The Chairman of the Senate Appropriations Committee, Patrick Leahy (D-VT) recently released the nine outstanding Senate Fiscal Year (FY) 2022 spending bills. The nine posted bills included the Labor-HHS-Education funding measure and the funding measure for the Department of Defense. These bills have not gone through the official markup process but were released to indicate Senate (largely Democratic) priorities and to facilitate timely negotiations with the House on final FY 2022 spending bills. The FY 2022 appropriations bills will ultimately need the support of both parties and both chambers (Republicans are already suggesting enhancements to defense spending), and negotiations are expected to stretch into December.
The FY 2022 Senate spending bills provide investments for medical research in general and support specific community priorities, include strong language regarding the use of CTSA funding. Below, please find a summary of key items from the Senate bill.
- $9.73 billion for the Centers for Disease Control and Prevention (CDC), an increase of $1.86 billion over FY 2021 and $820 million less than the House proposal.
- $47.92 billion for the National Institutes of Health (NIH), including:
- $2.6 billion discretionary increase for NIH, $900 million less than the House proposal.
- $2.4 billion to establish the Advanced Research Projects Agency for Health (ARPA-H), $600 million less than the House proposal.
- $3.07 billion for the National Institute of General Medical Sciences (NIGMS), an increase of $76.14 million over FY 2021 and $70 million less than the House proposal.
- $410.45 million for the Institutional Development Awards Program, an increase of $13.88 million over FY 2021 and $4.55 million less than the House proposal
- $661.88 million for the National Institute on Minority Health and Health Disparities (NIMHD), an increase of $260.24 million over FY 2021 and $10.78 million less than the House proposal.
- $878.07 million for the National Center for Advancing Translational Sciences (NCATS), an increase of $22.65 million over FY 2021 and $19.74 million less than the House proposal.
- $600.93 million for the Clinical and Translational Science Awards Program, an increase of $14.08 million over FY 2021 and $15.25 million less than the House proposal.
Clinical and Translational Science Awards [CTSA].—The Committee includes $600,925,000 for the CTSA program, an increase of $14,084,000 above the fiscal year 2021 enacted level. The Committee maintains its strong support for the CTSA program and commends the national network for their efforts to modernize the translation of research into health benefits across the full spectrum of medical research, for their contributions to the COVID–19 response, and for addressing health disparities and health equity, and enhancing rural care. The Committee is concerned the recent CTSA Funding Opportunity Announcement [FOA] could alter the CTSA’s strategic direction and divert appropriated resources intended for CTSA hubs. Resources provided by the Committee are intended to enhance funding for hubs, thus bolstering the national network. Therefore, NCATS is directed to ensure that any CTSA hub that has successfully recompeted through the new FOA does not receive more than a 5 percent reduction in total annual support for its core hub responsibilities. In addition, the Committee directs that all CTSA hub partner organizations that contribute key resources and expertise to a CTSA hub’s translational work should continue to be treated as full partners, including treatment of their entire NIH research enterprises in the calculation of hub budgets. This will support local CTSA hubs and maintain collaborations with community organizations and research and academic partners 140 that expand the full spectrum of research and translation, and foster innovation. Further, the Committee strongly encourages NCATS to fund expanded programs that address the significant disparities and burden of disease disproportionally affecting minority and special populations. Focusing on this capacity will reduce the burden of disease and promote health equity among vulnerable populations. In addition, NCATS is expected to support opportunities for CTSAs that substantively respond to disparities in racial health equity by promoting research and collaborations that address the distinctive medical and health needs of underserved populations; remediate the effects of environmental and structural racism; and advance the dissemination and implementation of learning around health equity. Finally, the Committee reiterates previous direction that NCATS inform the Committee prior to any planned changes to the size of hub awards, scope of the program, or strategic changes to the program, specifically noting that the Committee shall be consulted prior to any new CTSA initiatives being implemented.
Full Spectrum of Medical Research.—The Committee applauds NIH efforts to support and advance the full spectrum of medical research, which ensures breakthroughs in basic science are translated into therapies and diagnostic tools that benefit patient care while disseminating cutting-edge information to the professional community. The Committee notes the importance of flagship initiatives, including the Clinical and Translational Science Awards program, to these important efforts.