A future in which cancers are cured, heart disease prevented and devastating brain disorders reversed may just have gotten a bit more distant, leaders of the nation’s leading biomedical research organizations said Thursday.
In a budget blueprint that promises to “make America great again,” the Trump administration has proposed to cut $5.8 billion from the National Institutes of Health’s budget for fiscal year 2018, reducing its total spending to $25.9 billion. That would represent a roughly 20% decrease from its 2017 spending on biomedical research, which totaled $31.7 billion.
If approved, the proposed budget would reverse what has been a brief spurt in growth for the NIH after President Obama boosted its budget by $2 billion in 2016 and again in 2017.
Under President Trump’s proposal, NIH funding would lose almost as much ground in a single year as it did between 2003 and 2014, when inflation steadily eroded budgets that remained stagnant for a decade.
Leaders of scientific organizations across the country vowed to fight the proposed cuts. They warned that the administration’s proposal would blunt progress in improving the nation’s health and pointed to a recent congressional history of robust bipartisan backing for biomedical research.
“This is just a terrible proposal,” said Jon Retzlaff, chief policy officer of the American Assn. for Cancer Research. “To see a proposal that would gut NIH by 20% — that would put us back to the year 2000 in terms of funding. We’re astonished and dumbfounded.”
Noting that cancer research has “had so much momentum,” Retzlaff said that cuts of the magnitude proposed “will absolutely slow research” that could lead to new ways to prevent and treat the nation’s No. 2 killer, which claimed the lives of an estimated 595,690 Americans in 2016.
The Trump administration said its budget proposal “includes funds for … implementing the 21st Century Cures Act,” a law signed in December by Obama that calls for $1.8 billion in 2018 to accelerate cancer research and $1.6 billion to fund treatments for brain diseases.
“It doesn’t add up,” Retzlaff said. “If they’re going to support that ‘cancer moonshot,’ it makes no sense to cut the overall budget by 20%.”
Retzlaff’s ire was echoed by Dr. Gary Gilliland, president and director of the Fred Hutchinson Cancer Research Center in Seattle, which received more NIH funding in 2017 than any other cancer center in the country.
“We are at an inflection point in our efforts to develop cures for cancer and related diseases,” Gilliland said. He called the proposed cuts “indefensible” and warned that they “would severely impede our progress.”
Patients’ “lives are at stake,” he said. “We are fighting these cuts on behalf of our patients, our families and the entire scientific community.”
Even scientists that have been critical of the NIH rallied to its defense.
J. Craig Venter, a genetics pioneer and chief executive of the J. Craig Venter Institute in La Jolla, said the proposed cuts would forfeit American primacy in a sector where the United States enjoys “absolutely dominant leadership in the world.”
“This is an engine that drives our entire economy,” he said. “Our federal money can be better spent. But cutting these budgets will only make it 10 times worse.”
Faced with bare-bones budgets, Venter said, the NIH will put an end to any high-risk research. Like a drug company whose new CEO cuts costs by axing research and development, the U.S. could soon see its pipeline of innovative therapies has gone dry.
“The ones that suffer most are new investigators with new ideas,” he said. “It’ll just be a disaster for the U.S. economy.”
More than 80% of funding earmarked for the NIH leaves its sprawling campus in Bethesda, Md. Each year, its 19 institutes award close to 50,000 competitive grants to investigators at more than 2,500 universities, medical schools and other research institutions in every state and around the world. The University of California, for instance, received nearly $1.9 billion in total NIH funding last year, including more than $577 million for UC San Francisco.
At the Fred Hutchinson cancer center, NIH and other federal research funds make up 85% of the revenues earmarked for sponsored research. Gilliland said industry partnerships and philanthropic research “could never replace the federal funding needed to undertake and advance this critical research.”
The Trump administration’s budget blueprint does not get specific about how cuts to the NIH are to be apportioned. To save money, however, the plan does order “consolidations and structural changes across NIH organizations and activities.”
In a broad overview of funding for the Department of Health and Human Services, which oversees the NIH, administration officials said that the budget would eliminate “programs that are duplicative or have limited impact on public health and well-being.”
In keeping with Trump’s “American first” theme, the blueprint calls for eliminating the NIH’s Fogarty International Center, which helps helps build scientific capacity in other countries and coordinates the work of international scientists with American researchers.
That proposal drew a howl of protest from the American Society for Tropical Medicine and Hygiene, which argued that cutting off U.S. researchers from their collaborators abroad was “short-sighted and dangerous.”
“These cuts will put the health of millions of Americans at home and abroad at risk,” the organization said in a statement. In the last two years, the NIH’s National Institute of Allergy and Infectious Diseases has worked closely with researchers in other countries to develop vaccines for Ebola and Zika.
Dr. Georges C. Benjamin, who leads the American Public Health Assn., questioned whether Trump’s budget blueprint actually does put “America first.”
“Americans already live shorter lives and suffer more health problems than our peers in other high-income countries,” he said in a statement. “To become a healthier and more secure nation, we must invest in the health and safety of everyone, and not just in our military. Further cuts to the critical programs funded through discretionary health funding put us further away from this goal.”