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.

AADR opposes delay of “deeming” rule implementation

AADR and 50 other organizations signed onto a letter addressed to Department of Health and Human Services Secretary Tom Price opposing the delays in implementing the Food and Drug Administration’s (FDA’s) “deeming” rule. The “deeming” rule, finalized in May 2016, extends the FDA’s regulatory authority over tobacco products to include e-cigarettes, all cigars, hookah tobacco, pipe tobacco and nicotine gels that went on sale after February 15, 2007. The delay pushes several compliance dates back until late 2017 or 2018. These include requirements that manufacturers display health warnings on cigar packages and advertisements and disclose the ingredients of newly regulated tobacco products such as e-cigarettes.

From the letter:

The public health justification for regulation is as compelling now as it was a year ago, when the FDA issued the final deeming rule. There is, therefore, no basis for a reconsideration of the rule or a failure to defend it strongly in court. Every day of delay in its full implementation subjects the public to the continuing public health threat of unregulated, highly addictive and dangerous tobacco products, many of which come in sweet or candy flavors which are designed and marketed to appeal to children.

AADR supports bill prohibiting smoking at veterans’ facilities

AADR and 43 other organizations have signed onto a letter supporting a bill that would prohibit smoking at Veterans Health Administration (VHA) facilities if passed.

The bill was introduced by Representative Brad Wenstrup (R-OH, 2nd District), Iraq War veteran and Chairman of the Subcommittee on Health of the House Committee on Veterans’ Affairs. Current law permits the sale of tobacco products at VHA health facilities – although the VHA banned this practice since 1991 – and requires VHA facilities to provide indoor smoking areas.

The VHA has been using its authority to denormalize smoking and reduce exposure to second-hand smoke in and around its facilities for some time while still remaining within the requirements of the law to provide smoking areas. In addition to banning the sale or distribution of tobacco products, a 2008 directive (link downloads PDF from external site) required that indoor smoking areas take the form of smoking shelters detached from the health facility and that smoking areas should be at least 35 feet away from VHA buildings whenever possible.  Representative Wenstup’s bill would free VHA from the requirement to provide any designated smoking areas and would prohibit smoking indoors within 90 days of passage of the bill and smoking outdoors after October 1, 2022. This bill prohibits smoking of combustible tobacco products and e-cigarettes. Previous attempts to prohibit smoking at VHA facilities have been strongly opposed by the tobacco industry.



Appropriations Bill Now Law

On Friday, President Trump signed the Consolidated Appropriations Act, 2017 (H.R. 244) into law. This legislation was approved by a 309-118 vote in the House and a 79-18 vote in the Senate. This legislation includes a program level of $34.084 billion for NIH, a $2 billion (6.2 percent) increase over FY2016, including the $352 million provided through the 21st Century Cures Act in FY2017. Also, this bill includes $425.7 million for the National Institute of Dental and Craniofacial Research a $13 million increase from the FY2016 enacted level of $412.7 million.


A Deal on the Fiscal Year 2017 Appropriations Bill

This week, Congress reached a deal on the fiscal year (FY) 2017 appropriations bill to avoid a government shutdown this week and fund the federal government through the end of September. This legislation proposes $34.084 billion for the National Institutes of Health (NIH) an increase of $2 billion from the FY16 level of $32 billion and $425.7 million for the National Institute of Dental and Craniofacial Research (NIDCR) which is a $13 million increase over the FY16 enacted level of $412.7 million.

It is important to note that Congress rejected the Administration’s proposal to cut NIH by $1.2 billion in FY17. The increased funding provided in this bill for the remainder of the fiscal year for NIH and NIDCR represents a significant advocacy win for AADR and the broader biomedical research community. Since the beginning of the year AADR and our members conducted nearly 100 meetings with members of Congress and their staff; sent over 500 email messages to Congress; issued a statement; and sent a Friends of NIDCR letter signed by 63 organizations, patient advocacy groups and dental schools encouraging Congress to increase funding for NIH and NIDCR.

AADR advocacy reached historic levels during the past three months and the efforts of the AADR community did not go unnoticed by Congress.

According to the House Appropriations Committee summary of the bill the legislation provides, “Specific increases (at NIH) for research related to Alzheimer’s disease, the brain, antibiotic resistance and the Precision Medicine Initiative. The bill also provides a general increase to all NIH Institutes and Centers to continue progress in developing new treatments and cures, including increases for Clinical and Translational Science Awards and Institutional Development Awards.”

This legislation also provides the following funding levels:

  • $289 million, a nearly $9 million increase for the National Institute on Minority Health and Health Disparities
  • $18 million, level funding for the Centers for Disease Control and Prevention Division of Oral Health
  • $36.6 million an increase of $800,000 for the Health Resources and Services Administration Title VII oral health training program
  • $324 million, a $10 million decrease for the Agency for Healthcare Research and Quality
  • $160.4 million, level funding for the National Center for Health Statistics
  • $7.472 billion, an increase of $8.7 million for the National Science Foundation.

The bill provides the following report language:

  • HRSA Oral Health Training Report Language: The agreement includes an additional $800,000 for the Dental Faculty Loan Repayment Program under section 748 of the Public Health Service Act. The agreement directs HRSA to publish a new funding opportunity announcement and to give preference in grant awards to pediatric dentistry faculty supervising residents and to applicants providing clinical services in dental clinics located in dental schools, hospitals, or community-based affiliated sites.
  • NIH Report Language: The agreement expects NIH to support a consistent NIH-wide inflationary policy across all ICs that is no less than the general increase provided to all ICs (3.0 percent) for non-competing grants. The agreement expects that NIH will continue its focus on emerging investigators and first-time renewals of these young investigators with actions to significantly reduce the average age of an NIH-supported new investigator. The agreement expects NIH to support the number of Ruth L. Kirschstein National Research Service Awards and other training grants in proportion to at least the general IC level funding increase. The agreement expects NIH to provide a stipend level and inflationary increase to grantees that is at least consistent with any fiscal year 2017 Federal employee pay raise.

What’s Next? Congress will vote on the bill and the President is expected to sign it into law. After this legislation is approved, Congress is expected to begin working on the FY18 appropriations bill. As a reminder the President’s FY18 skinny budget proposed a $5.8 billion cut to NIH. Advocacy efforts will be critical during the next couple of months. Stay tuned for additional opportunities to engage with your members of Congress and their staff.

 For additional information
Click here to read the FY17 report language
Click here to read the summary of the bill