amfAR, The Foundation for AIDS Research

amfAR Speaks Out Against Proposed NIH Budget Cuts

Senate Subcommittee Hears Testimony About Effects of Reduced Funding

May 19, 2006—Testifying at a Senate subcommittee hearing on the President’s 2007 budget for the National Institutes of Health (NIH), Dr. Judith D. Auerbach, amfAR’s vice president for public policy and program development, expressed deep concern that the proposed budget will cut NIH funding overall and slash AIDS research by $15 million.

Dr. Auerbach spoke before the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education along with witnesses from health and research organizations such as the American Heart Association and the Christopher Reeve Foundation. Despite the continued rise in HIV/AIDS cases in the U.S. and around the world, she noted, NIH funding for HIV/AIDS research has stalled since 2003 and advances have been jeopardized. The full text of Dr. Auerbach’s written testimony, submitted in support of her statement, appears below.

Testimony before the Subcommittee on Labor, Health and Human Services, and Education, U. S. Senate. Hearing on the President’s FY 2007 Budget Request for the National Institutes of Health, May 19, 2006. Submitted by Judith D. Auerbach, Ph.D., vice president, public policy and program development, amfAR, The Foundation for AIDS Research.

amfAR, The Foundation for AIDS Research, is deeply concerned about the President’s proposed 2007 budget, which cuts the NIH budget overall and slashes AIDS research specifically by $15 million. Congress was wise in doubling the NIH budget between 1998 and 2003, as this allowed the agency to support many new investigators while continuing to fund those multiyear studies to which it had committed in previous years. Since 2003, however, funding for the NIH—including its AIDS research portfolio—has failed to keep up with the Biomedical Research and Development Price Index (BRDPI), damaging the success rate of approved grants and leaving very little money to fund promising new research. Since 2003, the success rate has fallen from 25.3% to a projected 19.5% in 2006. The President’s request means fewer than one in five of the grants with the highest scores under peer review will be funded.

The number of new HIV/AIDS cases continues to rise in various populations in the U.S. and around the world. There are now more than one million HIV-infected people in the U.S., the highest number in the epidemic’s 25-year history. Rates of infection have risen dramatically among vulnerable populations, including racial and ethnic minority women and men.

To make headway in the fight against HIV/AIDS, amfAR supports a strong federal commitment to research leading to more effective treatment and prevention methods, including vaccines and microbicides. NIH-funded research has a proud history helping to improve and prolong the lives of countless people living with HIV worldwide. Federal support for AIDS research has also led to new treatments for other diseases, including cancer, heart disease, hepatitis, and osteoporosis.

During the doubling of NIH’s budget, the agency was able to expand the knowledge base in basic research focusing on human immunology and macromolecular biology. This has led to the dramatic increase of the number of vaccine candidates in the pipeline. Specifically, NIH sponsored the evaluation of more than 30 additional vaccine candidates, some of which advanced to Phase IIB expanded trials. The doubling also provided needed resources to expand the NIH’s structural biology program, which resulted in the identification of new therapeutic targets. There are now more than 60 agents in clinical trials against HIV and its opportunistic infections. Some of these drugs have proved to be effective against other viral diseases such as hepatitis B. The new technology has also been applied to the development of a new antiviral for SARS. Moreover, the increased funding provided much needed support for non-vaccine prevention efforts and resulted in the identification and testing of new pipeline microbicide candidates and the implementation of critical HIV prevention trials among populations most at risk of infection.

But much of this progress is in jeopardy with the cuts to NIH already experienced in FY 2006 and those proposed for FY 2007. Factoring in the recently recalculated BRDPI, AIDS research at NIH was cut by about 2.4% between FY ’05 and FY ’06 and will be cut another 6% under the President’s ’07 request.

This has grave consequences—

For grants overall: The number of R01s in AIDS research decreased by 5% in both numbers and dollars from ’05 to ’06, and would decrease even further in ’07.

For expanded clinical trials of promising HIV prevention technologies and therapeutics: Under current budget constraints, it is anticipated that the AIDS clinical trials networks in which these studies take place will be allocated only 54% of what it is estimated they will need over the next seven years. This means important effectiveness trials of new prevention technologies and new therapeutics will not be launched.

For new and seasoned investigators: I would like to read to you some specifics provided by the director of an NIH-funded AIDS research center at an independent research institute located in New York City.

“The consequences of the reduced funding for the field are indeed dire. For example, several issues for [our institution] (and the field) include:

1. the loss of new investigators: we are losing potential new investigators who would be submitting their first grants, knowing that 60% are triaged and if not triaged, funding is not likely to occur until resubmission—this is raising concerns and individuals are looking for safer work environments, e.g., teaching rather than research.

2. the loss of mid-level and senior investigators—even those who have been funded in the past are now getting "unscored"—because of the need to triage most submissions- in the past 2 years, we have lost at least 3 PIs and 3 PDs (who are PhDs that one day could develop into PIs)—to either universities or governmental positions—primarily because of concern about the funding situation.

3. [Our institution] as an organization is also beginning to feel the consequences of the tightened funding environment: in the recent past our outstanding investigators had "hit rates" approaching 50%—this is no longer possible and the reduced funding and IDC [indirect costs] may begin jeopardizing the viability of independent research organizations such as [ours] hence potentially further reducing the entire field of researchers.”

This institution’s experience is shared by many others throughout the country. Altogether, this means that important AIDS research will not be undertaken, and people at risk for or living with HIV/AIDS will not have access to lifesaving interventions.

amfAR calls on Congress to continue the federal commitment to ending the suffering caused by AIDS and other diseases and to stop the erosion of the nation’s medical research budget by increasing funding for the NIH by 5% in FY 2007.

Thank you for the opportunity to provide these comments.