Most people understand that the health care plans proposed by the Republicans would likely be disastrous to many people, especially to the 22-24 million likely to be shorn of their medical insurance coverage. Less appreciated, however, is the danger posed by the latest budget submitted by Trump that would cut the 2018 National Institutes of Health (NIH) budget by about 18.3%, or $5.8 billion. This important governmental department currently has an overall budget of $32 billion, with nearly 80% being awarded through competitive grants supporting more than 300,000 researchers at 2,500 scientific institutions throughout the U.S.A. and around the world.
Unfortunately, the president’s proposal has far-reaching negative consequences for public health, technology and drug development. What’s even worse is that if cuts of this magnitude pass, we will likely lose a generation of scientists—especially future young stars, who depend upon grants to support their initial progress, as exemplified by Mary-Claire King, professor of genome sciences at the University of Washington, whose early funding from NIH led to the identification of the BRCA1 gene and its role in inherited breast cancer. Another example is provided by Feng Zhang of the Massachusetts Institute of Technology (MIT), whose ground-breaking work with colleagues was supported by a 5-year NIH grant that resulted in a technique for editing the genome, CRISPR-Cas9, deemed the 2015 breakthrough of the year by the American Association fro the Advancement of Science. Basic breakthroughs of this type often support the development of new therapies by the applied bio-technical and pharmaceutical industries. Up to 47% of important, trans-formative drugs approved by the FDA between 1988 and 2005 benefited at least in part from public-sector support. Commercial companies often avoid such basic research for fear that the risk involved will not provide sufficient profits. Economists uniformly believe that public-sector funding for scientific research produces high returns, fills an important gap, and disruptions in spending may ultimately undermine the United States’ worldwide advantage in science, technology, engineering, and math. Experts have estimated that NIH-funded research of each $10 million has produced an average of 2-3 patents of important new products, a result that is unlikely to be matched by for profit commercial companies.
The NIH is at least partially responsible for an increase of life expectancy of the average American by 8 years (a 43% reduction in mortality) between 1970 and 2013 that includes deaths from cardiac disease, diabetes, stroke and cancer.
By forming partnerships between health research institutions in other countries, the NIH influence extends beyond our borders, These are critical for coordinated research and for developing effective responses to global epidemics of diseases such as HIV, Ebola, SARS, and others.
Most experts agree that cuts to the NIH of any magnitude will ultimately hamper long term scientific progress and adversely affect local, national, and global economies, while inhibiting discoveries that are essential for fighting disease worldwide.
The NIH has long enjoyed bipartisan congressional support, as evidenced by the 21st Century Cures Act at the end of 2016. This year marks the beginning of proposed 10 year funding aimed at the conquering of such diseases as cancer (remember Joe Biden’s Cancer Moonshot) and Alzheimer’s disease. These lofty goals are being threatened by funding restrictions proposed by the current administration. The NIH is our crown jewel, providing the foundation for U.S. competitiveness in worldwide discovery and better health for all. Undermining this system will rob us of the best and brightest minds and lead to a global impact with far-reaching consequences.
We should all urge the U.S. congress to continue providing bipartisan support to the NIH in the advancement of science, technology, and medicine in the 21st century.