For five years the NIH budget has lost ground to biomedical research inflation, estimated at 3.5-3.7 percent. Since FY 2004 this situation has cost NIH more than 10 percent in purchasing power. At the same time, annual funding has fallen far short of that needed to adequately support biomedical research opportunities. The FY 2008 NIH budget of $29 billion, minus the set-aside for the Global Fund for HIV/AIDS, is a meager 0.5 percent increase over FY 2007. The FY 2009 proposal requests flat funding for the NIH. This budget request will further weaken fiscal support for NIH, which expends more than 80 percent of its budget on research at about 3,100 institutions and is the largest single funding source for research at universities and colleges in the United States.
Because of flat budgets and expanding research opportunities, the success rates for NIH research grant applications continue to fall. This is a sobering predictor of slower technical innovation and medical advances. At the National Institute of Allergy and Infectious Diseases (NIAID), the number of research grant requests rose from 1,993 in 1997 to 4,900 in 2007, while success rates slipped from about 43 percent to 23 percent. The Institute's FY 2008 funding level was 2.3 percent below FY 2007, and the FY 2009 NIAID budget request will continue to slow research and training.
The continuing erosion of support for the NIH will reduce the numbers of talented trainees and students who choose a career in biomedical research. At risk is the next generation of biomedical scientists who would otherwise be able to capitalize on recent advances in deciphering the human genome and translating research advances into tangible improvements in human health. These setbacks to biomedical research, training and public health will continue unless the NIH budget is increased.
The NIH Reform Act of 2006 authorized a funding level of $32.8 billion for the NIH's FY 2008 budget, which illustrates how far the NIH budget, currently at a program level of $29 billion in FY 2008, has fallen behind Congressionally authorized levels of growth. Continuing fiscal shortfalls will weaken efforts of NIH to develop new therapies, vaccines, and diagnostics for a myriad of infectious and chronic diseases. To help reverse the ongoing erosion of biomedical research the ASM recommends that the FY 2009 NIH budget be increased by $1.9 billion. This increase will help to restore purchasing power that has been eroded by five years of flat funding and would provide some measure of growth for biomedical research.
Federal investment in basic and applied research has had enormous payoff in medical advances against chronic and infectious diseases. The following are just several examples of the changeable nature of both pathogens and their human hosts and why strong biomedical research programs must be sustained:
The NIAID supports research on a wide array of infectious diseases, from the more familiar killers like influenza to those less common such as dengue fever, a flu-like illness, which is now expanding in severity into new geographic areas, including the United States/Mexico border. Seasonal influenza kills about 36,000 Americans each year and is an ever present concern. Even more worrisome is the potential for pandemic influenza. Since the avian influenza virus H5N1 resurfaced in 2003, it has spread to more than 60 countries and infected more than 350 people of which over 60 percent died. NIAID scientists are collaborating with others worldwide to prevent a possible pandemic. Last year, for example, NIAID researchers identified genetic changes on the H5N1 surface that could permit easier entry into human cells, thereby suggesting potential approaches to improved surveillance and vaccines.
Widespread, sometimes indiscriminate, use of antimicrobial drugs is a growing public health concern, as mutating pathogens become resistant to increasing classes of therapeutics. Antimicrobial resistance is a significant challenge to biomedical researchers trying to understand the mechanisms involved and develop countermeasures. Recent surveillance studies report yet another newly emerging antimicrobial resistant pathogen, a multiple-drug resistant variant of the already problematic methicillin-resistant Staphylococcus aureus (MRSA). In 2005, MRSA was responsible for an estimated 94,000 life threatening infections in the United States and more than 18,000 deaths. The newly described variant of MRSA is resistant to even more drugs and causes more virulent skin infections. NIAID supported research is providing key information on resistant staph infections, like the just published studies identifying specific proteins secreted by MRSA that determine disease severity in humans. NIAID funded scientists have used comparative genome sequencing to reveal the origins of epidemic community associated MRSA.
The NIH Roadmap for Medical Research is also leveraging resources against persistent threats from infectious and chronic diseases through interdisciplinary teams, state-of-the-art technologies, and harmonization of clinical research efforts. The NIH's singular ability to impact biomedical research broadly is epitomized by the launch of a new Roadmap initiative: the multi center Human Microbiome Project to map the genomes of all microorganisms present in or on the human body, to better understand host-microbe interactions in both sickness and health. With next generation DNA technologies, researchers will eventually sequence 1,000 microbial genomes, results to be deposited in public databases for use in designing new treatments and better methods to prevent disease.
The United States cannot afford not to make greater investment in biomedical research. The continuing complacency that has led to the leveling off and erosion of support for biomedical research can diminish our defenses against both expected and unpredictable diseases. Also at risk are the nation's high quality scientific workforce, the tradition of technological innovation, and competitiveness in global markets, all nurtured by NIH supported research, laboratories and institutions. To assure the benefits from biomedical research the ASM strongly recommends that Congress increase the NIH budget by $1.9 billion for FY 2009.