At the Plenary Policy Forum during the 2006 ASH Annual Meeting, we had the pleasure of hearing presentations from two of the most prominent health officials in science and medicine, Colin Blakemore, FMedSci, FRS, Chief Executive of the Medical Research Council since 2003, and Elias Zerhouni, MD, Director of the National Institutes of Health since 2002. During the forum, Dr. Zerhouni described the current NIH funding crisis as “The Perfect Storm.” The bottom line for me was that it is our responsibility to enlighten our House Representatives, Senators, and the President and educate our patients and the public to do the same. This is the only way for us to make lawmakers aware of our funding crisis and biomedical research’s dismal outlook for the future, given the current level of NIH funding.
Dr. Zerhouni knows the recent great advances in biomedical research — he reviewed many of them with the Senate Appropriations Subcommittee when he made his 2007 budget request. Dr. Zerhouni should be frustrated by the budget restrictions and reductions and probably is uneasy when he speaks to large groups such as the ASH/EHA Plenary Policy Forum. Yet, his testimony to the Senate Subcommittee on Labor-HHS-Education Appropriations regarding the FY2007 budget request was surprising. He spent a significant amount of time describing the tangible and unprecedented advances in cardiovascular disease, stroke, cancer, HIV/AIDS, influenza, and diabetes. However, he made no mention of a need to expand the research basis and funding — owing to the new research opportunities that came out of these advances — nor did he mention the record number of new grant applications to the NIH, or the decline in the rate of new grant application funding from 31 percent in 2003 to the current projection of 19 percent for 2007. To someone with pedestrian political interests, this seems like it would have been an opportune time to make our lawmakers aware of our needs; however, Dr. Zerhouni requested the same level of funding for 2007 as for 2006, without even a request to keep up with inflation.
He also spoke of making medicine predictive, personalized, and preemptive. These are goals that, in my humble opinion, will only be realized with continued growth and support. This is why we must, ourselves, educate the House, Senate, president, and the public in order to see that our funding needs are met.
In 1999, Congress initiated and followed through with a bipartisan goal to double the NIH budget over five years. As a result, significant progress and advances were made during those years. For example, the human genome sequencing was completed, the importance of epigenetic regulation of gene expression in aging and disease was realized, advances were made in understanding the role of micro-RNAs in cancer pathogenesis, and new techniques were developed for biologic imaging and computing, to name only a few. With recent advances, whole new fields of basic and applied research were discovered for study. Certainly, new and added resources are required to fully capitalize on this growth and discovery.
Since 2003, there has been no budgetary growth — in fact, there has been reduction and contraction. NIH’s budget in 2004 and 2005 failed to keep up with the inflationary cost of doing biomedical research. In 2006, it was cut for the first time in 36 years, by $62 million. This has demoralized established and experienced investigators and discouraged young investigators from pursuing a career in biomedical research.
In this era, biomedical research must be a global effort. With technology and the availability of information, we must consolidate, organize, and thoughtfully tackle an agenda for biomedical research, including our agenda for hematology research. We, as hematologists, must partner with NIH. In turn, NIH must partner with the MRC and other national bodies. ASH and EHA must double their efforts to search for a more profound way to impact and influence how government funds are allocated for biomedical research.
