NIH Director Francis Collins testifies before House and Senate Appropriators
In March, both the House and Senate Appropriations Subcommittees on Labor, Health and Human Services, Education and Related Agencies held hearings on the proposed budget for the National Institutes of Health (NIH) with Francis Collins, Director of NIH. He was accompanied by Tom Insel, who has been serving as the Acting Director of the new National Center for Advancing Translational Science (NCATS) as well as Director of the National Institute of Mental Health (NIMH) along with Directors from several other institutes. As mentioned in the APA Federal Budget Blog, the president has proposed level funding for the NIH at $30.86 billion for FY13, and Collins explained to Congressional appropriators how NIH is planning to manage its budget. In his testimony to both House and Senate appropriators, Collins reiterated that level funding for NIH has a deep impact on the ability of new scientists to establish successful research careers. Under current funding levels, a new investigator has a less than 20 percent chance of receiving funding, the lowest success rate in NIH history. The impact of possible sequestration in January 2013 that would reduce the NIH budget by eight to nine percent would be even more devastating; under those circumstances NIH would fund 2,300 fewer grants than are planned for FY13.
As an indicator of the traditional bipartisan support for the NIH, members on both sides supported NIH as a funding priority, even in the tough budget climate. In the Senate, Ranking Member Richard Shelby (R-AL) added that he was concerned that NIH’s possible strategies of capping grant amounts for individual investigators or capping inflationary costs may conflict with the policy of letting the merit review process determine which scientists receive funding. Expressing a common challenge for behavioral scientists and policymaker alike in preventing chronic disease like diabetes, Shelby asked Griffin Rogers, Director of the National Institute on Diabetes, Digestive Disorders and Kidney Disease (NIDDK), “How do you get people to eat an apple instead of a cheeseburger?” While Rogers cited research on offering more healthful choices to nudge individuals to make more healthy eating decisions, Chairman Tom Harkin (D-IA) also mentioned his support for NIDDK’s Diabetes Prevention Program, one of the scientifically proven behavioral interventions to prevent Type II diabetes.
Senator Jerry Moran (R-KS) asked Insel about NIMH’s research that would be helpful to returning veterans. In response, Insel stated that NIMH was “particularly concerned about returning veterans and the incidence of Post-Traumatic Stress Disorder (PTSD).” The NIMH’s largest single project, the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) project, is a joint collaboration with the Army that has enrolled more than 30,000 active duty soldiers and will identify risk and protective factors for mental health that may be applied to ongoing health promotion, risk reduction, and suicide prevention efforts.
Senator Sherrod Brown (D-OH) questioned the NIH’s decision to alter the geographic sampling of the National Children’s Study, a decision that has come under scrutiny from scientists concerned about the lack of random sampling in the final study. Having abandoned the household recruitment strategy to improve efficiency, Brown asked whether NIH was going to address the risk of omitting low-income children of mothers without a provider. Collins defended the decision, saying that “we are invested in the success of the NCS, with the goal of following 100,000 kids. We conducted vanguard studies on the best way to ascertain how to enroll that many people. We discovered ways that are at least as effective and considerably more efficient. The main study might be more efficient than knocking on doors, whereas working through geographically distributed providers. We are very sensitive to these issues you raise. It needs to include those with no coverage or providers, to have a representative group, but does give us the information we need to know about genetics and environment.” He encouraged those that have concerns to be part of the process going forward to ensure that NIH is getting all the information it needs.