LHHS subcommittee shows support for NIH during HHS appropriations hearing

by Tanner Godfrey

The Senate Subcommittee on Labor, Health and Human Services, Education, and Related Agencies met to discuss the 2018 budget recommendations and to question Secretary of Health and Human Services Tom Price. The President’s FY2018 budget proposes deep cuts to the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), Medicare and Medicaid. Senator Roy Blunt of Missouri, who chaired the session, opened by stating that he is committed to not cutting the NIH budget and won’t draft a bill for that cut. Price defended the President’s budget, stating that this was an effort to focus spending on programs that work.

Senator Richard Durbin of Illinois responded by asking, “Do I take it from that that you and the President have concluded that our medical research programs at the NIH have failed the American people?”

Secretary Price attempted to explain that they plan to fund the same number of grants and dollar amount per grant by cutting indirect costs, also called facilities & administration costs, or F&A for short.

This approach, however, also is threatening to scientific research. When a grant is awarded, 67-75% of the grant goes directly to the researcher for the cost of the research (supplies, equipment, salaries, students, etc.). The remaining amount goes to cover the research infrastructure and operating costs (laboratories, waste disposal, patient and animal safety, maintenance, administrative staff, etc.)

A statement from the Association of American Universities on indirect costs said:

Cuts to F&A research costs are cuts to research. If such cuts are made, they will reduce the amount of research universities and their scientists can conduct on behalf of the federal government to achieve key national goals to improve the health and welfare of the American people, grow the economy, and enhance our national security.

Furthermore, according to the congressional justification, NIH predicts with this proposed budget the grant success rate will drop to 13.7%, 1,648 fewer grants will be awarded, and less money will awarded with each grant as well.

The senators present were overwhelmingly supportive of NIH and appeared to be very reluctant to proceed with the President’s budget request. Senator Durbin emphasized, “This chairman along with the ranking member, and I might add Senator [Lamar] Alexander to this combination, have really staked out a grounds in the last two fiscal years that I think is the right path for America. 5% real growth in medical research funding across America, I am ready to debate that in any district, in any state in America; that is money well spent!”

House appropriations committee inquires about proposed NSF cuts

By Tanner Godfrey

The House Committee on Appropriations Science Subcommittee met to discuss the FY18 National Science Foundation (NSF) budget with Director Dr. France A. Córdova as a witness. Dr. Córdova spoke of the advances through NSF funded research touching on topics such as driverless cars, artificial intelligence to predict septic shock, 3D printing organs, and the detection of gravitational waves. The FY18 budget proposes an 11% cut in funding to NSF, the first cut in the organization’s history. If passed, this cut would directly affect the number of new grants awarded by a similar margin. Furthermore, the committee expressed concern for the impacts of decreased funding for cyber security, STEM education and diversity in science.  The representatives present were very supportive of NSF and requested that scientific community speak to their representatives and senators to encourage them to support funding for science. The full video of the hearing as well as Dr. Córdova’s testimony can be found here.

NIH reverses decision on grant cap; creates fund for young investigators

The National Institutes of Health (NIH) has reversed its decision to cap the number of grants that an investigator can receive after pointed opposition from some members of the scientific community and Advisory Committee to the Director. The NIH will instead create a pool of money reserved for early career investigators and mid-career investigators in danger of leaving the research workforce due to lack of funding or who are seeking their second award.

Initially, the NIH created a grant support index (GSI) that assigned a value to each type of research project grant. Under the initial plan, the NIH would essentially limit the number of grants any investigator could hold at once to the equivalent of three single-principle investigator R01s. The NIH estimated that this would create 1,600 new awards that could be more broadly shared among the research workforce. The plan was based on data that showed diminishing returns in productivity after an investigator received a certain number of grants and data that showed the difficulty early and mid-career investigators had in obtaining funding.

The GSI received positive feedback from many members of the scientific community, such as from Future of Research. However, negative feedback to the plan, prompted NIH officials to scrap the GSI and replace it with the Next Generation Research Initiative (NGRI). This new plan will reserve $210 million this year for early and mid-career investigators with the goal of increasing this fund to $1.1 billion dollars per year over 5 years if the budget allows.

The NGRI was announced at the latest meeting of the Advisory Committee to the Director. The NIH is accepting feedback through NIH Deputy Director for Extramural Research, Dr. Mike Lauer’s, blog or at publicinput@od.nih.gov. Information about the new research initiative will be communicated through the NGRI website.

AADR will continue to track developments with this initiative. Please contact Science Policy Analyst, Dr. Seun Ajiboye, at sajiboye@iadr.org with any questions, concerns and feedback.

Collins reappointed as NIH Director

The Trump administration has announced that Dr. Francis Collins will be reappointed as Director of the National Institutes of Health (NIH). Dr. Collins was originally appointed NIH Director by the Obama administration in 2009, having worked on former President Obama’s transition team.

At the end of each administration, political appointees turn in resignation letters to allow the incoming administration to select new personnel. Dr. Collins expected to finish his tenure with the Obama administration but indicated that he wanted to continue as the Director under Trump. Dr. Collins continued to serve on a temporary basis after President Trump took office until a permanent replacement could be named. However, Dr. Collins enjoyed broad support from the research community as well as members of Congress. In an unprecedented step, Republican leaders sent a letter to  President Trump urging him to reappoint Dr. Collins as the head of the NIH. President Trump met with Dr. Collins on many occasions both before and after the President’s inauguration, but Dr. Collins’ future at NIH was unclear until now.

AADR congratulates Dr. Collins on his reappointment and looks forward to continuing to work with the Director and the NIH to support and advance biomedical research.

 

AADR and FNIDCR submit testimony to LHHS

AADR president, Dr. Raul Garcia, submitted written testimony to the Senate Subcommittee on Labor, Health and Human Services and Education on behalf of AADR and Friends of the National Institute of Dental and Craniofacial Research (FNIDCR). The testimony outlined AADR and FNIDCR’s budget requests for various agencies for FY18. These requests included a $2 billion increase over FY17 levels for the National Institutes of Health and $452 million for NIDCR. AADR and FNIDCR also expressed support and funding requests for other agencies important to dental, oral and craniofacial research and training, including the Agency for Healthcare Research and Quality, the Health Resources and Services Administration and the Centers for Disease Control and Prevention.

 

NIH estimates 14% research project grant success rate based on FY18 budget proposal

The National Institutes of Health (NIH) has released its FY18 congressional budget justification. The congressional budget justification explains the agency’s budget request to the appropriations committees in Congress by providing estimates for how the budget will be used for the activities of the coming fiscal year. For FY18, President Trump proposed an NIH budget $26.9 billion, a more than 20% cut from FY17 omnibus level. At this funding level, the NIH predicts a 13.7% success rate for competing research project grants. This would be down from the FY16 success rate of 19.1% and the lowest success rate since 1970 (“Research Project and R01-equivalent grants: Success rates, 1970-present“), the earliest date for which the NIH has data. The impact of the FY18 budget request on the grant success rate for each individual institute was not available.

AADR joins 148 other organizations in an AAAS-led letter to congress supporting federal investment in R&D

AADR joined 148 organizations in a sign-on letter urging congressional leaders to reject the proposed cuts to federal science agencies in President Trump’s proposed FY18 budget. In addition to a 20% cut to the National Institutes of Health, the presidential budget proposes cuts to agencies conducting research in energy, agriculture, defense, and climate change.

In the AAAS-led sign-on letter, 149 professional scientific societies and universities reminded House and Senate Republican and Democratic leaders about the the critical role of research and innovation in driving American prosperity and job creation:

For many decades, the American people and our economy have reaped the enormous benefits of federally-supported research. It is time again for the bipartisan foresight of U.S. policymakers to prevail in support of research. For FY 2018, we urge you to reject the Administration’s proposed cuts to research investments and negotiate increased discretionary spending caps for next year and beyond that will permit sufficient federal research investments and sustain our nation’s status as the world’s innovation leader.

AADR will continue to monitor developments regarding the FY18 budget and notify members of how to engage and advocate for research funding.

President proposes 20% cut to NIH

by Tiffany Kaszuba

Today, President Donald Trump released his first full budget proposal, outlining his fiscal priorities for fiscal year (FY) 2018 and beyond. Overall, the budget cuts $54 billion from the nondefense discretionary budget, from which the National Institutes of Health (NIH) derives its funding, to increase spending at the Pentagon. NIH specifically was cut $7.2 billion, or 20 percent, in the proposal from levels passed in the FY 17 omnibus. The National Institute for Dental and Craniofacial Research received a similar hit, with the White House suggesting a 25 percent cut bringing the Institute’s budget down to $321 million.

These draconian dollar cuts were coupled in the budget with some policy proposals that are concerning to the science community including elimination of the Fogarty International Center. Under the President’s budget, the center’s staff and functions would be maintained throughout the remaining institutes and centers. However, this would be difficult given the additional strain on the individual institute budgets which are already seeing upwards of 20 percent cuts to support their current portfolio.

Further, the White House Budget proposes changes to indirect costs both in the process for receiving them and how much investigators will be eligible for. Historically, NIH has covered, on average, approximately 30 percent of indirect costs and required a significant amount of paperwork. Under President Trump’s proposal, that paperwork would be reduced in exchange for a uniform indirect payment rate of 10 percent.

Other changes would include consolidating the Agency for Healthcare Research and Quality into the NIH. Of the total NIH budget, $272 million would be dedicated to supporting the health services research that is currently housed at AHRQ. This would represent a cut equal to more than a third of AHRQ’s current budget, significantly reducing the amount and quality of research into how care is delivered, and further straining the resources available for biomedical research at NIH.

NIH was not the only loser in the President’s Budget. In fact, every agency within the Public Health Service was cut, putting at risk Americans’ health in the name of national security. However, it is important to note that it is Congress and not the President that makes the final spending decisions. In order to fund the NIH, NIDCR, and all of the public health agencies sufficiently and protect America’s health, Congress must acknowledge that both defense and nondefense programs contribute to our nation’s security and pass a budget that provides equal relief from the painful budget caps.

AADR submits ideas to NIDCR 2030

AADR has submitted comments to the National Institute of Dental and Craniofacial Research (NIDCR) for NIDCR 2030, the institute’s strategic planning initiative to guide the next 15 years of dental, oral and craniofacial research. NIDCR will use ideas submitted by stakeholders to plan future workshops and research initiatives. The number of votes each idea receives will help determine which ideas receive future emphasis and are translated into funding initiatives. Voting is open until June 2. Please visit the following links to vote for AADR’s submissions:

Workforce diversity

AADR applauds the inclusion of workforce diversity in NIDCR 2030. AADR recommends using data-driven and targeted methods to increase participation by underrepresented groups. NIDCR should also work to stabilize representation throughout the research career. In addition to increasing the diversity of the pool of potential researchers, NIDCR should also look to increase retention of researchers from diverse backgrounds at all career stages, especially the vulnerable career transition phases.

Oral Health and Aging

Research addressing the oral health of the aging population is urgently needed. The US “65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050” (National Institute of Aging). According to the 2011-2012 National Health and Nutrition Examination Survey, 25% of adults 75 and older were edentulous. NIDCR should prioritize research on the impact of aging on care as well as implementation research on interprofessional education and care.

Polymicrobial synergy

Oral diseases (as well as most other inflammatory diseases of the mucosae) are known to be triggered by the immunopathology resulting from the overabundance of particular combinations of species in the flora. There are now numerous microbiome studies of different inflammatory diseases, and it is becoming clear which species are associated with each of these diseases. However, extremely little is known about the mechanisms of polymicrobial synergy in oral and other diseases.

Link basic and applied periodontal disease/caries research

Some members of the dental community have expressed concern that periodontal disease and dental caries do not receive adequate research funding. However in AADR’s view, this concern is not being inclusive of the basic research findings that can be applied to the understanding, prevention and treatment of these diseases even though the specific aims of the project do not directly address periodontal disease and dental caries.

Novel Bioactive Materials

Recent trends in dental materials manufacturing demonstrate the increased inclusion of antibacterial and bioactive components in a variety of materials. Based on the reasons for failure of dental composites, and the higher than ideal failure rate, novel materials with bioactive additives that can inhibit disease and repair or replace lost tissue are essential.

AADR is also supporting the following ideas and encourages voting for them:

Precision Public Health to Avoid Increasing Health Disparities

Precision public health & precision population health (Khoury, 2016) are vital for precision health to create precision prevention, since 1/3 of mortality is preventable thru modifying social disparities in health (eg tobacco use, low physical activity, poor nutrition). Neighborhood- (eg census tract tobacco use prevalence and census tract air quality reports) and individual-level data (eg nicotine metabolic rate) could provide more precise prevention without increasing health disparities.

Promoting Diverse Investigators Through Mentoring Pilot Projects

For 20 years, NIA has funded the Resource Centers for Minority Aging Research (RCMAR). The main function of each RCMAR is its Investigator Development Core (IDC). Annually, IDCs solicit pilot project proposals (1 yr, $25-$30K) from local junior, minority investigators. Pilot projects are intended to provide preliminary results for subsequent NIH proposals. IDCs provide mentoring to awarded scholars, at least up through their first successful NIH grant award. NIDCR could do something similar.

Please click here for the full comments.

AADR submits comments on FY19 Trans-NIH HIV-Related Research Plan

AADR submitted comments to the Office of AIDS Research (OAR) on the FY19 Trans-NIH Plan for HIV-Related Research. AADR encouraged inclusion of oral health-related research objectives and consideration of oral tissues in treatment and prevention strategies.

For FY19, OAR requested input on the following high priority research areas:

1) Reducing the incidence of HIV/AIDS
2) Developing the next generation of HIV therapies
3) Identifying strategies towards a cure
4) Improving the prevention and treatment of HIV-associated comorbidities, coinfections, and complications
5) Cross-cutting basic research, behavioral and social science research, health disparities, and training.

OAR conducts an annual comment period to engage the research community in creating its annual strategic plan. This plan helps direct OAR research priorities for the year. OAR receives appropriations from Congress and then allocates these funds to institutes at the National Institutes of Health to support HIV and AIDS research. In FY16 and 17, the National Institute of Dental and Craniofacial Research received $18 million from OAR.