One of the least surprising developments in the omnibus was an increase for NIH, which remains one of the most clearly supported of all science agencies: appropriators had given NIH $2 billion plus-ups for the past two years, and had from the beginning vocally rejected the Trump Administration's steep cuts for the medical research agency; that rhetoric was backed up by spending bills in both chambers last summer that added at least $1.1 billion to the NIH budget even without a deal on the spending caps; and NIH continues to benefit from the extra spending enabled by the 21st Century Cures Act. The recent deal to raise the caps, then, meant the question wasn't whether NIH would get an increase, but by how much.
Bottom Line: NIH ultimately received a $3 billion increase to reach $37.3 billion in total funding. The increase is the largest since the FY 2009 stimulus, which directed $10 billion in one-time funding to NIH, and the largest in regular appropriations since FY 2003, when Congress was completing a five-year NIH budget doubling. Most institutes received increases of over five percent, and some got much more.
What's Increasing: Included in the general increase in institute budgets are several items:
- Congressional focus on Alzheimer's research continues, as the National Institute on Aging received an additional $414 million for related research, bringing the total to $1.8 billion.
- The BRAIN Initiative received $400 million, a 53.8 percent increase; the Precision Medicine/All of Us initiative received $290 million, a 26.1 percent increase. Both of these received much more than allocated via 21st Century Cures, which also enabled an increase to $10 million for regenerative medicine.
- The National Institute of Allergy and Infectious Diseases received $100 million for work on a flu vaccine, a 66.7 percent increase.
- The Clinical and Translational Science Awards (CTSA) program received a 5.2 percent increase to $542.8 million.
- A pair of National Institute of General Medical Sciences programs, the Institutional Development Awards (IDeA) and the Science Education Partnership Awards (SEPA), were both slated for 5.2 percent increases in line with the overall NIGMS increase.
- Legislators provided an additional $500 million for research on opioid addiction and alternatives, pain management, and addiction treatment, split between the National Institute of Neurological Disorders and Stroke and the National Institute on Drug Abuse.
- With a $3 billion increase, one might hope the success rate for research projects ticks upward in FY 2018. According to NIH data, the success rate for new awards fell slightly to 18.7 percent in FY 2017. This remains well below historical norms, though it has improved somewhat in recent years since the 2013 sequestration.
What's Decreasing: The likelihood (already low) that the Trump Administration will succeed in consolidating the Agency for Healthcare Research and Quality (AHRQ) within NIH. Appropriators rejected the proposal for FY 2018; the Administration has re-upped and expanded this proposal to include two additional consolidations in FY 2019.
What's New: Legislators mandated NIH to develop a multi-institute research strategy on Down syndrome.
In Historical Context: Adjusting for the rate of inflation in biomedical research, the omnibus roughly returns NIH to FY 2010 funding levels, and leaves the agency 11.5 percent below the historical peak in FY 2003. The NIH budget has increased by 13.1 percent since the 2013 sequestration year.
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