Friends of VA Medical Care and Health Research (FOVA)

FY 2003 Funding Recommendations

Medical and Prosthetics Research: $460 million

· Investments in investigator-initiated research projects at the VA have led to an explosion of knowledge that promises to advance our knowledge of disease and unlock new strategies for prevention, treatment and cures. However, many health challenges still confront the veteran community. Additional funding is needed to take advantage of the burgeoning scientific opportunities and improve the quality of life for our nation’s veterans. The VA has identified the following research funding priority areas for FY 2003:

Quality of Care: Additional funding for the Quality Enhancement Research Initiative (QUERI) program would be used to fund centers in prostate cancer and dementia/Alzheimer’s.

Special Populations: VA would expand research in quality of care, community access and restoration of function to achieve greater understanding of existing racial, ethnic and gender disparities in health care.

Chronic Disease Management: VA is proposing two major initiatives in comparing clinical efficacy of 1) vascular surgery conducted on and off cardiopulmonary bypass machines, and 2) open versus endovascular surgery for abdominal aortic aneurysms.

Treatment Strategies in Chronic Progressive Multiple Sclerosis: Recent studies have shown that immunotherapy of acute MS can reduce disability. More studies are needed to determine the optimal therapy for patients.

Micro Technology: In the area of low vision, work in retinal prostheses is an emerging science and may restore sight in a variety of disorders including age-related macular degeneration and retinal pigmentosa.

Patient Outcomes in Rehabilitative Care: Specific areas of emphasis include long-term care strategies to enhance patients’ independence and activities of daily life, consequences of community reintegration and impact of assistive technology on quality and functionality of life.

Diseases of the Brain: Additional studies are needed on the impact of different classes of psychiatric drugs on cognitive and behavioral function.

Bioterrorism: As the agency tasked with providing medical back up services in national emergencies, VA has a special responsibility as well as a unique ability to conduct research on disaster preparedness, pathogen detection, disease diagnosis and treatment, protection and vaccine development.

The complexity of research combined with biomedical research inflation has increased the costs of research. At least $15 -$20 million is required just to maintain the current level of research activity on conditions prevalent in the veteran population such as prostate cancer, diabetes, heart diseases, Parkinson’s disease, mental health, spinal cord injury and aging related diseases.

Research Facilities Improvement: $45 million

In 1997, NIH conducted site visits of six VA research facilities and concluded that, “VA has had increasing difficulty in providing sufficient resources via its congressional appropriation to satisfactorily fund the infrastructure necessary to support research at the VAMCs,” and VA has made no significant investment in its existing research facilities since this finding. Ventilation, electrical supply and plumbing appear frequently on lists of needed upgrades along with space reconfiguration. Under the current system, research must compete with other facility needs for basic infrastructure and physical plant support. FOVA recommends that a new funding mechanism be developed to provide a steady stream of resources dedicated to upgrading and renovating existing research facilities. State-of-the-art research requires state-of-the-art facilities.

Medical Care: $24.468 billion

Consistent with the Independent Budget, FOVA recommends an FY 2003 appropriation of at least $24.468 billion for the VA medical care budget. Our nation’s VA health care system is severely underfunded. The recommended increase would cover expected medical care inflation and mandated federal employee wage increases as well as necessary improvements to address the increasing complexity and volume of care needed by VA’s aging population.