NIH Budget Makes Up Ground

Between 2003 and 2015, the NIH budget was largely stagnant, failing to keep pace with medical inflation. However, since 2015, four consecutive years of substantial increases have expanded the agency's budget by $9 billion, or 30%—a boost that has helped to remedy the situation.

“Budget increases for biomedical research need to be sustainable, predictable, and substantial to get us back on track,” says Roy Jensen, MD, director of the University of Kansas Cancer Center in Kansas City. “We've enjoyed great increases over the last few years, and the basis of that has been the fact that we've been able to demonstrate the value propositions that biomedical research brings.”

For example, Jensen has participated in the annual Rally for Medical Research Hill Day, the goal of which is to communicate the importance of funding biomedical research to members of Congress.

Most recently, Congress passed a budget bill for fiscal year (FY) 2019 that includes a $2 billion funding increase for the NIH, bringing the agency's total budget to $39.1 billion. The bill also provides a $179.1 million bump for the NCI. “I think this is a great demonstration of the bipartisan support that biomedical research has in Congress,” Jensen says.

Tannaz Rasouli, senior director of Public Policy & Strategic Outreach at the Association of American Medical Colleges in Washington, DC, adds that the 2019 budget was approved before the end of the fiscal year for the first time in 22 years, which she anticipates will have a positive effect on the NIH and the broader research community.

“It gives NIH so much more flexibility, I think, in terms of its strategic planning and its thinking about how to distribute the funding, and in turn, I think will give the research community that much more flexibility … to really make progress,” she says.

Rasouli notes that for the past 4 years, the NIH budget increase has outstripped annual medical inflation. Even so, the agency's funding is still 9% below where it was in FY 2003, after adjusting for medical inflation. “We haven't fully recovered yet, we still have a little way to go, but we've obviously made some really substantial progress,” she says.

Although Rasouli and Jensen are pleased with the increase, they are already looking ahead. Rasouli notes that 2019 marks the end of a 2-year budget deal that raised discretionary spending caps, which could present challenges for the NIH budget in 2020. Jensen also has concerns about growing U.S. budget deficits. “I think a major question going forward, considering where our national budget is right now, is whether or not this is going to continue,” Jensen says. “I'm anxious that reality is going to come back and smack us in the face here as soon as next year.”

Congress is in the process of finalizing a separate FY 2019 spending package that includes the FDA, along with transportation, housing, and agriculture. Until then, the agencies will continue to be funded at FY 2018 levels. –Catherine Caruso