Specter-Durbin Amendment Ups NIH Stimulus to $10B

Update: See more recent post for update on how the NIH portion will be disbursed. The American Recovery and Reinvestment Act of 2009 keeps full $10B for the NIH, to be distributed as noted in the more recent conference report post.

I’d been waiting to see if more details came to light about this, but on Tuesday, the Senate approved the Specter-Durbin Amendment (with a secondary amendment to it by Tom Harkin) that will provide an additional $6.5 billion to the NIH as part of the economic stimulus package. This all seems to be going to the Office of the Director. According to Specter’s press release:

The Specter-Durbin Amendment provides an additional $6.5 billion for the NIH – bringing the total to $10 billion over two years – and is completely offset by funds from the State Fiscal Stabilization Fund. The additional dollars would be distributed to each of the Institutes and Centers in amounts proportional to their funding level in Fiscal Year 2008.

The Harkin Amendment simply eliminates the offset from the State Fiscal Stabilization Fund and reads as follows:

The amendment (No. 178), as modified, is as follows:

(Purpose: To provide an additional $6,500,000,000 to the National Institutes of Health for biomedical research).

On page 130, line 3, insert after the period the following: “The additional amount available for `Office of the Director’ in the previous sentence shall be increased by $6,500,000,000:

Provided, That a total of $7,850,000,000 shall be transferred pursuant to such sentence:

Provided further, That any amounts in this sentence shall be designated as an emergency requirement and necessary to meet emergency needs pursuant to section 204(a) of S. Con. Res. 21 (110th Congress) and section 301(b)(2) of S. Con. Res. 70 (110th Congress), the concurrent resolutions on the budget for fiscal years 2008 and 2009.

In case you are curious about how your elected representatives perceive the plight of the NIH and researchers throughout the US, I’ve included the discussion of the boost to the NIH on the Senate floor:

The amendment, as modified, is as follows:

(Purpose: To provide an additional $6,500,000,000 to the National Institutes of Health for biomedical research)
On page 130, line 3, insert after the period the following: “The additional amount available for `Office of the Director’ in the previous sentence shall be increased by $6,500,000,000:

Provided, That a total of $7,850,000,000 shall be transferred pursuant to such sentence:

Provided further, That any amounts in this sentence shall be designated as an emergency requirement and necessary to meet emergency needs pursuant to section 204(a) of S. Con. Res. 21 (110th Congress) and section 301(b)(2) of S. Con. Res. 70 (110th Congress), the concurrent resolutions on the budget for fiscal years 2008 and 2009:

Provided further, That the amount under the heading `State Fiscal Stabilization Fund’ under the heading `DEPARTMENT OF EDUCATION’ in title XIV shall be decreased by $6,500,000,000.”.

Mr. SPECTER. The basic amendment calls for the addition of $6.5 billion to the National Institutes of Health, and the modification provides for an offset from the State Fiscal Stabilization Fund.

Before proceeding directly to the discussion on the amendment, a few observations about the bill generally: I believe an economic stimulus is necessary. We have seen the unemployment rate rise to 7.2 percent last month. Some 2.8 million people lost their jobs last year. Each day brings new reports of additional people losing their jobs. We know the safety net is failing. We know there is a need to liberalize bank credit, the foreclosure rate is very high, and there is a need to provide Government intervention to stop the foreclosures. In the midst of all of these issues, there is, admittedly, the need for a stimulus package.

I am concerned about the House bill in a number of respects. I believe, for example, there is insufficient money in infrastructure. Pennsylvania Governor Rendell has assured me that the spending on highways, bridges, and roads could begin within a period of some 6 months.

There needs to be more on the tax cut side, in my opinion. There are many programs in the stimulus package which are very good programs–programs which I have fought for during my tenure as chairman or ranking member of the Labor, Health and Human Services, and Education Subcommittee–but many of these belong, really, in the appropriations process as opposed to a stimulus.

It is my hope, as we work our way through the bill, that the bill will be improved. I would like to see a bill emerge from the Senate that would be really directed toward stimulus, a bill which I could enthusiastically support.

The amendment which is offered here today is for the National Institutes of Health, which has been starved recently. During the decade when I chaired the Subcommittee on Labor, Health and Human Services, and Education, with the support of the ranking member, Senator Harkin–who is now chairman, and I am ranking member; and when Senator Harkin and I shift chairmanship, it is a seamless transfer; we work together on a partnership, bipartisan basis–together we took the lead in increasing NIH funding from $12 billion to $30 billion. Some years, the increases were as high as $3 billion, $3.5 billion. Lately, with the budget crunch, that has been impossible to maintain.

The cost-of-living adjustments have not been made, and there have been across-the-board cuts, so there has been an actual decline of some $5.2 billion of NIH funding in the last 7 years. This $10 billion allocation, if enacted, would correct that. It would give a boost and would provide jobs, high-paying jobs, at a time when the passage of the amendment would kill two birds with one stone. It would stimulate the economy by producing good, high-paying jobs, and by reducing major illnesses, which I will specify in a few moments, it would cut the cost of health care. What better way to reduce health care costs than to prevent illness, prevent heart disease, reduce the time of Alzheimer’s, and cut back on the incidence of cancer? The statistics show there would be good-paying jobs created by this $10 billion. According to NIH Acting Director Dr. Raynard Kington, the $10 billion would result in the creation of some 70,000 jobs over the next 2 years. These funds could go out in a range of 6 to 9 months, and certainly in less than a year, so it has the impact of being very promptly disseminated.

The benefits are statistically demonstrable by the high costs associated with diseases which these funds are designed to cure or to ameliorate. For example, the annual cost associated with cardiovascular disease amounts to $448.5 billion a year; cancer, $219 billion a year; Alzheimer’s, $148 billion; and so it goes on down the line.

The recent statistics show significant improvements on these maladies, I think attributable, fairly, to the advances by NIH research.

For example, between 1994 and the year 2004, the number of deaths from coronary heart disease declined by 18 percent and the stroke death rate fell by 24 percent. Were it not for groundbreaking research on the causes and treatment of heart disease, supported in large part by NIH, heart attacks would most probably account for an estimated 1.6 million deaths per year instead of the approximately 440,000 deaths experienced last year in 2008.
The absolute number of cancer deaths in the United States has declined 3 years in a row despite the growth and aging of our population, which is a truly unprecedented event in medical history. The 5-year survival rate for localized breast cancer has increased from 80 percent in the 1950s to 98 percent today. That is a pretty encouraging figure for people who have breast cancer or are fearful of getting breast cancer. For childhood cancers, the 5-year survival rate has improved from less than 50 percent in 1970 to 80 percent today. The 5-year survival rate for Hodgkin’s lymphoma has increased from 40 percent in 1963 to more than 86 percent in the year 2003. For non-Hodgkin’s lymphoma, the survival rate has increased from 31 percent in 1963 to 63.8 percent in 2003. Over the past 25 years, the 5-year survival rate for prostate cancer has increased from 69 percent to almost 99 percent.

Now, if you take anybody who is in the category of breast cancer or prostate cancer or Hodgkins or non-Hodgkins, those survival figures are very encouraging. I didn’t know–when I joined the Appropriations Committee and selected the Subcommittee on Labor, Health, Human Services and Education and led the fight with Senator Harkin to increase NIH funding from $12 billion to $30 billion and to have the National Cancer Institute funded by $5 billion–I didn’t know I would one day be standing on the floor of the Senate citing statistics which include me. When we talk about non-Hodgkins, that is Arlen Specter. I was shocked in February of 2005 to find that I had non-Hodgkins; tough chemotherapy, recovery, lost all my hair, got it all back, and fine. Then, last year, I had a recurrence; more chemotherapy, more rehabilitation, maintained my Senate duties, was on the floor, presided over the confirmation hearings of two Supreme Court Justices in 2005, worked with Senator Harkin, right down the line. So those are pretty important statistics if you are one of them–if you are one of them.

It is my opinion that it is scandalous in this country that we haven’t done more by way of combating these illnesses. I requested an estimate from the cancer community of what it would take to make a major attack to virtually cure cancer. We can’t talk about curing cancer, but the kind of a major attack which would reduce cancer very materially. We got back a figure of $335 billion over 15 years. Well, those are big numbers, but they would pay off in very substantial rewards when you consider the cost of cancer is over $200 billion a year. The cost of heart disease is almost $450 billion a year. There are ways and economies within the Federal budget to deal with those issues.

Today we are talking about a much lesser figure. We are talking about $10 billion. That would be a downpayment and a sign of a serious effort to go after these maladies. When you have a stimulus package of $819 billion in the House bill–it may go up higher than that–this is a relatively small sum. When we structured the original bill at $3.5 billion, we talked about what would be doable. We came up with $6.5 billion. I am not sure that we didn’t make a mistake, that we ought to be looking for more of the $800 billion plus to deal with these maladies, but at any rate, that is where we are.

Senator Harkin and I have a little difference of opinion on the funding as to whether there ought to be an offset. My view is it is a minor difference of opinion, but one which we are going to present to the body for a vote. In looking over the allocation of the entire budget, I found there is $79 billion in what is called a State fiscal stabilization fund. Well, I think there are limits as to how we ought to go on stabilizing the States’ fiscal policy, but at any rate, included in that amount is $24.7 billion to be used for a wide range of public safety and other governmental services which may include education or may not include education. All of these funds are proposed to go out under a population-based formula, but are in no way targeted to States with the biggest economic problems or greatest budget shortfalls.

It is unclear what stimulating effect this funding would have, and the purposes of the funding are undefined. So when you have almost $25 billion with the purposes of the funding undefined, it seems to me it is a much better use of that money, about a quarter of it, to fund the $6.5 billion which is the subject of the amendment which I have just described.

Senator Harkin and I have discussed this in an amiable way, as we always do. He is going to speak next and is going to propose a second-degree amendment so that there not be the offset. I have already stated my preference to have an offset because we are dealing with very serious deficit problems, and I thought that if it were possible to do this funding with an offset which was reasonable, it would be preferable than adding to the deficit. But if Senator Harkin prevails on his second-degree amendment and there is no offset, so be it, and we will have reached the core principle of trying to get these funds into the National Institutes of Health.

I yield the floor.

The PRESIDING OFFICER. The Senator from Iowa is recognized.

Mr. HARKIN. Madam President, first, let me thank my friend and my colleague from Pennsylvania, Senator Specter, for his continued support of basic research, biomedical research in this country. Ever since I first got on this committee back in 1988, Senator Specter, of course, was chair and I was ranking member, and later I became chair and he became ranking member, and then he became chair and I became ranking member. It has passed back and forth a lot of times since 1988. But the one person who has always been consistent in his support of biomedical research and support for the National Institutes of Health has been my friend, Arlen Specter of Pennsylvania.

I support his amendment, I wish to say right off the bat. Everything that is in it I support. We do have to bring NIH back up to its funding level. I say to my friend, one of my proudest achievements in the Senate was working with the Senator from Pennsylvania to double the funding of NIH over a 5-year period. To show my colleagues how bipartisan it was, it started under a Democratic President and ended under a Republican President. There was one change in there for a couple years when I was chair and the Senator from Pennsylvania was ranking member and then it went back and forth, but as the Senator said, that has always been kind of seamless in terms of passing the gavel back and forth. But doubling the funding for NIH over 5 years was a Herculean task and the Senator from Pennsylvania was a leader in that effort. We worked hard on that, and we got it done. That was in 2003.

Now, since 2003, we are 10 percent lower now in real funding for NIH than we were in 2003. I am sure my friend from Pennsylvania would agree that we did not work hard on both sides of the aisle and with two different administrations to get this done only to have it sort of sit there static, and then come back 10 years later or something, and then have to double it again. Our goal was to get NIH back up to a funding level so that the number of peer-reviewed grants that were funded would be closer to the 1-in-3, 1-in-2, 1-in-3 area that it had been in the earlier days of NIH. By the time we got to the point where we started the doubling–and that was in 1998, if I am not mistaken; it might have been 1999, 1998–we were down to where 1 in 10, 1 in 8 peer-reviewed grants were being funded. Sad to say, we are right back almost to that situation again. We are down to where maybe somewhere between 1 in 6 and 1 in 10 grants are being funded.

Now, what does that mean? That means researchers at NIH–let me back up here. That means that researchers at the University of Pennsylvania, at the University of Iowa, at the University of California, at universities in New York State, universities in Florida, universities in Illinois, universities in Wyoming, universities in Arizona, every State in the Nation gets funding through the NIH for research. These are universities, basically. So this funding goes all over the country.

So what does that mean, that we are now back at the level where 1 out of 6 to 1 out of 10 peer-reviewed grants are being funded? Well, what it means is that young researchers–and these are people who are at the top of their class; these are the brightest of the bright; these are students who have gone through either medical school or genetics or biomedicine or biology, a lot of different disciplines involved here, and they have some ideas they want to pursue, some basic research they want to pursue. They are in their twenties. They spent a lot of money going to college. They want to pursue a field of inquiry. Now they are told that the average age for getting their first grant is 42 years of age.
Well, if you are a young person and you are just out of college, are you going to wait around until you are 42? No. You are probably going to go to work for the private sector, private industry some place.

So what we are doing is we are losing a lot of bright young researchers. When we doubled the funding for NIH, a lot of young researchers started there, and they are there now, but we are losing a whole other generation of these young researchers. So that is the effect of what has happened at NIH.

What it means also is that we are losing our preeminent role in the world as the leader in biomedical research. We have to maintain it. We have always been sort of–if you want to talk about a city on a hill, when it comes to biomedical research, we have always been that to the rest of the world. The rest of the world looks to NIH. Keep in mind it was through the NIH that we mapped and sequenced the entire human genome, mapped and sequenced the entire human gene. Guess what. It is out there for researchers all over the world. Any researcher anywhere in the world can tap into the database at NIH and find out all the information they want on the genetic structure and use that for their research. Guess what. It is free of charge. Free of charge. That was a great investment by the taxpayers of this country and already paying big dividends.

So it pains me, I know as it pains my friend from Pennsylvania, to now see NIH going back down again in terms of its support. As I said, right now, NIH funding has dropped more than 10 percent in real terms since 2003. That was at the end of the doubling period.

Some people might say, Well, what does this have to do with stimulus? Well, this does stimulate the economy, both in the short term and in the long term. As I have said many times about this stimulus bill, it is two things. One, it is to, yes, put people to work right away. That has to do with a lot of the construction projects that are in here. But there are a lot of other things in this bill that provide for a foundation for solid recovery down the pike–2 years, 5 years, 10 years from now. Now, every time in the short term, when we think about NIH in the short term, every time a researcher gets a grant, it supports an average of seven jobs. Let me repeat that. Every time a researcher gets a grant, on average, it supports seven jobs. So it is not just one researcher in a lab by himself or herself; it is lab technicians, postoperative fellows, research assistants, and on and on. So there is a great multiplier effect.

There is also a ripple effect from this research. Keep in mind this is basic research. These are asking the most fundamental of questions.

Well, maybe the grant has led to basic research that will lead to a new compound that a pharmaceutical company wants to develop into a new drug that helps save lives. Senator Specter talked about the research at NCI, National Cancer Institute, and the great strides they have made. The Senator is living proof of that. We watched the Senator go through a long hard period, and it is wonderful to see him here as healthy, vibrant, and determined as ever to make sure we fund NIH. He is living proof of the great strides we have made. So that has a ripple effect. If there is more money now in the economy, maybe an entrepreneur will use some breakthrough on research to form a spin-off company. That happens all the time, and that stimulates the economy.

As I said, this money goes to researchers all over the country, not just to Bethesda, MD, where the headquarters is. Very little of it goes there. It goes to every State–to 90 percent of all congressional districts. So it helps the entire country.

Now, that is in the short term. There is a longer term benefit, which is improving people’s health. After all, that is the purpose of this research in the first place. It is called the National Institutes of Health, not the National Institutes of Biomedical Research. The goal is health. In the long term, it is going to be a healthier workforce, healthier people, cutting down on health care costs, making people more productive in their lives because of the research we do through NIH. We always say “at,” but it is “through” NIH. If our workers are healthier, they are going to be more productive.

Again, I support this amendment almost in its entirety–except for the way we are going to fund it. My friend spoke about that, and I have a small disagreement. The Senator’s amendment would take the money as an offset out of what is called the State fiscal stabilization fund. Here is the problem as I see it.

The State fiscal stabilization fund provides critically needed funding for education. Just this afternoon, I had the presidents of most of the independent colleges in my State visiting me. A lot of this money will go to help them in their colleges. It will help our community colleges. A lot of money will go to community colleges to help retrain workers for the future. Our pre-K through 12th grade money comes from the stabilization fund. There is a lot of money in that stabilization fund that goes for public safety and other government services. We don’t need to be laying off teachers. We need to keep our teachers hired.

That is what this money would go for. So I don’t think we ought to be cutting into that fund. I strongly support Senator Specter’s amendment–the main purpose of it–to increase funding for NIH. Again, I just have a slight difference on how it should be funded. Let’s face it, this whole bill is emergency spending. We are up to about $900 billion right now. As I have said before, a lot of economists, both liberal and conservative, have said we are not doing enough. We had Milton Friedman, President Reagan’s economist, a very conservative economist, who said we may not be doing enough; Alan Blinder, Mark Zandi–a broad spectrum of economists are saying this is one time when we should err on the upside not the downside.

If this whole bill is emergency spending, why, I ask, should the funding for NIH not be the same? Why would we want to take it out of education, take it out of public safety, out of other areas to pay for NIH. This whole bill is emergency spending. Quite frankly, I think it ought to be. We are in an emergency. Things are going downhill very rapidly in this country–in my State, and I know in every other State. Companies are shedding jobs every day–9,000 every day.

Since the whole bill is emergency spending, I think NIH ought to be right in there with everything else. It is that important. I think it ought to be emergency funding, so I have a second degree that I will be offering to the amendment by the Senator from Pennsylvania that would basically make the funding for the amendment the same as everything else in this bill. I hope we will get support for that. Why discriminate against NIH? Don’t do that. Put it in with everything else.

With that I yield the floor.

7 Comments »

  1. George Smiley said

    “This all seems to be going to the Office of the Director. ”

    So glad that Zerhouni’s left…

  2. D said

    I am wondering how they are going to spend it all so fast this fiscal year. Any new RFAs will have to have a very fast turn around time. Get your typing fingers ready to for some fast submissions.

    Considering that the current version of the bill gives preference to activities in which 50% of the funds can be in use no later than 120 days after the date of enactment and requires competitive grants be awarded no later than 90 after the date of enactment of the Act, this will be a REALLY fast turnaround for writing AND reviewing. – writedit

  3. writedit said

    Science has the same concern about spending such a huge wad of money so quickly. Jeffrey Mervis notes that

    the trick will be to avoid a crash when the stimulus money dries up. For infrastructure projects, that means not letting capacity outstrip the government’s ability to support the researchers who will occupy the space. The challenge is even greater for grants, requiring a delicate balancing of veteran and first-time grantees, consideration of the impact on underrepresented groups, and avoiding a bolus of new grants that expire at the same time and trigger a flood of application renewals. Any mistakes in managing either pot, say scientists from both the previous and current Administrations, could destabilize the overall scientific enterprise.

    He provides a nice synopsis for the NIH and NSF funding infusion as well:

    Acting NIH Director Raynard Kington says the agency has drawn up three ways to spend the grants’ portion of the windfall, which is $1.5 billion in the House version and $2.7 billion in the Senate. (Senator Arlen Specter (R-PA) has proposed bumping the Senate number to $9.2 billion.) The first would be a new call for proposals involving “topics in which there have been scientific or technical challenges” that might yield quick results with a blast of cash. Researchers would apply for accelerated review for awards of up to $500,000 a year for 2 years. These challenge grants would fit well with NIH’s emphasis on new investigators and high-risk science, Kington says.

    NIH would spend some of the stimulus money on standard investigator grants (R01s) that scored well in peer review last year but didn’t get funded. The catch: The money would last only 2 years instead of the usual 4 years. Finally, Kington says, NIH might also add to the size of the awards made to investigators whose requested budgets were cut or who can identify “related research areas that might be meritorious.” Again, however, the supplement would probably be for only a couple of years.

    All of these strategies are aimed at avoiding what Kingston calls the “hard lesson” of the 5-year doubling that left grantees with what Marburger describes as “a gargantuan appetite” that NIH hasn’t been able to fill. “There will be great pressure [to use the stimulus money] to fund more R01s just as we currently fund them,” Kington says. “But we have to be careful that we do not do anything imprudent, and that includes setting ourselves up to have big commitments 2 years out” that can’t be met.

    The House bill would also give NIH $1.5 billion to spend on repairs and improvements of extramural research facilities and for “shared instrumentation.” (The Senate would provide $300 million.) NIH is all set to handle awards like these and can do it quickly, Kington says. Both houses have proposed $500 million for renovations to the NIH campus.

    The House bill would give NSF $2 billion for new research grants and $900 million for three different types of infrastructure programs, including reviving and expanding one for university projects. The Senate is offering less in both categories–$1 billion and $350 million.

    Rather than asking for new proposals, Director Arden L. Bement says that program managers will dip into the pool of existing applications submitted since 1 October 2008, the start of the 2009 fiscal year, and fund those rated most highly by reviewers. “We have enough in our backlog to spend that [$2 billion] right now,” he says. The expansion will also allow NSF “to take care of young investigators,” he adds.

    Money for a multiyear grant (typically 3 years) would be committed up front, at the time of the award, rather than parceled out year by year. That will put pressure on investigators “to spend it quickly rather than putting it into the bank,” says Bement. NSF estimates that the House package translates into 3000 additional awards that would employ 12,750 scientists, postdocs, and graduate and undergraduate students. Then there’s the impact on the economy of what’s bought with the grant, everything from reagents to highend instrumentation.

    NSF also plans to stay the course on infrastructure spending. Bement says he will dust off and update the last solicitation for an identical but smaller academic modernization program that lapsed in 1997 if the $200 million proposed by the House makes it through the legislative gauntlet.

  4. rlspatient said

    Funding grants that missed the payline from last year ONLY is nice for those who did not give up submitting NIH grants during the 8 year “scientific winter” imposed by the Bush administration. But what about those PI’s who wish to submit grants designed to ask fundamental questions NOW? They won’t get a chance because NIH will spend the money as fast as they can on last year’s proposals that did not make the payline. What about those grants submitted 2, 3 or 4 years previously that missed the payline BUT WENT TO THE HIGH PRIORITY PROGRAM (HPP?) THAT INSTITUTES (e.g., NINDS) have in place to identify promising and fundamental, needed research that just missed the payline for that review cycle? These APPROVED BUT UNFUNDED Grants (due to sustained flat-budgets) have now been administratively withdrawn. Arguably, these APPROVED but UNFUNDED HPP grants should be considered for funding just as equally,if not preferentially, to last year’s grants that missed the payline. Arguably, they should be funded first since they were already vetted, disussed and approved by institute Council members, and presumably minutes were taken with records already in place to identify such outstanding fundable projects.
    The point here is that there is a lot of bad feelings by researchers out there who tried for so long to maintain adequate NIH funding to keep their programs going when the Bush Administration was so focused on waging wars. Director Bemet’s plan to pay those from Oct 2008 that missed current funding paylines ( up to 2 billion now) would be welcome but would ignore all previously highly meritorious research proposals from previous years. One can only hope that the payline is not pushed back so far as to ignore more meritious research proposals from previous fiscal years just to keep bookeeping at bay.
    An alternative may be to invite those PIs whose proposals were administratively withdrawn to re-submit under a fast tract review system to distribute the stimulus packaged (10 billion) more equitably.

  5. writedit said

    The NYT reports that the negotiated $789 billion stimulus package keeps all $10 billion for the NIH:

    For instance, even as negotiators accepted many of the Senate’s reduced spending provisions, they were careful to maintain an additional $6.5 billion for medical research that was inserted at the insistence of Senator Arlen Specter, Republican of Pennsylvania, who is a cancer survivor.

  6. […] for similar administrative supplement offers from other ICs looking to spend their stimulus wad. Possibly related posts: (automatically generated)NIH Grant Numbers […]

  7. writedit said

    Nature has a nice synopsis of how the money is distributed.

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