If US Congress has any intention of following President Donald Trump’s proposal to knock a fifth from the National Institutes of Health’s budget, it has shown no signs of it. Legislation to fund the federal government until the end of its fiscal year adds $2bn to the world’s biggest funder of basic medical research, news that should come as some relief to the sector.
The omnibus spending bill is expected to face a House of Representatives vote today; it is the result of agreements made last year in passing the 21st Century Cures Act, which boosted NIH spending as well as promising streamlined FDA processes. While Congress is not supporting the same increases in biomedical research spending that it did in the 1990s and early 2000s, it at least appears to recognise the implications of stagnant NIH spending (White House budget undoes hard-won deals, March 17, 2017).
The budget agreement sets NIH spending for the year at $34bn, with a specified boost of $400m for Alzheimer’s disease to $1.4bn and the addition of $120m to its precision medicine initiative. The expanded NIH funding is the top item cited by House Minority Leader Nancy Pelosi in a statement supporting the omnibus spending bill, suggesting that the legislation is likely to pass easily.
The bill will also avert a government shutdown because of a lack of spending authority. Federal spending has been set at fiscal 2016 levels since September 30 under a series of short-term spending measures, the latest of which expires this Friday.
The $2bn in new spending specifies $352m in NIH activities related to 21st Century Cures, which backed the cancer “moonshot”. The funding was the carrot for federal agencies, with a stick being applied to the FDA to consider real-world evidence, adaptive trial designs and novel statistical modelling for drug approvals; the agency was also asked to offer accelerated review for regenerative advanced therapies.
Backing away from the NIH funding promises, as Mr Trump has sought to do, would represent an unravelling of the bipartisan agreement that got 21st Century Cures through – thus the eagerness for both Republicans and Democrats to follow through in this spending measure (Cures bill races toward US enactment, December 1, 2016).
Both Asco and the advocacy group Research America praised Congress for providing the new NIH funding, with Asco's chief executive, Clifford Hudis, saying the legislation would “reinvigorate the scientific community as it continues to rebuild after a decade of flat funding”.
That is, until the next budget deadline. The end of federal fiscal year 2017 is less than five months away, and with the White House looking for hundreds of billions of dollars to pay for tax reform every last billion in spending will need to be fought for.