‘Disturbing’: Biden’s proposed NIH budget draws criticism

President Joe Biden’s 2023 budget would direct more money to medical research agencies, but some are surprised at the proposed spending for the National Institutes of Health.

The NIH, the chief source of federal funding for medical research, would get $49 billion, an increase of nearly 10%. However, the extra money is almost entirely dedicated to a new federal agency: the Advanced Research Projects Agency for Health. Take away the extra money for the new agency, and the NIH’s increase is less than 1%.

Research!America, an advocacy group that promotes investing in research, sharply criticized the Biden administration’s spending proposal for NIH.

“I was really shocked and many were that NIH got such an anemic increase,” said Eleanor Dehoney, vice president of policy and advocacy at Research!America.

“It was disturbing because if ever there’s been a moment where we have a sense of the impact diseases have on every facet of our lives and can just wreak havoc, it’s now,” she said.

“It’s worrisome to say the least,” she said.

The president’s spending plan will be reviewed and revamped by Congress. The NIH has enjoyed bipartisan support in Congress, so she expects lawmakers will put more money to the NIH, Dehoney said.

When asked if Congress will go above Biden’s proposed NIH request, Dehoney said, “I’d say it’s 99.9%. There’s very little chance this actual distribution stays in place.”

At the same time, Research!America and other advocates welcome the creation of the new agency known as ARPA-H. The Biden administration conceived of the new agency to focus on high-risk, high-reward research to find breakthroughs in cancer and other diseases. He made a pitch for the agency in his State of the Union address in early March where he implored Congress, “Let’s end cancer.”

Congress agreed to establish ARPA-H and directed $1 billion for it in the 2022 budget, which is much less than the $6.5 billion Biden originally sought. So Biden is proposing an additional $5 billion for ARPA-H in the 2023 spending plan.

Research advocates see value in the new agency but don’t want to see the NIH short-changed.

“We are very supportive of ARPA-H,” Dehoney said.

Research!America and other groups, such as the Association of American Medical Colleges, are hoping NIH and ARPA-H both get substantial increases in the 2023 budget.

David Skorton, the AAMC president and CEO, and Karen Fisher, the AAMC’s chief public policy officer, urged Congress to support both agencies. The NIH supports research at medical schools and teaching hospitals.

“The proposal’s increased investment in (the) Advanced Research Projects Agency for Health (ARPA-H) would support the new entity’s forthcoming agenda for transformational science,” Skorton and Fisher said in a joint statement.

“Yet stakeholders across the board agree that in order for ARPA-H to be successful, the investment in ARPA-H must be coupled with meaningful growth in the NIH base budget, which the budget request neglects to include.”

ARPA-H is going to operate separately from the NIH so it can take independent and innovative approaches, and Dehoney said that will give it a better chance for novel therapies and cures.

The Biden administration’s other proposals are drawing strong support.

The Centers for Disease Control and Prevention would get $10.68 billion in 2023, an increase of $2.3 billion, or about 27%, over the current year. The budget includes mandatory funding for pandemic preparedness.

Lawmakers are likely to ask some tough questions over how the CDC uses its money, Dehoney said. But the Biden administration’s proposal for CDC is a welcome step for an agency that hasn’t received the support it needs, Dehoney said.

“There is a recognition that you can’t run on fumes,” Dehoney said. “We’ve asked the CDC to do that for years.”

“They have needed more resources for years,” she said, adding, “It’s time for Congress to step up and help.”

Research!America also pointed to another agency that needs more support: the Agency for Healthcare Research and Quality. The agency focuses on improving patient safety.

Biden has proposed $376 million for the AHRQ, an increase of $26 million, or 7%.

The AHRQ proposal is a good step for an agency that “has been seriously underfunded,” Dehoney said.

The AHRQ can play a critical role in reviewing what went right and what wrong in the COVID-19 pandemic, she said. The agency can look at the number of hospital-acquired infections during the pandemic and ways to reduce them in future emergencies. They can also look at other ways to make sure healthcare gets delivered to everyone who needs it.

“They can do it quickly,” Dehoney said. “They just need the support. They need the charge from Congress.”