Research Funding

AGA POSITION: Congress should increase NIH funding to $36.1 billion in FY 2018.

AGA Advocates for Increased NIH Funding

Each year, more than 62 million Americans are diagnosed with digestive disorders, including foodborne illness, inflammatory bowel disease, obesity, gastrointestinal cancers and motility disorders. In some of these areas, medical research has brought us closer to developing lifesaving treatments and cures. Yet, in others, we still lack even the basic understanding of the cause and transmission of the diseases.

Without Increased Funding, Scientific Discovery Will Languish

According to surveys conducted by the National Center for Health Statistics in 2013, 40.4 million ambulatory care visits occur annually with a first-listed diagnosis of digestive disease.1 Many of these diseases are potentially deadly or debilitating, and include colon, liver and pancreatic cancers, inflammatory bowel disease, foodborne illness, and gastroesophageal reflux disease. The costs for treating these diseases exceed $141 billion annually.1,2

Recently updated burden statistics indicate that the five-year survival rate for individuals diagnosed with pancreatic cancer is 9 percent; for liver and intrahepatic bile duct cancer, it is 18 percent; and for esophageal cancer, the survival rate is 21 percent.3 Funding research to identify effective treatments and cures for these digestive diseases can save the health-care system in the U.S. billions of dollars and tens of thousands of lives.

Sound Economic Investment

Research funding has proven to be a wise investment given that life expectancy has increased; death from heart disease, cancer and stroke is declining; and new technologies are able to detect and treat disease more quickly. A recent study by United for Medical Research4 found that every NIH dollar generates more than twice as much in state economic output. NIH grants and contracts created and supported more than 379,000 jobs that generated over $64 billion in economic activity across all 50 states in 2016 alone.

NIH funding awards by state and the number of jobs supported by this funding can be found at http://www.unitedformedicalresearch.com/STATE-BY-STATE/.

A Case Study in Digestive Disease Innovation: The FMT National Registry

In 2016, NIH awarded AGA a five-year grant to establish an FMT (fecal microbiota transplant) National Registry, a centralized database for physicians and their patients to report data on safety, effectiveness and utilization of FMT. In partnership with the Crohn’s and Colitis Foundation, Infectious Diseases Society of America, and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, AGA will lead an effort to collect short- and long-term outcomes of FMT and promote greater scientific investigation into this promising new therapy for patients with Clostridium difficile infection, a prevalent and costly health-care-associated infection, as well as other disorders with implications for the gut microbiome. NIH funding for this project is critical for the future of this potential treatment for millions of patients.

The NIH Budget Has Lagged Behind Inflation for Years

It is essential that the momentum in research progress that NIH funding has generated be sustained by taking the next step to invest in predictable and sustained, long-term growth in NIH funding.This research enables our nation’s scientists to continue to make progress that will help improve the quality of care that Americans receive and ultimately find cures for so many diseases. Across the board budget cuts, known as “sequestration,” have had a devastating impact on research at NIH. According to data from NIH, these cuts have had the following impact:5

  • From fiscal year (FY) 2003 to FY 2015, NIH lost 22 percent of its capacity to fund research due to budget cuts, sequestration and inflationary losses.
  • Awards for R01-equivalent grants, the primary mechanism for supporting investigator-initiated research, also suffered substantial losses. The number awarded fell by 1,420 (19 percent) between 2003 and 2016

A reduction in funding for researchers, especially early career investigators, threatens the ability to attract the best minds who are committed to finding cures and better treatment options, which, ultimately, saves lives.

In FY 2016 and 2017, Congress appropriated substantial increases to NIH’s budget in an effort to restore funding to pre-sequestration levels but more work still needs to be done.The current funding level represents what it should have been in 2012 when considering inflation. The two-year increase in funding has led to 832 additional research grants being awarded. AGA strongly encourages Congress to continue to rebuild and supply sustainable funding levels that encourage growth and innovation in the field of science.

Indirect Costs

An additional burden for FY 2018 funding is the administration’s proposed budget cuts for facility and administrative expenses, also referred to as overhead or indirect costs. Indirect costs are a crucial component of research funding. These funds provide necessary financial support to institutions that host researchers and maintain top of the line facilities that abide by state and federal regulatory guidelines. The proposed FY 2018 budget reflects a $7.2 billion or 21 percent6 cut to NIH’s facility and administrative expense funding, which is driven by the administration’s recommendation to cut facility and administrative expense funding from its current rate of 30 percent to 10 percent per grantee. Such cuts will stunt the ability of outside institutions to support the thousands of research initiatives offered by NIH.

Call to Action: AGA Supports Increasing NIH Funding to $36.1 Billion in FY 2018

AGA appreciates the fiscal constraints that our country is experiencing, and we believe it is critical to get our country back on sound fiscal footing. However, given the role that research funding plays in promoting economic development, AGA recommends that Congress fund NIH at $36.1 billion for fiscal year 2018, including funds provided through the 21st Century Cures Act. This increase represents the minimum investment necessary to avoid further loss of promising research and to allow the NIH budget to keep pace with inflation. AGA also urges Congress to continue to protect NIH from additional automatic cuts, which could further erode progress in research and impede job creation and global competitiveness in the life sciences industry. 

References

(1) NCHS, National Ambulatory Medical Care Survey, 2013.

(2) NCHS, National Hospital Ambulatory Medical Care Survey, 2013.

(3) Everhart JE, editor. The Burden of Digestive Diseases in the United States. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443.

(4) American Cancer Society. (2017). Cancer facts & figures 2017. Atlanta, GA: American Cancer Society. Accessed at 
https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf.

(5) Ehrlich E. NIH’S Role in Sustaining the U.S. Economy. United for Medical Research. 2016. Accessed at  
http://www.unitedformedicalresearch.com/wp-content/uploads/2016/05/NIH-Role-in-the-Economy-FY15-FINAL-5.23.16.pdf.

(6) Federation of American Societies for Experimental Biology. NIH Research Funding Trends. 2017. Accessed at  
http://www.faseb.org/Portals/2/PDFs/opa/2017/2017Factsheet_Restore%20NIH%20Funding.pdf.

(7) Office of Management and Budget. (2017). Major savings and reforms: Budget of the U.S. government, Fiscal year 2018. Accessed at  
https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/budget/fy2018/msar.pdf.

October 2017