Critics call NIH bloated. Advocates insist spending cuts are a matter of mortal danger.
Congress's year-end budget deal would blunt spending cuts scheduled to hit the federal government's premier medical research board, but that's cold comfort to advocates who insist the sequester spending cuts are already putting the public in peril.
The National Institutes of Health was on track for an additional 2 percent budget cut come January, but the new budget deal would raise the total spending cap on nondefense spending by $22.5 billion, restoring about 61 percent of sequestration cuts on that side. The specific impact on NIH will not be determined until the Appropriations committees decide how to allocate the funding by Jan. 15.
The House voted to pass the legislation Thursday, and the Senate is tentatively expected to do so before leaving town for the year.
But while the deal grants some relief from spending cuts, the NIH budget will still remain lower than it would be without sequestration. The increase in some discretionary funding in 2014 does not fully undo the first round of sequester spending cuts, which amounted to $1.55 billion -- 5 percent of NIH's annual budget -- in fiscal 2013.
Leaving those cuts in place is a major sticking point for the institutes' champions in Congress. "We're about to kill the goose that lay the golden egg," Rep. Jackie Speier, D-Calif., told reporters last Tuesday.
"We have so many great success stories to point to. To think we are now starving the great institution that has borne so much fruit is really quite disturbing," Speier continued, citing the role the agency played in reducing cancer and heart disease mortality in recent decades.
But just because NIH's advocates are alarmed doesn't mean that its critics are happy.
"The NIH budget is huge. I don't doubt there is a lot of good and useful research they do. There's also no question they literally waste millions on studies you can't call anything other than stupid research," says Hans von Spakovsky, senior legal fellow at the Heritage Foundation.
Von Spakovsky says NIH funding should be going to "real research," such as the development of new antibiotics. He argues the budget cuts should refocus attention to those kinds of grants, and cites recent NIH studies—including one at Ohio State University on massage therapy in rabbits, and one at the University of California San Francisco on the role of breathing in meditation—as examples of wasteful research spending.
"I don't see any reason for sequestration cuts to be restored," he says. "They haven't shown any acknowledgment or plan to stop giving to ridiculous studies."
The NIH budget debate is part of the larger budget battle over the sequester. Those more sympathetic to government spending insist the cuts are eroding the building blocks of economic growth and national well-being, but doing so in a way that's not immediately obvious. Spending hawks are saying the damage is not obvious because, by and large, it's not occurring at all.
Carrie Wolinetz, president of United for Medical Research, a coalition of research institutions and patient and health advocates, says the budget cuts prevent NIH from continuing the full extent of its life-saving research.
The group launched a series called "Sequester Profiles: How Vast Budget Cuts to NIH Are Plaguing U.S. Research Labs" to emphasize the importance of medical research and the damage sequester cuts have on NIH's progress.
Advocates name limited medical innovation, delayed research, loss of jobs, and decreased international competitiveness as harms of the agency's cuts that were implemented this year.
UMR notes that in 2012 alone, NIH funding supported more than 402,000 jobs and $57.8 billion in nationwide economic output. NIH estimates that 640 fewer research project grants will be awarded in fiscal 2013 compared with 2012.
"One of the things most respected throughout our work is the contribution we've made to the rest of world," said Dr. Donald Small, director of the Pediatric Oncology Division at Johns Hopkins University School of Medicine Sidney Kimmel Comprehensive Cancer Center. "We're worried we're losing that leadership right now, along with all the jobs that go with it."