Congress rejects Trump’s plan to cut NIH funding

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The US Congress has not only rejected President Donald Trump’s proposal for deep cuts to the National Institutes of Health but in a bipartisan move has increased funding on biomedical research.

Back in March, when US President Donald Trump released the first draft of his budget proposal for the coming fiscal year, he asked lawmakers for deep cuts to one of their favorite institutions, the National Institutes of Health – part of a broad reordering of priorities, away from science and social spending, toward defense and border security. The New York Times reports that six months later, Congress has not only rejected the president’s NIH proposal; lawmakers from both parties have joined forces to increase spending on biomedical research – and have bragged about it.

The Senate Appropriations Committee approved a bipartisan Bill last week providing $36.1bn for the health institutes in the fiscal year that starts next month. Senator Roy Blunt and the chair of the subcommittee responsible for health spending, said it was the third consecutive year in which he had secured a $2bn increase for the agency, amounting to an increase of about 20% over three years.

The report says Trump had proposed to cut funds for the health institutes by $7.5bn, or 22%, to $26.6bn. Congress pushed back hard. The president’s proposal “would have crippled American innovation in medical research, delayed new cures and treatments and brought NIH funding to its lowest level since 2002,” said Senator Richard J Durbin of Illinois.

The House Appropriations Committee, though less generous than the Senate, still approved a $1.1bn increase for the health research agency. Lawmakers on both sides of the Capitol said they expected the final figure to be close to the higher amount in the Senate Bill. “The spectacular increase provided by the Senate Appropriations Committee is amazing in the current fiscal environment,” said Anthony J Mazzaschi, a lobbyist at the Association of Schools and Programs of Public Health. “Neither the Senate nor the House paid much attention to the president’s recommendations.”

The report says the appropriations committees in both houses rejected Trump’s proposal to slash payments to universities for overhead — the “indirect costs” of research financed by the health institutes. These include the cost of utilities, internet service, data storage, the construction and upkeep of laboratories and compliance with federal rules protecting human subjects of clinical research. In identical language, the House and Senate Bills explicitly prohibit the Trump administration from changing the formula used for decades to calculate and pay indirect costs.

“The administration’s proposal would radically change the nature of the federal government’s relationship with the research community, abandoning the government’s long-established responsibility for underwriting much of the nation’s research infrastructure, and jeopardising biomedical research nationwide,” the Senate Appropriations Committee said in a report on its Bill. The proposed cuts, it said, could not be made “without throwing research programmes across the country into disarray.”

According to the report, Tom Price, the secretary of health and human services, had argued for the proposed cuts, saying they would not harm research. “About 30% of the grant money that goes out is used for indirect expenses, which, as you know, means that that money goes for something other than the research that’s being done,” Price told the House Appropriations Committee in March.

But, the report says, he won few converts. “Indirect costs are very real costs,” said Dr Landon S King, the executive vice dean of the Johns Hopkins University School of Medicine, and “there is not another source to pay for them.”

The Senate Bill provides a 29% increase in funds for research on Alzheimer’s disease, bringing the total to $1.8bn for next year. The House Bill provides a similar increase. The Senate committee described Alzheimer’s as “the most expensive disease in America.’’ The nation spends nearly $260bn a year caring for people with Alzheimer’s and other forms of dementia, with Medicare and Medicaid accounting for two-thirds of that amount, according to the Alzheimer’s Association.

The report says the House and Senate committees also rejected Trump’s proposal to eliminate a unit of the NIH that works with other countries to combat global health threats. “Disease knows no borders,” the Senate panel said. As evidence of its value, the committee pointed to the work of the NIH unit, the Fogarty International Centre, in fighting Ebola, Zika, malaria and many other diseases.

The actions on both sides of the Capitol amounted to a vote of confidence in Dr Francis S Collins, the director of the National Institutes of Health, who was appointed by President Barack Obama in 2009 and retained by Trump. Collins helped identify a gene responsible for cystic fibrosis and led the government’s successful effort to map the human genome, deciphering the instruction book for human DNA.

The New York Times report

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