AAMC Reporter: February 2006

AAMC Holds Forum on NIH Funding

Amid grim predictions that the federal government will not increase the National Institutes of Health's (NIH) budget for fiscal year 2007, the AAMC hosted a roundtable forum Jan. 17 with more than 20 leaders in academic medicine to discuss the political and budgetary obstacles confronting the NIH and what steps the academic medicine community can take to respond more effectively to these challenges.

"We are facing an extraordinarily difficult period, and there's a lot of work to do," said AAMC President Jordan J. Cohen, M.D. "We have to achieve some consensus and form a plan to garner the considerable force within the academic community and speak with fewer voices, if not one voice."

With inflation factored in, federal support for the NIH has actually dropped by 5 percent over the past three years. Ongoing "flat" funding for the NIH will mean significantly less money for new research grants at AAMC institutions. In 2004, the NIH research grants for medical schools and teaching hospitals totaled about $13 billion — or 55 percent of its total budget. The NIH budget for fiscal year 2006 is $28.3 billion, a 0.1 percent decrease from fiscal year 2005.

During the meeting, Susan E. Quantius, a staff member of the U.S. House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, told the group that federal spending on defense, disaster relief, and other programs, coupled with lawmakers' views that the NIH has sufficient funding, is likely to preclude additional federal support for the agency in the short term.

"There isn't much knowledge among members [of Congress] and their staffs about the NIH and its mission," Quantius said

G. William Hoagland, director of budget and appropriations for Senate Majority Leader Bill Frist, M.D., also offered a gloomy forecast for the NIH's immediate financial future.

"I don't expect we will get a [fiscal year 2007] Labor-HHS bill passed before the elections in November," Hoagland said. "I would expect NIH to be flat-funded for 2007 .… the NIH budget over these last several years has grown at double the rate of the economy. You should not expect any change in the fiscal pressure that is being put on NIH."

Developing a New Message

With those realities in mind, meeting attendees held a wide-ranging discussion on possible ways to convince Congress and the administration of the need for a thriving NIH budget.

Hoagland and other attendees said NIH advocates should find a way to connect medical research funding to the quest to lower health care costs.

"You have to tie [NIH funding] back to the rising cost of health care," Hoagland said. "Somehow, you have to be a solution to that problem … The issue of preventing catastrophic illness down the road, in the long run, lowers the cost of health care."

"If we could link more [NIH] science to disease prevention, I think that's an argument that would have some weight," added Raymond Ruddon, M.D., Ph.D., senior associate dean for research and graduate studies at the University of Michigan Medical School.

Meeting participants seemed to find consensus on a few key issues, including using "plain English" to educate political leaders, civic groups, and the media on the NIH's role in improving the nation's health.

"There needs to be a re-engineering of perspectives," said Albert Reece, M.D., Ph.D., dean and vice chancellor at the University of Arkansas College of Medicine. "We need to continue to educate. We need to be clear, and we need to be simple … I would welcome a more aggressive campaign within our own states to educate all our legislators. We need to also find bipartisan advocates to convey this message on our behalf."

"We need consistent and clear, but not conflicting, messages," added Victor Dzau, M.D., chancellor for health affairs at Duke University. "[Academic medical leaders] don't write enough newspaper op-ed pieces. We don't do enough with our visibility."

In addition to discussing new messages, other academic leaders attending the forum called for a fresh approach to NIH advocacy.

"We tend to speak too specifically, about individual technical discoveries and the like," said Glen Gaulton, Ph.D., vice dean, research and training at the University of Pennsylvania School of Medicine. "Why not step back 10 years and see how we treated a disease like diabetes back then, versus how we treat diabetes now? Then, we use this comparison as a case study and show it to people, to show what research has done comprehensively."

Moving forward, the AAMC's leadership pledged to formulate strategies and talking points for use in various local forums, including business and political groups; heighten efforts to educate congressional staff about the status of NIH-funded research through the association's Fulfilling the Promise campaign; bring more members of Congress together with researchers via Project Medical Education; and place op-eds and generate other media coverage on this issue by local media.

Many attendees agreed problems exist when communicating to the public about the NIH budget, and expressed a willingness to re-dedicate themselves to advocacy.

"We haven't really made the case that we are serving the public with [NIH-funded research]," said Stephen Spielberg, M.D., Ph.D., dean of Dartmouth Medical School. "Sometimes with research, it's seemingly about our own interests, not those of our patients. We need a crisp, new message."

— By Scott Harris

Contact Us    © 1995-2008 AAMC    Terms and Conditions    Privacy Statement