‘2013: A bad year to have a good idea’

WASHINGTON, D.C.—American biomedical researchers are beingforced to make difficult decisions as they grapple with the rippling effects ofsequestration, or $85 billion in across-the-board cuts to governmentspending—with their primary benefactor, the U.S. National Institutes of Health(NIH), bracing for the expected loss of 5.1 percent of its already stretchedresearch funding budget.

"2013 is a bad year to have a good idea," Dr. LauraNiedernhofer, associate professor of the Department of Metabolism & Agingat Scripps Florida, told the Federation of American Societies for ExperimentalBiology (FASEB) in its recent report, "Sequestration Cuts Biomedical andBiological Research."

Concerns over government funding cuts have loomed over theAmerican medical research community for more than a year. With the UnitedStates' debt-ceiling crisis keeping lawmakers up at night, Congress in August2011 passed the Budget Control Act (BCA) of 2011, which provided for a JointSelect Committee on Deficit Reduction to produce legislation by late Novemberthat would decrease the deficit by $1.2 trillion over the next decade. When theso-called "super committee" failed to act, a portion of the BCA went intoaffect that directed automatic sequestrations split evenly between defense anddomestic spending beginning Jan. 2. The debate's resolution, the AmericanTaxpayer Relief Act of 2012 (ATRA), then reduced some of the planned cuts anddelayed budget sequestrations for two months.

Failing to reach a budget compromise, the research communityfinally learned its fate on March 1, when sequestration went into effect: $85billion will be slashed from government departments, agencies and programs thisyear. In particular, the NIH says it will lose $1.6 billion of its $30-billionbudget in fiscal-year 2013.

The NIH's budget for biomedical research has already beenstretched thin for about the past decade, notes the agency's director, Dr. FrancisCollins.

"After boom times, since 2003, the NIH budget has alreadylost about 20 percent of its purchasing power by flat budgets that have beeneroded by inflation," he says.Consequently, the chances of grant-seekers being awardedfunds from the NIH decreased from about 1 in 3—a probability that existed fornearly half a century—to about 1 in 6, and the sequestration will drop thatlikelihood even further, says Collins.

According to Collins, each of the NIH's 27 institutes arerequired to take the same cuts, and "we have no opportunity to do any shiftingaround among institutes," he says, but adds, "each of the institute's directorshas the ability to spread the pain between grants and contracts in theIntramural Program, but there aren't going to be any easy answers there."

No disease area will be spared the cuts, and Collinslamented that progress will be significantly slowed in fast-growing areas ofunmet medical need such as cancer, Alzheimer's disease and influenza.

"We will try to prioritize those things that seem criticalfor public health, but there is no way to eliminate consequences for all ofthese projects," he says.

Thanks to the ARTA, the cuts are slightly less painful thanthe 11.1 percent, or $2.8 billion, in cuts to the NIH's extramural budget thatFASEB estimated in what it called a "conservative" analysis released in May2012, but the effects of the cuts are still going to be "devastating" forresearchers in every state, notes the organization's president, Dr. Joseph C.LaManna.

"More than 80 percent of NIH funding is distributed toresearchers in nearly every Congressional district in the United States," henotes.

"What the NIH has told us is that all research areas aregoing to be affected," adds LaManna's colleague, Jennifer Zeitzer, FASEB'sdirector of legislative affairs. "It has to cut all of its budget, and it can'texempt any research areas. It's getting harder and harder to get a grant fromthe NIH. People are really carefully considering the cuts when they submitgrants. All grants submitted last year may be in limbo and not be funded. We'reseeing a lot of anxiety in the community."

With the NIH supporting about 430,000 jobs, about 20,000"high-paying, high-quality" jobs will be lost, says Collins. Of particularconcern to the NIH is the impact the cuts may have on job opportunities foryoung, up-and-coming scientists.

"I worry deeply that we are putting an entire generation ofscientists at risk by the very significant difficulty they see in obtainingsupport," says Collins. "I think unless something turns the corner pretty soon,a number of our most talented young scientists will basically decide to dosomething else."

Dr. Curt Civin, associate dean of Research at the Universityof Maryland School of Medicine and director of the Center for Stem Cell Biology& Regenerative Medicine, has a successful research career spanning severaldecades—backed by millions of dollars in NIH funding—but says he worries that"we are turning off our future and turning off the pipeline of new ideas."

"If you have competition to get a grant, and you have a veryexperienced investigator with a long track record of success, and a youngwhipper-snapper who seems like he has a great idea, but not as much experiencebehind him, who are you going to fund?" Civin asks. "In addition, everyone whohas a grant is going to have cuts. How do we deal with those cuts? In anygrant, the biggest category of budget items is people. It's hard to cut peoplefast, but if you have a post-doctorate or graduate student finishing up or atechnician who has another job offer, you don't replace them. There are thekinds of economies we'll be making, and science just isn't good on a budget."

The result will be the loss of thousands of talented youngscientists to other countries where government research funding is moreplentiful and prioritized, says Civin.

"We will start to eat dust in that direction," he says."Europe and China are expected to double any biomedical research investmentsthey are making. We have excelled and led the way for so many good discoveries,and done so many good things for society, but this will not be kept on ourshores."

Dr. Kerri A. Mowen, assistant professor in the Departmentsof Chemical Physiology & Immunology and Microbial Sciences at the ScrippsResearch Institute in La Jolla, Calif., tells ddn she is already losing colleagues to South Korea, Singapore andIndia "because those places are increasing their investment in research." Withher lab, which focuses on autoimmune disease research, heavily reliant on NIHfunding, "I don't know that we'll exist anymore," she admits.

"Maintaining my lab completely depends on maintainingresearch funding. Rather than doing the very best, informative experiments, weare doing what we can afford," she says.

Mowen asserts, "all cuts are not created equal. That iswhere the failing really is in the sequestration. If I were the owner of asmall business, I wouldn't make decisions that cause my business to shut down.We have to recognize which parts of the budget are investments, and what willlead to economic growth. That is what we really need to get out of this entiresituation."

At press time, President Barack Obama released a 2014 budgetproposal that seeks to cancel sequestration and replace it with an additional$1.8 trillion in deficit reduction through new revenue, $400 billion in savingsand $200 billion in discretionary cuts split evenly between defense andnondefense programs in 2017. That budget provides $31 billion for the NIH, aslight increase over the pre-sequestration amount provided for the agency.

"Biomedical research contributes to improving the health ofthe American people, as well as the economy," Obama said in a statement."Tomorrow's advances in healthcare depend on today's investments in basicresearch."

For now, the sequestration cuts remain, and ultimately, theymay have a significant impact on human health, says Jim Greenwood, presidentand CEO of the Biotechnology Industry Association, or BIO.

"There are many sick people out there hoping for newtreatments and cures. We fear that sequestration may impact the FDA's abilityto review and approve these products in the timeliest of fashions, thusimpacting patients' ability to access these treatments in a timely manner. Itis our hope that Congress and the president will work together to find a way toend the sequestration."

A rallying point for cancer research

AACR demonstration calls on Congress to spare NIH fromsequestration cuts

By Jim Cirigliano

WASHINGTON, D.C.—On April 8, the American Association forCancer Research (AACR) shut down its Annual Meeting 2013 to join nearly 200partnering organizations in a rally to support government funding of medicalresearch funding.

Officially dubbed the Rally for Medical Research, organized bythe AACR, the rally's specific call to action was to spur Congress to spare theU.S. National Institutes of Health (NIH) from the mandatory budget cuts broughtabout by the sequestration. The NIH lost $1.6 billion in federal funding formedical research when sequestration cuts went into effect on March 1.

Participants demonstrated on the Carnegie Library grounds atMt. Vernon Square in downtown Washington. AACR meeting attendees wereencouraged to participate; those who did were joined by cancer patients,physicians and advocates from around the country looking to voice their supportof sustained investment in the NIH's medical research.

Speakers featured at the rally included RockefellerUniversity President Dr. Marc Tessier-Lavigne, AACR CEO Dr. Margaret Foti, U.S.Reps. Rosa DeLauro (D-Conn.) and Chris Van Hollen (D-Md.) and formerCongressman John Porter (R-Ill.), along with several survivors and patientadvocates. ABC News political analyst and National Public Radio (NPR) seniornews analyst Cokie Roberts served as the rally's emcee.

"Listening to the patient advocates was really touching,"says Tabitha Bauman, a spokesperson for Rockland Immunochemicals. "They hadamazing stories, which were probably the highlight of the whole event."