels. That Senate passed the amendment 73-27 but the House of Representatives still has to pass their amendment. It is not yet clear that the Republican-dominated House will be willing to restore the NIH budget. It is likely that the House will propose a smaller restoration of the NIH budget and the final budget will be decided in conference.

    Many people have put their hope in passage of Stem Cell Research Enhancement Act of 2005 (SCREA) but do not know that the legislation does not appropriate funding for the research. In other words, it is an unfunded mandate. Stem cell research applications must compete with all the other applications. This situation pits stem cell research against other therapeutic approaches. Even if the Specter-Harkin amendmen were to pass, the likelihood of any increase in stem cell or spinal cord injury research funding by NIH is low.

    Spinal cord injury research has lost ground in the past five years. As the above analysis shows, there will be 15% less spinal cord injury research in FY07 compared to FY03. This is why passage of the Christopher Reeve Paralysis Act is more important than ever. It should restore help anchor the establishment of a clinical trial network for promising spinal cord injury therapies and rehabiitation. We should understand, however, that the legislation will barely reverse the cutbacks of the field in the past five years.

    In summary, NIH spending over the past five years has shown a clear pattern. The Bush Administration has placed a high priority on infectious disease and biodefense research, allocating billions of dollars to these programs. Stem cell research received a modest 5% increase but mostly in basic non-human adult stem cell research while funding human adult/umbilical cord blood research has declined. Funding for some disease conditions have stayed the same but most declined between FY03 and FY06. The White House has proposed draconian cuts of NIH budget for FY07. The Senate passed the Specter-Harkin Amendment to restore the NIH budget to 2005 levels but the House has yet to pass a corresponding amendment. Passage of the Christopher Reeve Paralysis Act, which will appropriate $100 million per year for paralysis and rehabilitation research, is more important than ever in this situation.

    Wise.
    Last edited by Wise Young; 04-13-2006 at 02:23 PM.

  2. #2
    Great work Wise, thank you.

    John
    "Hope is like a road in the country; there was never a road, but when many people walk on it, the road comes into existence." Lin Yutang

  3. #3
    unbelieveably comprehensive.......is what you are Wise! Thank you, this is a great resource.

  4. #4
    Thank you Wise. This is a very comprehensive breakdown...tells the story in spades.
    Mimi

  5. #5

    Great job Wise in laying everything out

    This is what I have been trying to impress upon people, people should be very angry, but for some reason they are not. Restorative Central Nervous System Therapies are not going to come for free, a lot of people seem to believe things are just going happen being that we live in this wonderful high tech world where anything is possible. The other feeling is that everything should be funded private, I totally disagree with this, I feel it is a governments role to take care of its people and I dont see this happening.

    A lot of people are now really seeing the light as far as how the G.W Bush administration has made so many mistakes, in my opinion right now more than ever is our chance to create the anger in the public for their mis-management of federal goverment tax-payer dollars. I still think my rally t shirt idea of "Future G.W Bush Fatality" is a good one. It hits the nail right on the head that if things continue as they are there are going to be a lot of future fatalities as I believe it will be proven that ESC does work in humans in the future and a lot of people will have been lost in the 8 years G.W Bush was in office. I dont believe any at the rally could be arrested on the grounds of wearing such a t-shirt or for that matter even asked to leave the grounds, it is just free speech and it would really make the public see how serious a problem the area of government funding is, I even believe we would get a lot of press coverage with this idea. Do you believe we as a SCI group need to get more aggressive against the US government Wise?

  6. #6
    Quote Originally Posted by Curt Leatherbee
    I dont believe any at the rally could be arrested on the grounds of wearing such a t-shirt or for that matter even asked to leave the grounds, it is just free speech and it would really make the public see how serious a problem the area of government funding is, I even believe we would get a lot of press coverage with this idea. Do you believe we as a SCI group need to get more aggressive against the US government Wise?
    Excellent Idea, or banners if not t-shirts? I'd go to the slammer for the cause anyhow! But you're right, this does not overstep any boundaries.

  7. #7
    Quote Originally Posted by Curt Leatherbee
    This is what I have been trying to impress upon people, people should be very angry, but for some reason they are not. Restorative Central Nervous System Therapies are not going to come for free, a lot of people seem to believe things are just going happen being that we live in this wonderful high tech world where anything is possible. The other feeling is that everything should be funded private, I totally disagree with this, I feel it is a governments role to take care of its people and I dont see this happening.

    A lot of people are now really seeing the light as far as how the G.W Bush administration has made so many mistakes, in my opinion right now more than ever is our chance to create the anger in the public for their mis-management of federal goverment tax-payer dollars. I still think my rally t shirt idea of "Future G.W Bush Fatality" is a good one. It hits the nail right on the head that if things continue as they are there are going to be a lot of future fatalities as I believe it will be proven that ESC does work in humans in the future and a lot of people will have been lost in the 8 years G.W Bush was in office. I dont believe any at the rally could be arrested on the grounds of wearing such a t-shirt or for that matter even asked to leave the grounds, it is just free speech and it would really make the public see how serious a problem the area of government funding is, I even believe we would get a lot of press coverage with this idea. Do you believe we as a SCI group need to get more aggressive against the US government Wise?
    Curt,

    People should understand the goal and process of lobbying. The goal of lobbying is to get your senator or representative to vote the way that you want. You want to make friends, not enemies. You try to persuade. You do not want to burn bridges. You are there not only representing yourself but your community.

    The first step is to do research on your senator and representative. Know what his or her position is related to the Christopher Reeve Paralysis Act (CRPA) and the Stem Cell Research Enhancement Act (SCREA). Last May, the House of Representatives passed SCREA H.R.810 by a 238-194 margin (see roll call of votes) and 41 senators have already signed up as sponsors for SCREA (S.471). However, only a minority of senators (25) and representatives (61) have signed up to be sponsors of CRPA. Based on the senator or representative's position, you make your pitch and request. There are five likely possibilities, listed in order of likelihood below, and my analysis of how they should be approached.

    • Your senator or representative already supports SCREA (i.e. is a senate sponsor or voted for HR810 last year) but has not yet taken a position on CRPA. This is the most likely situation. Most of the Democrats will be in this category. I would recommend praising and thanking your senator and representative for supporting SCREA and focus your presentation on CRPA in such a case. Tell him or her how important CRPA is to you and your family, give the economic benefits of a cure for spinal cord injury, ask for his or her support of CRPA.
    • Your senator or representative opposes SCREA (i.e. voted against HR810 last year) but has not taken a position on CRPA. This is the second most likely scenario. This is the position of most Republicans. If the Senator or Representative is on record as strongly against embryonic stem cell research, I would recommend focussing only on CRPA and avoiding the subject of SCREA. If the Senator or Representative has not taken a strong public stance on SCREA, ask politely for the Senator's position on SCREA after you have made the pitch for CRPA. Be sensitive and do not jeopardize the possibility of support for CRPA.
    • If your senator or representative opposes SCREA (i.e. voted against HR810 last year) and also opposes CRPA. This is likely to be the position of some Republicans who oppose SCREA and believe that there is not enough money in the budget for CRPA. Note that they will seldom tell you to your face that they oppose CRPA. They will use the subterfuge of budgetary limitations. I recommend talking about why CRPA is important to you and your family. Be prepared to make the economic argumen for CRPA. Tell the Senator or Representative that several studies have shown that care and welfare of people with spinal cord injury costs $10 billion a year. If the $100 million/per year investment into spinal cord injury research and clinical trials yields therapies that restores even 10% of the people with spinal cord injury, this will save $10 billon over the coming decade, a hundredfold return on the investment, not to mention the humanitarian benefits. I would not recommend making a pitch for SCREA because the likelihood of convincing the person to support SCREA is low and it is very likely to jeopardize any possibility of support for CRPA.
    • Your senator or representative opposes SCREA (i.e. voted against HR810 last year) but supports CRPA (i.e. is a sponsor of CRPA). This should be relatively rare. About 25 senators and 61 representatives have signed up to sponsor CRPA. Most democrats who support CRPA already support SCREA. Most republicans who support CRPA also supports SCREA. In such a case, thank your representative for supporting CRPA. Ask politely concerning the senator's or representative's position on SCREA. I recommend not getting into an argument about SCREA.
    • If your senator or representatives supports SCREA (i.e. voted for HR810 last year or is a senate sponsor of SCREA) but opposes CRPA (because he/she thinks that there is not enough money). This should be rare. Thank the representative for supporting SCREA. Talk about why CRPA is important to you and your family. Be prepared to make the economic arguments for the value of CRPA and the funding of CRPA.


    In my opinion, people should be focussing their attention on senators and representatives who have not yet taken a position on CRPA. This includes a majority of senators and representatives since only 25 senators and 61 representatives have signed up as sponsors for the bill. If you find out that the senator or representative supports CRPA but is not a sponsor of the bill, you should ask if they could be sponsors and show their public support of the bill.

    Wise.
    Last edited by Wise Young; 04-13-2006 at 04:06 PM.

  8. #8
    Quote Originally Posted by Curt Leatherbee
    I still think my rally t shirt idea of "Future G.W Bush Fatality" is a good one.
    Sorry Curt, I have missed it, culd you give me a link to that idea?

    Paolo

  9. #9
    I moved some posts to the Members Only Forum...
    http://carecure.org/forum/showthread.php?t=61634

  10. #10
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    Quote Originally Posted by Wise Young
    Curt,

    People should understand the goal and process of lobbying. The goal of lobbying is to get your senator or representative to vote the way that you want. You want to make friends, not enemies. You try to persuade.
    Dr Young,

    There are many ways to lobby. There is not just one way. Playing Nice works and ideally it does,..........sure. BUT sometimes you got to stand up and fight.

    As Don Reed says:
    There are
    two opposing forces: a vocal minority for the “Hell-yes-it’s-awful” position, and a similar group on the “Let’s-be-polite-and-not-make-ripples” side.

    "There’s far too much unthinking respect given to authority,” Molly Ivins explained; “What you need is sustained outrage.”
    Kerr, Keirstead, McDonald, Stice and Jun Yan courageously work on ESCR to Cure SCI.

    Divisiveness comes from not following Christopher Reeve's ESCR lead.
    Young does ASCR.
    [I]I do not tear down CRPA, I ONLY make peopl

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