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Posted at 6:27 PM ET, 02/14/2011

Budget 2012: NIH and CDC

By David Brown

The National Institutes of Health, which is the major vehicle for public financing of biomedical research, gets a $745 million bump up in the president's 2012 budget, to a total of $32 billion. With the rate of inflation in the medical research sector running about 3.5 percent a year, the president's request is the equivalent of flat funding.

While protected in relative terms, NIH is watching a slow unwinding of the unprecedented doubling of its budget that occurred from 1998 to 2003. In terms of purchasing power, NIH's proposed 2012 budget will be roughly what it was in 2000, according to agency officials.

About 83 percent of the budget would pay for experiments and research projects at more than 3,000 universities and hospitals around the country (and some overseas). The rest would underwrite research by scientists at the NIH's Bethesda campus and hospital. The fraction of research proposals that win grants varies among NIH's 27 institutes and centers, but it averages 19 percent overall. While that success rate is not expected to fall in 2012, experts think it needs to be closer to 30 percent to capture the most promising ideas. NIH officials estimate the 2012 budget would fund 9,158 individual research projects, down slightly from 9,386 in the 2010 budget year.

The flood of insights into the molecular underpinnings of disease -- much of it the product of rapid gene-sequencing and comparative genomics -- has provided many new "targets" for disease detection and treatment. NIH plans to create a new National Center for Advancing Translational Sciences whose purpose is to help fast-track these insights into clinical products. It will do so by helping set up public-private partnerships and working with the Food and Drug Administration to find the best ways to evaluate novel diagnostic tests.

NIH director Francis S. Collins, a genome researcher, made the best of the proposed budget at a briefing on Monday. He said that "the chance for NIH to get $745 million more is a reflection of how strongly the president views science and innovation as a driver of the economy."

The Centers for Disease Control and Prevention -- the federal government's main public health and epidemiology arm -- will see a small decrease in the discretionary part of its budget, from $6.5 billion to $5.9 billion. But CDC has a substantial number of mandatory services, such as the Vaccines for Children program, which provides immunization to children in low-income households. When those mandates are included, the Atlanta-based agency's budget for 2012 would be $11.2 billion, up slightly from the 2010 budget of $10.8 billion.

Among the CDC programs that would see small funding cuts: occupational safety and health, environmental health, and assistance to states for disaster planning. Those that would get a boost: childhood vaccines, domestic HIV/AIDS programs (including a national campaign to detect disease and focus on prevention in high-risk populations), and programs to battle chronic diseases such as diabetes and smoking-related ailments.

CDC's 2012 budget also includes $112 million for polio eradication, an increase of $11 million over the 2010 level. Begun in 1988, the eradication is in a final push in four countries where the paralyzing infection remains endemic. CDC, along with Rotary International, UNICEF and, more recently, the Bill and Melinda Gates Foundation, has been a major funder of the effort.

Elsewhere in the Department of Health and Human Services budget, the Substance Abuse and Mental Health Services Administration would lose $44 million. But there would be more funds for substance abuse and mental health block grants to states, and a small uptick in a program to prevent homelessness in people with serious mental illness. The Agency for Healthcare Research and Quality, which pays for studies on how to put new medical knowledge into practice, would lose $12 million from the 2010 budget, down to $390 million. But there would be more money to support research on the effectiveness of different treatment options.

Budget 2012 analysis: Full list of agencies

This post has been updated since it was first published.

By David Brown  | February 14, 2011; 6:27 PM ET
Categories:  44 The Obama Presidency  
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Comments

This is a misleading statement: "Among the CDC programs that would see small funding cuts: occupational safety and health, environmental health, and . . . "

These cuts are in effect financing the boosts in funding for domestic HIV/AIDS programs and smoking-related programs. It is no coincidence that the latter "winners" in this budget are the personal interests of Director Frieden.

For example, the FY2012 budget cynically merges, as one budget line item, two programs in environmental health--asthma control and healthy homes/lead abatment--that operate in entirely different and non-complementary ways, then cuts their budget in half, freeing up over $30 million for de facto reassignment while sentencing one or both of these long-standing and successful programs to slow death.

To describe this as some sort of "administrative savings" may be the party line, but it shades the truth of what is really going on at CDC.

Posted by: Allen7 | February 16, 2011 8:56 PM | Report abuse

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