Ups and downs for health research Essay

The administration’s fiscal year 1986 budget proposes
continued health for some biomedical research activities and amputation for others. While promising the maintenance of “a strong national
health research capability,” the budget calls for a $290 million
cut in the National Institutes of Health’s (NIH) budget, a net gain
of $4 million for the Food and Drug Administration (FDA) and a $16
million drop for the Centers for Disease Control (CDC), which includes
an $8 million loss for occupational safety and health.

The NIH budget proposal presumes that a novel bit of bookkeeping the administration has planned will be allowed to stand–allocating
approved FY 1985 dollars for expenditure in 1986 and 1987 by funding
some grants for three years. Pushing “hard” money
appropriated in one year into the future is apparently a funding first.
Says one staffer on the Senate Health and Human Services subcommittee,
“If it isn’t illegal it’s on the cusp of being
illegal.” Rep. Henry A. Waxman (D.-Calif.) has introduced a House
resolution that directs NIH to use its FY ’85 money as initially

The total proposed reduction in NIH’s budget is from a $5.14
billion obligation to $4.85 billion; research activities would drop from
$2.79 billion to $2.61 billion. Research trainees would be spared the
ax, their numbers holding steady at 9,900.

Usually a new one-year grant carries the promise of funding for the
next two years anyway, so a three-year commitment wouldn’t change
much for the recipients. Congress okayed 6,500 first-year grants for FY
’85, a jump from the level of around 5,000 that has been maintained
sinced 1980. NIH has thus far funded about 2,000 grants in FY ’85;
the President hopes to move $203 million from the remaining pool (and
$35 million from research centers) into 1986 and 1987, dropping the
grant number back down.

Reaction from the research community has been, not unexpectedly,
negative. What Congress will do with the FY ’86 budget depends on
whether it lets stand the FY ’85 change.

FDA’s $4 million gain from its $410 million ceiling in 1985
won’t cost the taxpayers if plans to initiate users’ fees go
through. Under the President’s plan pharmaceutical companies will
have to pay to apply for new drug approvals. CDC’s budget also
calls for users’ fees, with the anticipated generation of $1
million collected for laboratory certification.

AIDS research fares well in the proposed budget, with plans for an
$86 million expenditure in 1986.


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