Prospects Looking Better for NIH Funding in 2014

Congressional action on a budget deal in the final days of 2013 means that things are looking up somewhat heading into 2014. On December 10, 2013, U.S. House and Senate budget negotiators reached a deal that may reverse some federal budget cuts in 2014 and 2015. The deal raises budget caps that were established by Congress as part of its deficit reduction efforts in the Budget Control Act of 2011 (Table 1).

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If the deal is approved by Congress—which as of press time looks likely—appropriations for both defense and non-defense discretionary (NDD) appropriations would increase from the caps. NDD appropriations include funding for medical research, public health, and other non–defense-related public services.

While the deal does not replace all of the budget cuts, it is a start. Under the proposal, the NDD cap for 2014 would increase to about $492 billion (up from $468 billion in 2013). If passed, the House and Senate Appropriations Committees would have discretion of which NDD programs to allocate these new dollars towards. Under that scenario, chances are favorable that funding for the National Institutes of Health (NIH), the biggest funder of medical research in the world, would be restored to 2012 levels of $30.8 billion—an increase of $1.1 billion in funding from 2013 levels. It is also possible NIH could even get a slight increase over 2012.

“This is a good deal for kidney disease patients,” said ASN President Sharon M. Moe, MD, FASN. “ASN is urging Congress to pass this legislation, and I hope lawmakers will move quickly to adopt it and pass a budget that restores funding to NIH.”

Advancing research is one of ASN’s central missions and public policy priorities for 2014. ASN’s research advocacy consists of congressional advocacy to raise awareness of and advocate for appropriations for kidney research, and advocacy within federal research agencies for support for kidney research.

ASN launches strategy for research advocacy

In 2014, ASN will implement an aggressive new research advocacy strategy. In addition to advocating for more NIH funding, ASN will ask Congress to direct the Government Accountability Office to develop a comprehensive report that assesses the adequacy of federal investments in kidney research relative to federal expenditures for kidney care. ASN plans to use the report to help bolster its new request for $1.5 billion for kidney research ($150 million over 10 years) above the current funding level.

ASN estimates based on publicly available data indicate that the annual combined total of all federal funding for kidney research is equivalent to less than 1 percent of the annual cost of kidney disease care. NIH is the largest source of federal funding for kidney research. In 2012, the agency awarded $556 million in grants, contracts, and other funding mechanisms for kidney research, which represents just 0.7 percent of the total cost of kidney care in the Medicare system.

In 2014, ASN will also double down on advocacy for more health disparity research funding. Researchers estimate that racial health disparities cost the United States $229 billion between 2003 and 2006. For instance, African Americans in the United States are on average up to four times more likely than other Americans to progress to kidney failure. NIH-supported research recently led to the exciting discovery that African Americans have mutations in the APOL1 gene, which may explain their higher rates of kidney disease. This discovery could lead to better prevention, therapies, and potentially even a cure, but that cannot happen without additional NIH funding for health disparities research.

Moreover, ASN will engage partners in the kidney community to develop a unified advocacy message to promote the public health burden of all kidney diseases and benefits of federal investments in research. During a first-ever meeting with most of the kidney patient and professional organizations at Kidney Week 2013, the participants present agreed on the need and importance of working together and committed to joint collaborations in 2014.

“I believe ASN’s thoughtful research advocacy strategy outlines a forceful approach that should improve funding for kidney research,” said ASN Treasurer-Secretary and Research Advocacy Committee Chair John R. Sedor, MD, FASN. “And while we’re all appreciative of the budget deal, that strategy will be more important than ever in what continues to be tough budget environment.”