NATIONAL INSTITUTES OF HEALTH (NIH)
Under the the NIH budget would drop by $4.9 billion or 12.6 percent to $34.4 billion, which would put NIH funding at slightly below FY 2001 levels in inflation-adjusted dollars.
Several Congressionally-popular initiatives would see reductions in FY 2020, including the (to $195 million from $400 million in FY 2019); the initiative (to $312.6 million from $379 million); and the (to $140 million from $429 million, split between the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health). The budget does propose $50 million for the first year of a new multiyear pediatric cancer research effort and keeps opioids-related research flat at $1.3 billion. The request also sustains funding for facility repair and improvements at $200 million.
Overall, the budget proposes a 12 percent or $495.7 million reduction to intramural research, a 9.8 percent or $87.1 million reduction to Kirchstein training awards, and a 13.6 percent or $3.8 billion reduction to research grants.
The request would reduce the number of competing research project grants to 7,894 in FY 2020, a drop of over 3,700, or 32.4 percent fewer new RPG awards compared to FY 2019.
While the majority of individual institutes and centers would fund fewer awards, changes from FY 2019 levels would vary wildly. At one end, the National Institute on Aging proposes a reduction of 848 awards and the National Institute of General Medical Sciences proposes a 777-award reduction, with both institutes issuing about a third as many competing awards as in FY 2019. On the other hand, the National Cancer Institute and the National Heart Lung and Blood Institute both say they’ll increase their competing award numbers, by 6.9 percent and 10 percent, respectively, in spite of substantial funding cuts for both.
Institute variation aside, the funding reductions would translate to a shockingly low 13.4 percent success rate in FY 2020.
Other notes on the budget:
- It includes $100 million for the .
- The budget includes another twoyear reauthorization of at $150 million per year. The program was funded at that level for the past two years but requires another reup beginning in FY 2020.
- The budget includes $66.6 million for the National Institute of Environmental Health Sciences appropriated through the Interior bill, a 15.7 percent decrease from enacted FY 2019 levels. The program investigates health challenges and implications of hazardous waste and disaster response.
- funding from the National Institute of General Medical Sciences would be reduced by $50.3 million or 13.9 percent to $311.3 million total in FY 2020.
- Within the National Center for Advancing Translational Sciences, funding for the and for would each be reduced by 13.9 percent to $42.2 million and $481.8 million, respectively.
- For the third year in a row, the Administration proposes consolidation of the Agency for Healthcare Research and Quality within NIH. Appropriators have rejected the proposal thus far.
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
CDC discretionary funding would drop by a total $763 million or 10.4 percent below FY 2019 enacted levels (see table below). For the third year in a row, the Administration seeks to eliminate the agency’s $25 million Prevention Research Centers program, a network of 26 academic institutions that studies how individuals and communities can prevent chronic illnesses. The budget again proposes to terminate $9 million for CDC’s ten Injury Control Research Centers, which focus on ways to prevent motor vehicle injuries, suicide, opioid overdoses, and traumatic brain injuries, among other incidents. The budget also echoes previous attempts to eliminate $8 million in support for the Academic Centers for Public Health Preparedness, a program established in 2000 to address bioterrorism and other public health threats by linking academic expertise to state and local health agencies.
Within Environmental Health, the Administration again proposes to eliminate $10 million in climate change research as well as the Amyotrophic Lateral Sclerosis (ALS) Registry, which funds extramural studies exploring the causes and potential risk factors of ALS. CDC’s Environmental Health Laboratory would see a large $10 million or 15 percent reduction. Elsewhere, funding would be terminated for research on prion disease, chronic fatigue syndrome, and harmful algal blooms. There is also a significant $31 million or 18.5 percent cut to the agency’s Antibiotic Resistance Initiative, which is the main focus of national efforts to address antibiotic-resistant threats in the U.S. and abroad.
Amid the breadth of reductions, the Administration prioritizes domestic HIV/AIDS research, which receives a $140 million boost to a total $929 million in FY 2020, building on the Administration’s recently-announced HIV prevention initiative known as ‘A Plan for America.’ The budget would also expand activities to address the opioid epidemic with funding set to grow by $53 million above last year’s initial $5 million appropriation. The Administration also requests a $10 million or 5.3 percent increase for efforts to improve influenza vaccine effectiveness and production technology.
VETERANS AFFAIRS (VA) MEDICAL AND PROSTHETIC RESEARCH
VA’s Medical and Prosthetic Research program would drop by $17 million or 2.2 percent below FY 2019 enacted levels, though this decline reflects a one-time $27 million appropriation last year for a joint VA-DOE Big Data Science Initiative for analyzing medical health records using supercomputing capabilities. Setting aside this project, VA research funding would see a slight increase of 1.3 percent across its research portfolio (see table below). VA estimates that it will support 2,200 projects during FY 2020, the same amount as last year.
The VA would continue work in several ongoing priority areas. Of particular importance is VA’s research on opioids and pain management – guided by the agency’s Opioid Safety Initiative – with an emphasis on safe prescribing and non-drug treatment approaches. Another continuing priority is suicide prevention, building on a recent executive order that directs the VA and the Departments of Defense and Homeland Security to coordinate mental health care and suicide prevention efforts for returning service members. Support is maintained for research into post-traumatic stress disorder (PTSD), including the PTSD Psychopharmacology Initiative to test new PTSD medications in clinical trials.
The VA would sustain research on traumatic brain injury (TBI) with continued funding for the agency’s translational research center focused on TBI and stress disorders. Other priority areas include genomic-driven cancer care, notably the Research Precision Oncology Program (RePOP), designed to bring personalized health care to Veterans. The VA is also pursuing exoskeleton research with a special emphasis on motorized orthoses for stroke and TBI patients. Additionally, the agency is seeking to expand research and development of devices for female amputees as directed by House appropriators last year.
Defense Health Program Research (DOD)
Medical research funded through the Defense Health Program would receive $732.3 million in research, development, test and evaluation (RDT&E) funding in FY 2020, much of it for projects conducted through the Uniformed Services University of the Health Sciences (). This includes a 10.8 percent increase to $12.6 million total for basic science program elements. Excluding legislative funding additions for last year – which approached $1.2 billion in FY 2019 appropriations – total RDT&E funding would decline by $188.5 million, a 20.5 percent decline.