Federal medical research began 2022 in a state of transition. Dr. Lawrence Tabak is currently serving as Acting Director of the National Institutes of Health (NIH) following the departure of long-time NIH Director, Dr. Francis Collins. Meanwhile, Dr. Joni Rutter continues to serve as the Acting Director of the National Center for Advancing Translational Sciences (NCATS) at NIH. While active searchers are underway, candidates have yet to be put forward for either the role of NIH Director or NCATS Director. The NIH Director position requires presidential nomination and Senate confirmation and with how politicized science has been recently, this may prove to be a high-profile and protracted confirmation process.
Meanwhile on Capitol Hill, Congress continues working to complete the Fiscal Year (FY) 2022 appropriations process. Federal agencies, including NIH, are currently operating under a continuing appropriations resolution (CR) that serves as a stop gap measure and keeps programs operating at current funding levels. The CR is set to expire on February 18th, and House and Senate negotiators are seeking consensus on a final FY22 omnibus package. The current House and Senate spending bills are extremely generous to NIH, medical research, public health, and health workforce programs, but one of the key items left to be negotiated is the final balance between defense and non-defense spending. The real threat comes if lawmakers cannot find a compromise and instead enact a full year CR, thus forgoing any funding increases for FY 2022.
It is an election year and Congress is shaping up to have a substantial legislative agenda to consider during the lame duck session after the November elections. In addition to considering the FY 2023 spending bills, Congress has numerous timely healthcare priorities including legislation to establish the Advanced Research Projects Agency for Health. Moreover, with the prospects for the Build Back Better Act unclear, popular healthcare proposals may need to find another vehicle or be considered as stand-alone measures later this year. While virtual advocacy continues to be the order of the day, congressional offices have been highly accessible and receptive to advocates that engage with them and request support for key priorities (including funding recommendations and healthcare legislation).