As many of you already know, I am usually a man of many words, but last week after reading descriptions of President Donald Trump’s proposed budget, only one word came to me—“disturbing.” A former NIH Director during the George W. Bush era had another one—“catastrophic.” Many words have come to me since, but these two are still on my mind.
What is most disturbing about the President’s proposal is how it surgically targets science. The conventional wisdom in Washington is that the President’s budget (any Presidents’ budget) is dead on arrival at Capitol Hill. Congress jealously guards its spending prerogatives and loves to remind the White House that Congress—not the President—holds the strings of the U.S. taxpayers’ purse. But presidential budget proposals are priority statements. After studying this one, I am left with the conclusion that science does not appear to be a priority for America anymore. Improving human health, safeguarding our energy future, and caring for the earth, the oceans, and the air are no longer vital to the national interest. It is concerning that this budget, by slashing science investments, will consequently hinder evidence-based policy making.
Let’s start with the facts. The President is proposing a savage $5.8 billion (~20%) cut to the National Institutes of Health (NIH) and a $900 million cut to the Department of Energy’s (DoE) Office of Science, along with drastic reductions at the Environmental Protection Agency (EPA) Office of Research & Development, the National Oceanic and Atmospheric Administration (NOAA), and the National Aeronautics and Space Administration (NASA).
The President’s budget does contain some good news for science. In particular, I applaud the establishment of an Emergency Response Fund to cope with emerging biothreats. This would help avoid a mad scramble for resources during, for example, a pandemic crisis, a time when time and energy are better directed at action than administrative hurdles. Establishing this emergency fund was one of the recommendations that ASM made to the new Administration’s transition team, and I am glad it was included in the budget proposal. Last week ASM issued a statement recommending an allocation of at least minimum of $2 billion for this Emergency Response Fund. In addition, I am glad to see support for the Department of Agriculture’s Competitive Research Program and for key global health initiatives such as the Global Fund and the President's Emergency Plan for AIDS Relief (PEPFAR). This last is a program where ASM is deeply involved in training microbiologists in sub-Saharan Africa to build capacity for effective and rapid diagnostics to combat infectious diseases.
Despite these positive notes, this proposed budget, if it were implemented as proposed, would be a bad deal for the country. Let’s start from the economics. Nobel laureate Robert Solow studied the productivity function and described how capital, labor, materials, and energy combine to generate growth and increase welfare. Subsequently, other economists traced the sources of productivity growth, finding that innovation explained more than three-quarters of the post-1995 increase in US productivity! This underscores how innovation is the main engine of growth in our economy. Look at the impact of NIH spending—using standard Department of Labor methodologies (RIMS II), it is estimated that the $22.8 billion disbursed by NIH through its extramural research program created 352,349 jobs nationwide in 2015 while producing over $60 billion in new economic activities.
None of this measures progress like advances in human health, which is the central mission of biomedical research. Looking only at research areas where members of the ASM have been most active, we can see breathtaking impacts on human health. The CDC’s most recent data indicate that age-adjusted death rates due to influenza and pneumonia were halved from 1990 to 2014, from 36.8 per 100,000 population in 1990 to 15.1 per 100,000 in 2014. If we turn to HIV/AIDS, we can see the mortality rate of 10.2 per 100,000 individuals in the general population in 1990 drop to 2.0 per 100,000 by 2014. This is a fivefold decrease. In less impersonal terms, it means that medical research converted a virtual death sentence for those diagnosed with HIV into a chronic, manageable illness, giving patients a life expectancy very similar to the general population. This gives hope to millions in the U.S. and around the world who will be able to live, grow, work, and conduct productive lives.
Or we can look at the progress we made on finding renewable source to fossil fuels. In 2007 the George W. Bush Administration and the DOE Office of Science started the Bioenergy Research Center program in order to provide the basic science knowledge to advance the production of transportation fuels from the nonedible or lignocellulosic portion of plant biomass. By the Spring of 2016, these centers had filed over 500 invention disclosures, negotiated more than 100 licenses or options, and spawned the formation of more than a dozen startup companies. This is a rate of technology output that is remarkable and a glorious investment of taxpayer’s money. The knowledge produced by the Centers will create new revenue streams for farmers and biomass producers, form the basis of technology to support the needs of a growing industry, lead to new local jobs for biomass processors and refiners, and provide cost-effective and locally produced fuels and other products to consumers.
Science is hope. Without science, we will trap present and future generations in a dangerous status quo. Without science, we will become all prisoners of stagnant knowledge, caged up with existing maladies and vulnerable to new threats. Research and innovation are the keys to escape such a squashed future. Some may argue that this budget proposal would not shut down research completely, only save money that we cannot afford to spend. This is flawed thinking, in my personal view. Science is not a linear process, where given so much steel and so many engineers, a new machine will be built. Research science is not linear at all. Science is about the long haul, it is not a turn-key machine. What we stop today may, we may not be able to start again tomorrow. Budget cuts of this severity will cost us the next generation of scientists. Our universities will decline. We will no longer be able to attract talent from all over the world. This budget would cost us people, institutions, knowledge, but most of all it will cost us time. No budget can bring back lost time in scientific research.
We can lay off scientists, close labs, and turn away a generation of researchers, but we cannot so easily eliminate the daunting global challenges already confronting humanity. In microbiology, we are well aware of the growing menace of antimicrobial resistance. We run the risk of a world where simple wounds could once again become a common cause of death. Our global medicine cabinet is nearly empty as antibiotic-resistant bacteria proliferate. This is a world problem, with resistance reservoirs growing everywhere, including the US, where we don’t have the option of hiding inside a fantasy gasket-tight microbial border. The United Nations made antibiotic resistance a priority for the 2016 General Assembly. It is a priority that we no longer have the luxury of ignoring.
The Director of the NIH National Institute of Allergy and Infectious Diseases, Dr. Tony Fauci, recently published an interesting commentary on his involvement in advising five Presidents. Starting with Ronald Reagan, Fauci noted that each Administration was confronted with some sort of pandemic challenge. Scientific expertise, preparedness, and early response were fundamental to overcoming what seemed insurmountable threats at the time. But this was only possible because of the investments made in research over the years. It was the already accumulated basic biological knowledge that allowed those five Presidents to respond to each crisis.
Fauci’s perspective haunts me. My powers of prophecy are minimal, but it requires no crystal ball to expect that in the next four years, this administration will find itself facing at least a sixth major health crisis. It may be something old turned suddenly virulent or something local turned suddenly global. There should still be a considerable body of expertise and scientific resourcefulness around to draw on. But what of the seventh or eighth crisis to come? What of the next administration 8 or 12 years down the road? Who will respond to those calls? The American scientists who never were, the breakthrough that was never made, or the technology that was never discovered? Or will the Oval Office have to beg help from more scientifically advanced countries?
I still hope the President and his administration will appreciate the importance of funding science now and for the future. It was encouraging to hear the President’s remarks at the joint session of Congress on February 28, when he reminded all of us of the inventions that America was proud to display in 1876 for its 100th anniversary. President Trump went on to envision the scientific and technological wonders that America will be able to display in the upcoming 250th anniversary. As science advocates, we at ASM encourage the President to buttress the scientific enterprise, we are available to help the Administration in any way we can toward this common goal.