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AAMC Recommends $49B for NIH in FY 2023; NIH Leaders Testify

May 13, 2022

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The Ad Hoc Group for Medical Research, convened by the AAMC, delivered its fiscal year (FY) 2023 funding recommendation for the National Institutes of Health (NIH) to Congress on May 11.  

Nearly 400 organizations and institutions across the NIH stakeholder community recommended an appropriation of at least $49 billion for the NIH in FY 2023 and strongly urged lawmakers to ensure that any funding for the new Advanced Research Projects Agency for Health (ARPA-H) supplement the $49 billion recommendation for the NIH’s base budget, rather than supplant the essential foundational investment in the NIH. The coalition reiterated this funding recommendation through outside witness testimony to the Senate Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations Subcommittee on May 11 [refer to related story].

The coalition recommendation was delivered as leaders from the NIH testified before the House Labor-HHS Appropriations Subcommittee on May 11 regarding the president’s fiscal year FY 2023 budget proposal.

In her opening statement, chair Rosa DeLauro (D-Conn.) said, “I am so proud that over the past seven years, Congress has increased NIH funding by nearly $15 billion or 49%.” She also noted the importance of historic funding for the agency in combatting COVID-19. “It was the years of research and investment in the research that allowed us to move as quickly as we were able to. So, through the research of our scientists, researchers at grantee institutions, and partnerships with the private sector, our knowledge of the virus has dramatically improved.”

Members from both parties addressed recent activities to establish ARPA-H. “It is critical that we strike a balance between the investments that we make in ARPA-H and those in basic research and discovery at the NIH. … While I strongly support NIH and recognize this long record of success in supporting vital medical research, I believe that placing ARPA-H within NIH is a mistake,” said DeLauro, referring to the late March announcement from Health and Human Services Secretary Xavier Becerra to house ARPA-H within the NIH [refer to Washington Highlights, April 1].

Ranking member Tom Cole (R-Okla.) added his concerns about the administration’s proposed increase for ARPA-H. “We don't know how ARPA-H will interface with existing NIH institutes and research or how we can ensure that it will be value added rather than an agency that competes with and siphons off talent. … So, I think it makes no sense to propose an enormous increase of $4 billion for this new agency while proposing what is essentially flat funding and for some important agencies, even a modest cut for the rest of NIH.”

NIH’s Acting Director Larry Tabak, DDS, PhD, testified that the search for ARPA-H’s inaugural director is ongoing with the intention to move “as rapidly as possible.”

Several members asked about the NIH’s workforce, including support for early-stage investigators and efforts to diversify the workforce. Tabak highlighted the Maximizing Opportunities for Scientific and Academic Independent Careers (MOSAIC) program aimed at supporting early-stage investigators from diverse backgrounds to achieve tenure track positions. The NIH awarded the AAMC funding in FY 2021 to establish a Career Development Program for MOSAIC scholars, which currently supports seven investigators.  

In his opening statement, Tabak also addressed the NIH’s new efforts to study the social, behavioral, and economic impacts of COVID-19 across the country, including mental health impacts. Several subcommittee members inquired further on related issues including substance use disorders.

Rep. Mark Pocan (D-Wis.) asked Tabak if he knew of any recent Food and Drug Administration-approved drugs that did not have underlying NIH research that led to their discovery, suggesting that the NIH should invoke march-in rights on costly medications.

Tabak noted that while he did not know of any FDA-approved drugs that NIH-funded discoveries had not led to, federal agencies did not believe “that price per se met the criteria that are needed for march-in. … If there are no manufacturing plants that are available to manufacture a drug, that would be an example of perhaps where march-in would be used. In this case the barrier is strictly a financial one.”

Subcommittee members also inquired about a range of other topics, including Alzheimer’s disease, maternal mortality, marijuana research, and gun violence prevention research. Joining Tabak were Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases; Diana Bianchi, MD, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development; Douglas Lowy, MD, acting director of the National Cancer Institute; Gary Gibbons, MD, director of the National Heart, Lung, and Blood Institute; and Nora Volkow, MD, director of the National Institute on Drug Abuse.

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