The Debt Ceiling Deal and Health Research

Time is running out to cut a deal. On August 2nd, the US debt ceiling will be reached and meanwhile, talks between the White House and Congressional leaders have stalled.

If Republicans and Democrats can come to an agreement it may be a short term increase in the debt limit to provide additional time for negotiations. However, President Obama has indicated that he has little interest in short-term measures and prefers to craft a far-reaching compromise that could fundamentally alter the fiscal state of the federal government.

If a major deal can be struck, it will likely contain spending cuts and possibly caps for government programs. On the mandatory side, these cuts could mean reduced benefits for Medicaid, Medicare, and Social Security beneficiaries. The cuts could be dramatic as these programs are considered to be the primary driver of federal spending and have seen unprecedented growth in recent years.

On the discretionary side, caps would limit the amount by which agency budgets are able to grow. The NIH budget, for example, is currently at about the $31B level for this fiscal year. A long-term cap on discretionary spending could place restrictions on spending by budget function, which is a high-level aggregate of spending. The NIH and health research fall into the function 550 category, which is broadly labeled ‘health.’

Caps or cuts to the health budget function could place major constraints on the nation’s ability to carry out health research. In the short term, appropriations hearings are underway in the House and these decisions may impact the makeup of a broader compromise over the debt ceiling and federal spending.

Health research is an engine for innovation critical to the future of our economy, and a source of treatments and cures critical to the health of our population. Act now so your representatives know that cuts to research should not be part of any deal now or in the future.

Spending cuts again?

Source: Chip Somodevilla/Getty Images North America, September 15, 2010

Appropriations season is upon us! This is that special time of year when Congress makes funding recommendations for all discretionary programs. I wanted to take this opportunity to provide a quick rundown of how health research agencies have fared, and what the prospects are for the next fiscal year.

As part of the recent FY 2011 budget deal, the White House and Congressional leaders agreed to a budget that would fund the government through September 30, 2011. Remember, this was the 11th hour deal that narrowly averted a government shutdown. However, this deal resulted in budget cuts to several health research agencies.

NIH was cut by $320M (1.2%), CDC received a whopping 11% cut – dialing their funding back to 2003 levels, the NSF was cut by $53M, which will mean about 250 fewer awards, and the Agency for Healthcare Research and Quality was cut by $25M (6%). The FDA was given a $107M boost in funding (for FY 2011), but the House recently passed an FY 2012 cut of $285M.

In general, the House is highly averse to any new spending and is even reluctant to accept flat budgets for discretionary agencies. Many of the new Members in the House feel that they are in office to slash agency budgets and deeply cut government spending.

On the Senate side, Members are more open to flat-funding government agencies. It’s hard to say what all of this will mean for health research in the FY 2012, but given the current political climate and state of our national debt, we can expect cuts to continue.

That is why it is more important than ever that you reach out to your representatives and let them know that further cuts are unacceptable. At the end of the day you are their constituent - this means that your representative’s work for you. If you talk, they will listen.

An Issue Close to my Heart

The heart is an amazing organ. I work on heart development which makes me a little biased, but let me tell you why I think so. Every cell in your body requires oxygen and the way oxygen gets around is in blood. The heart is required for pumping blood that has been loaded up with oxygen to the tiniest capillaries in your brain and the very tips of your fingers and toes. Once the blood has given up its oxygen, it has to be pumped back from the furthest reaches of your body to your lungs to reload. The heart does all of that pumping. But wait- there’s more.

The heart is one of the first organs to form during embryonic development. It starts out as a simple tube but quickly folds up and pinches off into hollow chambers. Think of those balloon animals you got at birthday parties as a kid, that’s what your heart has to do only it has to work while it’s doing it! This is something like driving a car while building its engine at the same time.

Needless to say, heart development is very complicated and a lot of things can and do go wrong. In fact, congenital heart defects are one of the most common birth defects in America and the leading cause of birth defect-related death. Heart defects are present in 50 out of every 1000 live births. Apart from the emotional difficulties of dealing with these illnesses, they also come with a high economic cost. The lifetime costs associated with heart defects for all of the babies born in a year exceeds $1 billion.

While physicians have made a lot of progress in diagnosing and repairing these defects, little is known about what causes them. This is where basic science comes in. Scientists are hard at work trying to understand how the heart forms and what genes are involved in the process. We have to first understand normal development if we want to figure out what is going wrong when defects occur.

If scientists can identify the key genetic players at work in heart development, it could lead to improved screening and treatments. In order to shed light on congenital heart disease they need a lot of support which is just one more reason why we need to make sure the NIH has the funding it needs. The tiniest Americans are depending on it.

Social Math & Priorities

Yesterday, my colleague Brian wrote about rapping economists (a brilliant Tuneage Tuesday idea!). This passage really got me thinking about priorities:

The idea of social math is presenting complex issues in a way that can be easily understood by anyone: For example, a 2010 report by the National Retail Federation found that graduates were expected to receive nearly $90 in gifts – in all, spending on grad’s gifts were expected to reach $3.9 billion.

Few of us can comprehend a billion dollars, unless you had boatloads of Microsoft stock back when it took off. Social math, then, insists we take another step: Find a way to translate. Knowing our audience here, that $3.9 billion could fund all but two institutes at the National Institutes of Health for a year – and in many cases, for several years. (Even the two exceptions, NCI and NIAID, would have a majority of their budgets covered by that amount.) The same $3.9 billion would fund 8,193 NIH research grants, according to FY10 numbers.

Social math is finding the common ground between a niche and the mainstream.

The case described above doesn't just elaborate on the social math - making it simpler to see what billions of dollars represent - it makes a point about the value of our dollars. If we're willing to spend $3.9 billion dollars on stuffed animals in graduation garb, balloons, and alma mater mugs, would an extra dollar a week in taxes to advance research be a real burden on American finances? For the cost of a beanie baby or tassel a piece, could we mark an important genome? Treat cancer? Provide a healthier future for all those graduates?

I'm not saying don't celebrate or shower grads with gifts (most of my first apartment's security deposit came from graduation gifts, and I still have a Minnie Mouse that plays Pomp and Circumstance). I'm just saying that in tight times, it's important to make investments in the things that really matter. Whether that's siblings using air horns to cheer for the first person in their family to receive a diploma or the government keeping pace with inflation at federal research agencies.

Priorities matter. What are ours?

Budget Bewilderment

It’s a new year and time for a new budget! President Obama is expected to release his federal budget request for 2012 in early February. This makes for a confusing navigation of budgets, though. You see, Congress may receive the President’s request for the fiscal year (FY) 2012 budget before they have even passed the FY 2011 budget, despite the fact that FY 2011 started three months ago. And this means that most agencies are operating at FY 2010 levels. Whew!

The budget process itself is dizzying. For one, what is the fiscal year? Unfortunately, the fiscal year is not concurrent with the calendar year, which just confuses everything. The fiscal year begins October 1 of the previous year and ends September 30 of the following year. So FY 2011 began October 1, 2010 and will end September 30, 2011. Ideally, the FY 2011 budget, the layout for how much money government agencies receive for that fiscal year, should have been passed by the two chambers of Congress before the fiscal year began on October 1, 2010, but that is rarely the case, especially in an election year.

There is a lot for the chambers of Congress to get through and agree upon before they can pass the budget. After receiving the President’s budget request, the House and Senate Budget Committees each develop a budget resolution, which is a ceiling for how much money Congress can spend in certain categories, or “functions”. This is the allocations process. Then, each chamber debates the budget resolution. Finally, a House-Senate conference resolves the differences between the House and Senate resolutions, and the conference report must be passed by both houses. This is all supposed to be accomplished by April 15th, but rarely makes that mark.

Although the budget resolution is an incredibly important step, it’s not a bill and doesn’t actually give any money to anyone, but sets the spending limit for government functions. Legislation for spending, or appropriations bills, must also be passed in the House and the Senate and the spending must fall within the allocations laid out in the budget resolution.

Because the FY 2011 budget is not yet decided upon, you may have heard words thrown around like “continuing resolution,” “omnibus” and “government shutdown.” Technically, if appropriations have not been made by the beginning of a fiscal year, the government agencies should not be able to continue work and would shutdown. However, in these circumstances, Congress usually passes a continuing resolution for a set amount of time, perhaps another month, so that the government can continue operating at the previous year’s levels while Congress continues to work on an appropriations bill. For FY 2011, Congress has passed four continuing resolutions, the most recent lasting until March 4, 2011, halfway through the fiscal year!

Oftentimes, when appropriations have not been made before the start of the fiscal year, the spending is combined into one large omnibus appropriations bill rather than separate bills. Congress just withdrew an omnibus bill for FY 2011 in favor of a continuing resolution in order to avoid a government shutdown. Now the incoming Congress will have to finish the FY 2011 budget and start debating the FY 2012 budget nearly simultaneously.

Let’s hope this year’s budget process goes a little more smoothly than last.

ARRA: Putting America to Work

Much of the country, including scientists, benefited from the stimulus plan set forth by President Obama when the economy took a downturn. Biomedical researchers celebrated when this stimulus, the American Recovery and Reinvestment Act of 2009 (ARRA), allotted $10 billion to the National Institutes of Health (NIH), over $8 billion of which went to extramural researchers, creating jobs and supporting innovative research across the country.

Research!America has been tracking where the NIH ARRA money went. Every state and most of the US territories received funding for research projects from the NIH. In total, 15,614 projects were funded by ARRA money from the NIH. You can see how your state fared at the Research!America website.

California was awarded the most NIH ARRA money, bringing in $1.3 billion for 2,117 projects. Stanford University Medical School alone was able to create or save 45 medical research jobs because of the stimulus. These researchers are able to continue studying a range of important biomedical issues, including cancer, congenital heart disease in children, and the functioning of the immune system.

Duke University in North Carolina was able to create or save 166 jobs with the ARRA funding it received. North Carolina ranked sixth in the nation for the $359 million it was awarded in NIH ARRA money. In fact, North Carolina’s fourth district, encompassing Duke University and the University of North Carolina, was the third highest ranked district in the nation, underscoring the excellent research being performed at these universities.

Many researchers agree that the stimulus was a much-needed shot of money. Before ARRA, NIH funding had been flat, meaning it wasn't even keeping up with inflation, resulting in only 20% of the grants submitted being awarded money. This low percentage means brilliant ideas go unstudied and young scientists look for jobs elsewhere. These results are detrimental at a time when the country is worrying about its global competitiveness in science.

Yes, the stimulus helped, but it was only a temporary fix. The ARRA grants will run out in 2011, creating a huge dropoff in research money. The rate of successful grants could fall to 15%, leaving a glut of scientists who again can’t find money for their research. The NIH must receive more funding to be able to support these scientists.

The President is now considering the federal budget for 2012. Urge him to propose $35 billion for the NIH budget because robust investment in science is critical to creating jobs, improving health, encouraging innovation and revitalizing the economy.

Act Now: Urge the President to Support $35 Billion for NIH in FY2012

Final decisions about the President’s FY2012 budget recommendations are being made now, making it a critical time to take action. Cuts to the entire federal budget have been proposed – including NIH. Please remind the President that a robust investment in science is critical to creating jobs, improving health, encouraging innovation and revitalizing the economy.

Take action now. Urge President Obama to maintain his commitment to “restore science to its rightful place” by proposing and fighting for $35 billion in NIH funding in FY2012.

Investing in Our Future

Yesterday, Research!America and the American Chemical Society co-hosted a congressional briefing that is right up our alley: Investing in Our Future: A New Generation of Researchers. (See Rachel Shoop’s summary of the event.) Clearly, investing in young scientists resonates with the community, as was seen by the large turnout.

As Mr. John Edward Porter, former Congressman and current chair of Research!America, pointed out, the US is the global leader in scientific research but there are strong competitors. We must work to maintain our competitiveness, and that means investing in science, technology, innovation and research, particularly in the young scientists that are our future.

Apparently, it’s not just the early-career investigators out there who think this funding is crucial. These scientists have a much bigger impact than simply satisfying their scientific curiosity. According to Iain Cockburn, PhD, Professor of Finance and Economics, School of Management, Boston University, the life sciences are the “crown jewel” of our economy. Scientists’ progress leads to improvements in human health, more jobs, and economic growth. The point is that a small investment in young scientists now will have a huge payoff later.

What’s more, the lack of investment can have devastating effects. Meryl Comer, president and CEO of the Geoffrey Beene Gives Back Alzheimer’s Initiative, emphasized that the lack of funding is not only decimating the research but also discouraging young scientists from pursuing research as a career. This is where we are going to lose our competitiveness.

Raquel Lieberman, PhD, Assistant Professor, Georgia Institute of Technology, a brilliant early-career investigator herself, pointed out what many late-stage graduate students are shocked to realize: running a lab is more like running a small business, only they didn’t go to business school. The job becomes all about funding, with new investigators writing around 20 grants in their first year. How can they take care of the rest of the “business” when they worry so much about where the money is coming from?

Marshall Hussain Shuler, PhD of Johns Hopkins University demonstrated the level of expertise and creativity these early-career researchers have - essential components of discovery. Their new and unique visions will blaze the path for the future of research.

To make that happen, we must alleviate the pressure from these early-career investigators. It seems that they just can’t find enough money or time. There needs to be more funding directed to early-career investigators so they can focus on the research and teaching aspects of their jobs. Those are the aspects that will have the most impact.

Regardless, there definitely needs to be more advocacy. Ms. Comer and Mr. Porter both stressed the importance of advocacy in getting support for an issue meaningful to you. This is a very important issue--we need to let others know, too.

Eye on Investment: U.S. Health Research

Research!America has been annually estimating how much the U.S. spends on health research for nearly a decade. The past few estimates have been fairly predictable, but I was interested to begin work on the 2009 report (released today) to see the impacts of the recession and the American Recovery and Reinvestment Act funding meant to stimulate research and the economy.

Without the ARRA funding, the investment in health research would have practically flat-lined in actual dollar amounts. It is the only reason that the percentage of the national expenditures for health that was spent on research was stable at 5.6%. Let’s take a closer look at some of the numbers, starting with industry.

We rely on the annual Pharmaceutical Industry Profile published by the Pharmaceutical Research and Manufacturers of America for our pharmaceutical and biotechnology industry numbers. Although some may be skeptical of the data, I learned at a meeting last year that we are considered lucky by many others in the field of research resources tracking to have an industry that does a comprehensive annual survey on R&D expenditures. The 2010 Profile estimates that the biopharmaceutical industry spent $65.3 billion in 2009. That is a $1.6 billion increase over the actual 2008 amount of $63.7 billion, but just $0.1 billion over the previous year’s $63.2 billion estimate (which is what we used in our 2008 report).

Tracking R&D resources in the medical technology industry as a whole is a fairly new endeavor. Ernst & Young published for the first time last year their Pulse of the Industry: Medical Technology Report. Ernst &Young shared with us their most up-to-date figures for the industry—$9.047 billion spent on R&D in 2009— which can vary based on the make-up of the current roster of public U.S. companies as well as re-statements by the companies.

Although the health research industry did not experience a big decline in R&D spending as some other industries have, it is apparent that the recession brought steady growth in industry R&D to a halt. Other private funders, such as the voluntary health associations, were also negatively affected. Not surprising since many rely on donations and their investments to support their research and other programs. On the flip-side, independent research institutes stepped-up their R&D spending from their endowments, possibly to compensate for reduced funding from other sources.

The ARRA funding played the greatest role by far in helping to counteract the effects of the recession as well as several years of flat federal funding for research to improve health. That said, it also made analyzing the funding much more complicated since it was all appropriated in 2009, but it could be spent by the agencies through the end of fiscal year 2010. To stay as consistent as possible with previous estimates, I tried to only include ARRA dollars that were spent in 2009 in the current estimate. Some agencies made that easier than others…

The National Institutes of Health, which accounts for the majority of federal health research funding, spent $4.953 billion of its ARRA funding in 2009 in addition to its regular program level of $30.554 billion. The National Science Foundation’s FY 2011 budget request shows the actual 2009 ARRA funding, which added up to $880 million for the disciplines that we include based on our definition of health research. Another agency that received a significant boost in research funding due to ARRA was the Department of Energy Office of Science, of which $327 million was for research to improve health.

Nearly three-quarters of the increase in the U.S. investment in health research from 2008 to 2009 was due to ARRA funding. The effects of stimulus will last through FY 2010, but the funding for research to improve health must grow long-term. Industry, the federal government, academic institutions, state and local governments and other private funders must make a commitment to improving the health of Americans and the economy by increasing their investments in research.


Read the 2009 U.S. Investment in Health Research report for more information.

Event: Investing in Our Future

If you're in the DC area, you're strongly encouraged to join some of your fellow New Voices on Capitol Hill next Thursday to discuss the value of investing in the next generation of researchers (read: you!).

The invite is below. RSVP ASAP and leave a comment so we can be sure to catch you at the event.


and honorary co-hosts

Senator Barbara Mikulski
Representative Rush Holt
Representative Vernon Ehlers

cordially invite you to a luncheon briefing:

Investing in Our Future:
A New Generation of Researchers

October 7, 2010, 12:00-1:30 p.m.
Dirksen Senate Office Building G50

A robust U.S. scientific workforce is essential for maintaining our nation's global competitiveness, increasing our long-term economic prosperity, and solving many of the pressing global problems we face. But when resources are limited, surviving in an already competitive federal R&D system becomes even more difficult for early-career researchers.

To ensure that we have the research leaders of tomorrow, the U.S. must cultivate a new generation of scientists now, by investing in agencies such as the National Institutes of Health and the National Science Foundation. This briefing will highlight the societal benefits of federal research and the challenges and opportunities early-career investigators face in establishing a foothold in the scientific profession.

Opening Remarks
The Honorable John Edward Porter, Chair, Research!America

Moderator
James Gentile, PhD, President, Research Corporation for Science Advancement

Panelists
Iain Cockburn, PhD, Professor of Finance and Economics, School of Management, Boston University 
Marshall Shuler, PhD, Assistant Professor of Neuroscience, The Johns Hopkins University 
Raquel Lieberman, PhD, Assistant Professor, Georgia Institute of Technology 
Meryl Comer, President, Geoffrey Beene Gives Back Alzheimer's Initiative

To RSVP: Register online or contact Michelle Hernandez by email mhernandez@researchamerica.org or phone 571-482-2715.

Stand Up to Cancer

I am going to remain in my comfort zone for my very first New Voices blog post. I figure my background in cancer research qualifies me to discuss the topic of…cancer research. In honor of Stand Up to Cancer Day, I will highlight some of the important work being done by a group searching for a cure to cancer. Stand Up to Cancer (SU2C) is a charitable organization dedicated to accelerating groundbreaking cancer research.

At 8pm this evening, SU2C will host a live broadcast to raise awareness and money for cancer research. I know that sounds about as fun as hearing your uncle’s “why did the chicken cross the road?” joke for the 13th time--especially on a Friday night. But, it promises to be entertaining and informative (if only school could combine the two!). Many actors, comedians, and musicians will take the stage as well as scientists and advocates.

One featured group, 46 Mommas, is an amazing group of 46 women who represent the 46 children who are diagnosed with cancer every day. They are hoping to raise $1 million for childhood cancer research, and they even shaved their heads to raise awareness for the cause!

In 2008, SU2C hosted a hugely successful live broadcast that was aired across the country, featuring celebrities who believe in the cause. It raised much-needed awareness and brought in over $100 million for cancer research, which I find pretty exciting (the rest of you can enjoy watching these ladies stand up).



With this money, SU2C is trying to change the way research is done. They are promoting cutting-edge research done by young scientists that might not be funded by other means, which is a huge deal for these young scientists! SU2C has funded thirteen “Innovative Research Grants”. These projects are risky--they may not work. But if they do work, they promise to be a breakthrough in cancer therapy.

One project looks at the role a particular protein, BCL6, plays in leukemia development, particularly in leukemia stem cells. The stem cells initiate the cancer, but are particularly difficult to kill using chemotherapy. Even worse, they can cause the disease to come back once the drugs are stopped. This is why many researchers are studying how to kill the leukemia stem cells.

In addition to innovation, SU2C is encouraging more cooperation among scientists. They funded five “Dream Team Grants”, where each project is tackled in labs across the country.

One such grant involves researchers from New York to Texas who are trying to identify targeted therapies for women with cancer. A targeted therapy is one that is directed to cells with a particular marker or mutation. You may have heard of a common targeted therapy called Gleevec, which kills cells with the BCR-Abl mutation in chronic myelogenous leukemia.

Well, the Dream Team scientists have found that mutations in a gene called PI3K are found in breast and ovarian cancer. They are trying to use drugs that specifically block PI3K to kill the cancer cells. Targeted therapies like these will mean doctors can give each patient the best drug based on the markers in their particular cancer with less side effects than standard chemotherapy.

There is so much great work being accomplished in areas at the forefront of cancer research because of SU2C. I can’t do all of these brilliant researchers justice. You can read more on the SU2C website or tune in to the show to hear from the scientists themselves.

There is still much knowledge to be gained and many brilliant researchers looking for a cure. Funding will give them, and us, a chance.

A=B; B=A

Ever wonder how connected science policy and science research is? About as much as Siamese twins attached at the head. Look at some of the current policy issues that affect research (and vice versa).

Climate Change
Serious health and environmental concerns may be triggered by increases in UV radiation and a depleted ozone layer. A climate change bill passed through the House in ‘09 but is facing obstacles in the Senate. The success or failure of current and future climate change legislation will be influenced by scientists and researchers

Stem Cell Regulation
In ’05 and ’07 the Stem Cell Research Enhancement Act was passed by Congress but was vetoed by the President. Although President Obama has lifted some barriers to stem cell research, the ‘09 version of the Stem Cell Bill has not passed either branch of Congress.

Genetic Testing
Should consumers have the right to personally administer genetic tests on themselves? In 2008 the Genetic Information Nondiscrimination Act (GINA) restricted employers and insurance company from discrimination based on results from genetic tests, but no federal policy regulates how the tests are conducted.

The Environment and Offshore Drilling
Researchers and engineers will play an integral role in determining the Congressional legislative reaction to the BP oil spill. In ‘08, a 27 year offshore drilling ban was lifted, which may now be reinstated.

Cloning
The FDA allows animals to be cloned and their meat sold for human consumption - should scientists be allowed to clone human organs for research or transplant? Should we be allowed to clone extinct or endangered species? Legislation addressing such issues will be framed soon.

Health Records and Internet Privacy
Should restrictions exist when accessing health records electronically? Do search engines have the right to save search data? In ‘10 an online privacy bill was presented in the House, which will effect digital privacy laws and medical record storage. Doctors and researchers will dictate these quality of these regulations.

Tax Credit for Research
The Federal Research and Development tax credit was worth $5.6 billion to U.S. companies in ‘09. The credit includes qualified research, computer time-sharing costs, and a percentage of contract research expenses. It is a temporary program that has been renewed annually for 28 years, but whether it becomes part of the permanent tax code has not been decided.

Competitiveness
The 2010 America COMPETES Act is currently being considered by Congress. It will not only affect NSF funding for the next five years, but legislate energy, STEM education, and technology transfer efforts.

No matter what field you're in or what type of research you do, you should work to affect the policies that affect research.


This is Part 3 of 3 in the Science of Advocacy series.
Part 1 - Senator PhD?
Part 2 - Baby don't cry, baby don't get no milk
Part 3 - A=B; B=A

Baby don't cry, baby don't get no milk

Is it frightening to you that American's spend more money on their lawn and gardens than the National Institutes of Health receive to try and cure cancer, AIDS, Alzheimer's and diabetes? How about that the budget of the National Science Foundation is a quarter of what we spend on video games? There are many reasons why researchers should be increasing their role in science policy, but perhaps the most relevant is economic.

Research funding is a constant and annual process and no amount of money is predictable or ever guaranteed. Researchers should be screaming from the rafters how badly they need money - hence the title of this post.

Want proof that advocacy works? The graph on the left demonstrates the changing budget of the NIH since 1970. Notice that from 2002 to 2008 the funding trend flattens out but then jumps up significantly during 2009 and 2010. This is due to the hard work of health research advocates such as Research!America. Being vocal and aggressive about the importance of increasing research funding resulted in the NIH receiving billions of extra dollars from the American Recovery and Reinvestment Act (ARRA) funds. For this trend to continue, scientists and researchers must make a lot more noise than they are right now.


This is Part 2 of 3 in the Science of Advocacy series.
Part 1 - Senator PhD?
Part 2 - Baby don't cry, baby don't get no milk
Part 3 - A=B; B=A

AAAS Science & Technology Policy Forum - Day 1

Two of your New Voices bloggers were at the AAAS Science & Technology Policy Forum last week to hear the latest policy news on issues in the scientific community. There was a ton of information shared over the two days, so we're breaking it down into three segments for you: day 1, day 2, and the William D. Carey lecture. (A full agenda is available for more details.)

The themes are captured here, and we'll be sharing quotes starting tomorrow morning on our Twitter feed - so follow us @NV4Research for even more coverage of the forum.

Budgetary and Policy Context for R&D in FY2011

• The budget for research is increasing in fiscal year 2011
• The Obama administration cares about science; demonstrated by 30 members of the National Academies of Sciences on his staff.
• Investment at the federal level is more important than ever as state economies suffer from the recession and deal with budget cuts.
• It's hard to change institutions, because due to unions, firing people is difficult.
• Extending the Bush tax cuts would be terrible for the economy
• There is a long, slow gray area between a good and a bad economy, and we are in that gray area right now.

Societal Impacts of Science and Technology

• Greater health directly relates to greater wealth.
• It is hard to analyze the impact of R&D, because there is often not a direct link between the two.

Beyond Cap and Trade: Other Climate Issues

• Geo-engineering poses a number of both scientific and moral questions, not the least of which is, who's hand is on the thermostat if we do have the ability to change the climate?
• Energy and climate change are inherently security issues, because they serve as threat multipliers for instability in the world.
• Who are the experts and which experts do you trust on which issues?
• There is a mismatch between agencies with social science expertise and those with environmental missions, which makes explaining the complexity of climate change an even more difficult task.
• We need more strategies for adapting to climate change, including advanced disease surveillance that accounts for differences in regional climates.
  

Spring Break Homework

It’s spring break for many, including members of Congress. Although this time of year often conjures up images of relaxing somewhere sunny, we want you to go to work now. Your congressional delegation is most likely at home, providing an ideal opportunity to reach out to them.

Heather recently posted a list of town hall meetings. Members also hold and attend a variety of other types of events, so be on the lookout for those as well. Scheduling a meeting at a district or state office during a recess can also improve your odds of actually meeting with your representative and senators.

When Congress returns to DC, they will start the budget and appropriations process in earnest, making now an ideal time to speak out for research.

The funding levels necessary to sustain or grow research to improve health in FY 2011 are:

• National Institutes of Health - $35 billion
• Centers for Disease Control and Prevention - $8.8 billion
• Agency for Healthcare Research and Quality - $611 million
• National Science Foundation - $7.4 billion

Contact your representative and senators to take action locally now or, at a minimum, send your members an e-mail.

World Tuberculosis Day 2010

Tuberculosis, or TB for short is not something most people will think about today. But we should, which is why public health advocate Karen Goraleski is guest posting today to give us a little history about TB.

***

More than 125 years after the discovery of the cause of TB we are still fighting this ancient killer. Even more incredible, we are using drugs and treatments developed nearly a half-century ago. The major burden of TB is found in developing countries, where 98% of TB deaths occur. In addition to killing people, it wields a double hit by draining $12 billion annually from the world’s poorest communities, where families caring for a loved one with TB spend eight to 20% of their income on treatment. Businesses and local economies must also cope with the absence of employees with TB, who will lose three to four months of work on average.

We don’t think about TB here in the U.S., but we need to. In the 1980s and under a false sense of security, America relaxed its monitoring of TB. As a result, TB returned with a vengeance in the 1990s. Flash forward another ten plus years to 2007 and we have more than 13,000 TB cases reported.

An increased investment in research to develop new tools to diagnose and treat TB is essential to prevent the needless suffering caused by TB and its often fatal drug resistant strains. Without this, TB can quickly overpower the current inadequate response to this long-standing but beatable disease.

In this world where disease is just a plane ride away for all of us, where business and commerce are expanding globally, where students and youth groups routinely travel to distant places, it is critical for the U.S. to invest in global health research to develop better prevention and treatment for TB, and to find a definitive cure.


Karen Goraleski is the vice president of public health partnerships at Research!America.

For more on tuberculosis, check out this fact sheet.

Invest in Tomorrow. Invest in Research.

A week or so ago, we invited New Voices to attend Research!America's 2010 National Forum, Invest in Tomorrow. Invest in Research. It was an amazing event - and we'll all be telling you more about it soon. But as a recap, check out Kimberly's live tweeting on NV4Research and the podcasts of the panel sessions below.

From left: R. Tjian, J. Howse, T. Frieden, J. Woodruff, P. Chew, C. Clancy

Panel 1: Working Toward Better Health for All

Moderator: Judy Woodruff, "PBS Newshour"

• Paul Chew, MD, chief science & medical officer, sanofi-aventis U.S.
• Carolyn M. Clancy, MD, director, Agency for Healthcare Research and Quality
• Thomas R. Frieden, MD, MPH, director, Centers for Disease Control and Prevention
• Jennifer Howse, PhD, president, March of Dimes Foundation
• Robert Tjian, PhD, president, Howard Hughes Medical Institute.

From left: M. Hamburg, F. Collins, B. Kunz, M. Kinsley, J. Watters,
& M. Anderson

Panel 2: Translating Discoveries into Better Health

Moderator: Michael Kinsley, The Atlantic

• Margaret Anderson, executive director, FasterCures
• Francis S. Collins, MD, PhD, director, National Institutes of Health
• Margaret Hamburg, MD, commissioner, Food and Drug Administration
• Barbara Kunz, president, Health and Life Sciences Global Business, Battelle Memorial Institute
• Jack T. Watters, MD, vice president of external medical affairs, Pfizer Inc.

View more photos from the 2010 National Forum.

Urge Congress to Strengthen the Momentum for Research in FY 2011

Funding for research to improve health in FY 2011 is now in the hands of Congress, and it's time to take action! Let your representative and senators know that the U.S. must continue to robustly invest in research to strengthen the scientific momentum generated by the American Recovery and Reinvestment Act.

The funding levels necessary to sustain or grow research to improve health in FY 2011 are:

• National Institutes of Health - $35 billion
• Centers for Disease Control and Prevention - $8.8 billion
• Agency for Healthcare Research and Quality - $611 million
• National Science Foundation - $7.4 billion

Write to your delegation in support of research now!

Health Research in the President's FY2011 Budget

With the release of his FY 2011 budget proposal, President Obama reaffirmed his commitment to science and research by making them a priority amid efforts to limit spending. Although President Obama recommended a freeze on the part of the budget that includes research, he opted to increase funding for the National Institutes of Health, the Agency for Healthcare Research and Quality and the National Science Foundation.

Under the President’s proposal, the overall NIH budget would increase 3.2% percent to $32.1 billion in FY 2011. This recommended boost to the budget is an excellent beginning to the priority-setting conversation that now moves to Congress. Ultimately, an FY2011 budget less than $35 billion will not allow NIH to sustain the research capacity made possible through the American Recovery and Reinvestment Act. The NIH has been functioning with a $35 billion budget for two years and we cannot afford to lose ground as the nation struggles out of the Great Recession.

In a briefing Monday afternoon, NIH Director, Francis Collins, MD, PhD, emphasized that the administration is focused on science-based budgeting, with the intent to prioritize resources and take advantage of the greatest scientific opportunity. Dr. Collins most recently outlined his priorities for the agency in Science magazine (subscription required). As a result of the science-based budgeting approach, percent increases for individual institutes and centers varied across NIH. President Obama again called for specific increases for cancer and autism research as he did in his 2010 budget proposal.

Maintaining an emphasis on evidence-based medicine, President Obama proposed $611 million for the Agency for Healthcare Research and Quality, a 53.9% increase. Of this, $286 million is allocated for comparative effectiveness research. President Obama is keeping the NSF on a budget doubling track, by recommending $7.4 billion for the agency, an 8.0% increase. The Centers for Disease Control and Prevention did not fare as well, with the President recommending a 2% cut to $6.3 billion.

Since the budget and appropriations process is now in the hands of Congress, it is time for advocates to start contacting their representatives and senators in support of robust increases for research to improve health in FY 2011. New Voices will keep you posted on updates in the budget and appropriations process and alert you when your voice can make the most difference.

Our Woman in Havana

Presenting at the Global Forum for Health Research held at the Palacio de Convenciones in Havana, Cuba.

So I'm not a spy, but I did have what will likely be a once in a lifetime opportunity to go to Havana, Cuba. I recently attended the Global Forum for Health Research, which I was able to do as a U.S. citizen under a general license to attend a professional meeting organized by an international organization.

Because of the work that Research!America does tracking the U.S. investment in health research, we were invited to participate in a day-long meeting that brought together other experts in the field of tracking resources for health research. I have been studying the U.S. investment in health research for more than five years now, so it was interesting to meet others from around the world doing similar work. The participants came from a variety of backgrounds with a range of perspectives about tracking health research resources. Some—like Research!America—focused on country-level spending, others looked at disease-specific research and still others took a more global view.

I think one thing that all of the meeting attendees could agree on is that tracking investments in health research, and specifically research for global health, is a challenge and that more information about what is being spent on research for health around the world is needed. As is often the case in meetings like this, more questions than answers were generated. Some of the key questions include:

• What is the definition of research? Should infrastructure, salaries, capital investments and other research enabling activities be included?
• Is there a difference between “health research” and “research for health?”
• Which countries/organizations are tracking health research investments?
• How can we establish guidelines for cross-country comparisons of their investments in health research?
• How can this data be most effectively used for advocacy?
• Should methodology differ when the data will be used in advocacy?
  

In addition to this meeting, I also had the opportunity to participate in a panel discussion titled “Who’s Investing and Who Cares?” that was moderated by New England Journal of Medicine Editor-in-Chief, Jeffrey Drazen, MD. I shared our data on the U.S. investments in health research and global health research, some of our public opinion polling that shows that Americans do care about the issue and information about Research!America’s Paul G. Rogers Society for Global Health Research.

Attending the Global Forum for Health Research also allowed me to meet an interesting array of people from around the world, all working in some way on global health, and to learn more about topics outside the realm of my day-to-day work, such as product development partnerships, incentives for global health research and the Cuban health system. Much more to come in my post tomorrow about the travel experience, Cuba and photos from a brief tour of Havana.