Leaders from the National Institutes of Health (NIH) testified before Appropriations Subcommittees on Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) in the House on May 25 and Senate on May 26 on the president’s fiscal year (FY) 2022 budget proposal. President Joe Biden released an overview of the discretionary funding request on April 9 [refer to Washington Highlights, April 16].
Members from both subcommittees shared enthusiasm for the president’s proposal to increase the NIH budget in FY 2022, citing a proposed $2.5 billion increase to the agency’s base budget.
“A sustained commitment to increasing funding for the NIH is a vital step in preserving our status as the world leader in biomedical research and to finding novel treatments and cures for the many diseases burdening our strained healthcare system,” said House Ranking Member Tom Cole (R-Okla.).
Senate subcommittee Chair Patty Murray (D-Wash.) highlighted the proposed increase in the NIH budget and importance of the investment. “The pace of discovery we’ve seen this past year was made possible by research into mRNA vaccines we funded in response to Ebola and other viruses and by a biomedical research enterprise that has been built over decades. … This should be an important reminder, when it comes to biomedical research—you can never fully predict how the discoveries of today, will prepare you for the challenges of tomorrow.”
Both subcommittee chairs and ranking members questioned NIH Director Francis Collins, MD, PhD, on the proposed Advanced Research Projects Agency for Health (ARPA-H) aimed at speeding the translation of research findings into health care applications. The president is proposing a $6.5 billion investment in ARPA-H that would be available for three years.
Senate Labor-HHS Ranking Member Roy Blunt (R-Mo.) highlighted NIH’s COVID-19 diagnostic testing initiative, RADx, as evidence for his support for ARPA-H. “I think [RADx] put us in a different place than we would have been two years ago in thinking about how we can look at some of our research efforts in another way. That's why I want to work with the administration to support the ARPA-H initiative.”
Members questioned how ARPA-H would fit in at the NIH and how it would function differently than the existing National Center for Advancing Translational Sciences (NCATS). Collins commented that ARPA-H would “be like NCATS on steroids,” noting the momentum in delivering clinical advances in response to COVID-19 and how the new initiative could go to support research efforts from all NIH institutes and centers. Collins also worked to allay concerns about the future of the Clinical and Translational Science Awards (CTSA) program within NCATS, adding that the NIH would soon announce changes to ease the CTSA renewal application process.
Related to ARPA-H, House Chairwoman Rosa DeLauro (D-Conn.) added, “I look forward to learning more about this proposal and I want to emphasize that it is critical that we strike a balance between this new approach and investments in basic research and fundamental discovery at NIH.”
Blunt also questioned Collins on the pandemic’s impact to medical research progress outside of COVID-19, following months-long lab closures and a slow return to normal operations. Collins responded that the limited access of researchers to labs was another “terrible casualty” of the pandemic.
“Our estimates are that it's about a $16 billion loss that has occurred because of the way in which this has affected research in our extramural institutions that they are in a tough place to try to make up,” Collins stated. This estimate is an increase from the estimated $10 billion impact to non-COVID-19 research Collins cited in May 2020 [refer to Washington Highlights, May 8].
Several members questioned Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Director Diana Bianchi, MD, on COVID-19 impacts on children. Bianchi described NIH’s work through RADx to better identify children who would be more likely to develop severe COVID-19 symptoms and to implement comprehensive testing programs in schools.
Eliseo Pérez-Stable, MD, director of the National Institute on Minority Health and Health Disparities, discussed NIH’s efforts to address social determinants of health and health equity. He highlighted utilization of standard measures in all human health research to better understand social determinants of health, including race, ethnicity, socioeconomic status, age, gender, as well as housing and other structural measures.
Murray noted concern about diversity in the biomedical research workforce. “Unfortunately, we know that in the biomedical research community the prevalence of researchers of color is too low and the prevalence of sexual harassment is too high,” Murray stated, while also acknowledging NIH’s efforts to address these concerns.
During the House hearing, Collins cited the NIH’s work on structural racism and its impact on the medical and research workforce through the UNITE initiative [refer to Washington Highlights, March 5]. He noted that one component of UNITE would address recruitment of black men in medicine, including efforts to ensure that the research environment would be welcoming in order to retain black medical researchers.
Members from both chambers also inquired about a range of other topics, including gun violence prevention, the impact of climate change on health, the use of animals in research, marijuana research, and foreign government influence in research.
Joining Drs. Collins, Bianchi, and Pérez-Stable were Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases; Ned Sharpless, MD, director of the National Cancer Institute; Gary Gibbons, MD, director of the National Heart, Lung, and Blood Institute; Bruce Tromberg, PhD, director of the National Institute of Biomedical Imaging and Bioengineering; and Nora Volkow, MD, director of the National Institute on Drug Abuse.