Trump Administration Budget Rocks Medical Research Advocates

The skinny on President Trump’s slimmed down Fiscal Year 2018 budget is anything but positive for advocates of medical research.

In a White House budget officially released the morning of Thursday, March 16, the administration is proposing a sizeable reduction in funding for the National Institutes of Health (NIH) budget, putting forward a $5.8 billion cut from the current level (annualized to reflect the current continuing resolution). If enacted, the budget would reduce the agency’s total FY 2018 funding level to just under $26 billion. The cut to NIH comes as part of a much larger reduction to most domestic departments, agencies and programs—all made to facilitate increased spending on administration priorities including the Departments of Defense, Homeland Security and Veterans Affairs.

Few details beyond the top-level NIH amount have been released, including specific levels for each of the NIH’s 27 institutes and centers. However, the administration has proposed to fold the Agency for Healthcare Research and Quality (AHRQ) into the NIH, to eliminate the NIH center that supports global health, and to reorganize the NIH “to help focus resources on the highest priority research and training activities.”

The proposed cuts to an agency that has long enjoyed a sterling reputation among both Republicans and Democrats on Capitol Hill will be met with strong opposition. This past December, Congress enacted the 21st Century Cures Act, which provided a $5 billion increase over 10 years to the NIH in the interests of advancing a handful of priority programs, including the Precision Medicine Initiative (PMI), the BRAIN Initiative (which is focused on developing tools and technologies to better understand the workings of the brain), cancer research and regenerative medicine.

In addition, Senate and House appropriators have a lengthy history of working in a bipartisan manner to protect or grow NIH funding. In late 2015, Congress approved an appropriations package that increased NIH funding by $2 billion, and similar increases have been put forward for the still-incomplete FY 2017 spending package.

Notably, the president’s blueprint also recommends doubling (from $1 billion to $2 billion) user fees collected by the Food and Drug Administration (FDA) from pharmaceutical companies and medical-device makers for the agency’s review of new therapies and devices. These changes would need to be agreed to by Congress under FDA reauthorization.

The administration’s budget proposal is the starting point of a lengthy budget and appropriations process, the outcome of which will be heavily influenced by Congress Advocates for the NIH. Related programs will want to continue to work closely with congressional appropriators to underscore the importance of these programs, their impact on advancing scientific breakthroughs, and their connection to the discovery and development of new therapies and interventions.