The administration kicked off the Fiscal Year (FY) 2021 appropriations process on Capitol Hill with the release of the president’s annual budget request to Congress. The non-binding document once again calls for deep cuts to non-defense discretionary programs, including medical research and public health activities. The budget request also includes the administration’s position on some policy issues and program activities. Congress is unlikely to support any funding cuts for medical research or public health in FY 2021, and the upcoming effort to craft the spending bills will clarify the support for key areas of interest.
The FY 2021 budget request includes:
- $38.69 billion for the National Institutes of Health (NIH), a proposed decrease of $2.99 billion below FY 2020.
- $2.67 billion for the National Institute of General Medical Sciences at NIH, a proposed decrease of $265 million from FY 2020.
- $351.78 million for the Institutional Development Awards (IDeA) program, a proposed decrease of $34.8 million from FY 2020.
- $305 million for the National Institute on Minority Health and Health Disparities at NIH, a decrease of $30 million from FY 2020.
- $68.25 million for the Research Centers at Minority Institutions program, a proposed decrease of $6.25 million from FY 2020.
- $788 million for the National Center for Advancing Translational Sciences at NIH, a proposed decrease of $45 million from FY 2020.
- Specific funding for the CTSA program is not specified.
- $2.1 billion for the Office of the Director at NIH, a proposed decrease of $148 million from FY 2020.
Receiving Input to Strengthen the CTSA Program: NCATS is considering updates to the CTSA Program to meet its broad scientific mission to improve the efficiency and effectiveness of clinical research and translational science. As part of the process, the Center sought broad input from stakeholder communities through a Request for Information issued in September 2019 and will seek additional input at a “town hall” to be held in early 2020. This requested input will provide suggestions on how the CTSA Program might be strengthened to deliver on its promise to develop, demonstrate, and disseminate innovative approaches, methodologies, and interventions that translate into improved human health. Prior to implementation, NCATS will share any planned updates to the CTSA Program with the appropriations committees. Budget Policy: The FY 2021 President’s Budget request for Clinical and Translational Science Activities is $526.0 million, a decrease of $52.2 million or 9.0 percent compared with the FY 2020 Enacted level. NCATS will maintain the same number of CTSA hubs as funded in FY 2020, which is 60 hubs.
Research Centers at Minority Institutions- The Committee recognizes the important role of the RCMI program in developing the infrastructure required to enhance biomedical research conducted at historically minority serving institutions. This infrastructure is critical to supporting the development of new investigators and sustaining an established workforce conducting world-class biomedical research that emphasizes the advancement of minority health and the reduction of health disparities. Therefore, the Committee includes $75,000,000, an increase of $11,186,000, for RCMIs to ensure that critical capacity development in historically minority graduate and health professional schools continues to be enhanced to meet these critical needs. In addition, the Committee recognizes the importance of the RCMI Translational Research Network in ensuring that collectively, institutions can engage in multi-site collaborative research.
Action taken or to be taken: The Research Centers in Minority Institutions (RCMI) program220 supports NIMHD’s vision to advance the science of minority health and health disparities research by providing all investigators within the program the resources to engage in rigorous research experiences focused on diseases that disproportionately affect racial and ethnic minorities, and other health disparity populations. RCMI institutions provide shared resources including research infrastructure, research and technical training, mentorship, career development, grant writing, database support for community-based research studies, and opportunities for professional networking to foster collaboration across RCMI sites. NIMHD funding to RCMI institutions also supports neurogenetics research, cell culture facilities, imaging and image analysis instrumentation, state-of-the-art analytical facilities for proteomics research, high-throughput screening, molecular modeling techniques, informatics, and statistical support. RCMI institutions are a critical link to establishing a diverse biomedical workforce. These institutions support post-doctoral fellows, early-stage investigators, and mid-career scientists with an interest in advancing their scientific careers in basic, translational, clinical, behavioral and populations sciences. RCMI institutions also provide trainees and scholars access to the necessary tools to conduct their proposed research projects to be successful. The RCMI program has been strengthened to offer more flexibility with respect to the types of research studies conducted to include basic, clinical, and behavioral research. The RCMI Specialized Centers program expands the national capacity for research in the health sciences by providing cooperative agreement support to eligible institutions. An example of the type of research the RCMI program supports is a study that aims to identify new treatment for triplenegative breast cancer, which is the most aggressive type of breast cancer and disproportionately affects African American and Latina women. The study discovered that Monocyte Chemoattractant Protein-1 (MCP-1) mediated pathways could have the potential for treating triple-negative breast cancer and consequently reducing cancer health disparities. Another study is conducting research to identify candidate genes and genetic pathways associated with type 2 diabetes and Hepatitis C virus infection. The goal is to gain insights into possible mechanisms by which the Hepatitis C virus may contribute to the burden of type 2 diabetes, and potentially identify novel treatment and prevention avenues for health disparity populations with both conditions. Other research taking place at RCMI Centers focus on topics such as environmental factors, substance use, HIV-AIDS, prostate cancer, racial and ethnic differences in periodontal disease microbiomes, and adversity-driven chronic pain. The RCMI program has transitioned from a grant award mechanism, designed for researchrelated support, to a cooperative agreement, which supports meritorious research projects as well as access to core facilities resources. This also allows NIH staff to have more substantial programmatic involvement. NIMHD staff have met with representatives from RCMI institutions to develop the best strategies for the RCMI institutions to coordinate collaborative efforts among the institutions and leverage their respective capabilities to maximize their impact. NIMHD will continue to support the RCMI program to leverage the diverse expertise of the RCMI-funded institutions as important partners in advancing the mission of NIMHD to improve minority health and eliminate health disparities.
Supporting World-Class Researchers- NIH aims to sustain and diversify the biomedical research workforce to foster creative discoveries and innovative research to protect and improve health. Over the last decade, NIH implemented policies to expand opportunities for early-career investigators to secure funding. NIH focuses resources on the longterm stability of the biomedical research workforce by prioritizing meritorious applications from early stage investigators and developing evidence-based strategies to support research-specific workforce issues. NIH will continue to identify and pursue activities to improve management of the biomedical research enterprise. NIH is also committed to a robust portfolio of training grants to prepare scientists at all academic levels for careers that have a significant impact on the health related research needs of the nation. This includes the Ruth L. Kirschstein Institutional National Research infrastructure to broaden the geographic distribution of NIH funding. The IDeA program also serves the unique populations of these areas, such as rural and medically underserved communities. Leveraging research institutions supported by the IDeA program, the IDeA States Pediatric Clinical Trials Network broadens access to cutting-edge clinical trials, applies findings from other relevant pediatric studies to children in IDeA state locations, and builds national pediatric research capacity. The Budget provides $15 million for the IDeA States Pediatric Clinical Trials Network to continue studies such as the multi-site clinical trial. This clinical trial evaluates the dosing, safety, and efficacy of drugs that are commonly prescribed to children. NIH-funded activities will also advance a study that aims to decrease pediatric obesity rates in rural areas through use of mobile health technology.