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Protect the National Institutes of Health from the Sequester

Gordon F. Tomaselli, M.D., is president of the American Heart Association and chief of the division of cardiology at The Johns Hopkins University School of Medicine.

Next January, unless Congress and the White House take action, the National Institutes of Health, or NIH, and the critical medical research it supports will face an uncertain future. Under current law, most domestic spending, including every NIH institute and center, will be subject to a mandatory cut of at least 7.8 percent.

The cuts—which will go into effect January 2—are the result of the Joint Select Committee on Deficit Reduction’s failure to come up with a plan that would reduce the deficit by $1.2 trillion over the next decade. The debt limit deal, which created the committee, established a backup “sequestration” procedure as a mechanism to encourage compromise. Sequestration is a form of automatic budget cuts that are applied across the board.

Military programs are also on the chopping block, and the defense establishment has made it clear that it will fight these cuts to the bitter end. Supporters of domestic programs, however, have been silent. Thankfully, advocates for the NIH refuse to remain quiet and complacent. We believe there is simply too much at stake.

United for Medical Research, or UMR—a coalition comprised of the American Heart Association, other patient and health advocates, research institutions, and private industry—has made it its mission to educate Congress about the short- and long-term consequences of this budget “sequestration” and the devastating impact it will have on the nation’s economy. A new UMR analysis, “Engine Stalled:  Sequestration’s Impact on NIH and the Biomedical Enterprise,” projects that a 7.8 percent cut would mean a loss of 33,000 jobs across the United States in 2013 and a staggering $4.5 billion decline in economic activity. According to NIH Director Francis Collins, cuts of this size will reduce the number of NIH grants by 2,300.

Few Americans realize that roughly 85 percent of NIH grants support laboratories and research centers in every state. These laboratories function like small businesses that create positive economic ripples throughout their communities. They buy equipment and supplies from a variety of local companies, and they employ researchers and their support staff, who in turn buy goods and services. A reduction of this magnitude would have a chilling effect on this economic progress.

Furthermore, this dramatic decrease in federal funding has long-term implications for our nation’s status as the world leader in medical research, for the next generation of researchers, and for research advances never realized that could vastly improve the health of all Americans and ultimately lower our nation’s health care costs.

Each year the American Heart Association hosts Scientific Sessions, a gathering of scientists and health care professionals from around the globe who focus on cardiovascular disease and stroke. Because of flat NIH funding over the last few years, I have observed an increase in conference presentations from scientific investigators outside the country compared to those submitted by U.S. scientists. China, India, the European Union, and Russia have declared their intentions to increase their research investment despite their fiscal challenges. China is boosting its research efforts by 26 percent while India is increasing research funding by double digits. Europe is hoping to ramp up their research investment by 40 percent and even Russia has planned a 65 percent increase. Meanwhile, in the United States, research funding has not kept pace with inflation and sequestration could reduce NIH funding to 2004 levels. In other words, we are not only falling behind, but we are completely reversing our progress to this point.

I see the impact of these cuts every day on the next generation of young, promising investigators. The best and brightest are unwilling to settle for a lifetime of rejected grant applications. Consequently, we lose many of these gifted individuals to other careers, and along with them, immense talent that could contribute to scientific breakthroughs.

As a practicing cardiologist, scientist and president of a voluntary health organization, I am also concerned about the impact of these cuts on patients—now and in the future. Research has made a real difference for the diseases that I treat. Sixty years ago, heart disease and stroke were a virtual death sentence. But research has helped reduce the mortality rate from heart disease by more than 60 percent and from stroke by 70 percent since 1940.

Nearly all of the research breakthroughs that contributed to this amazing success story came from fundamental science. Among them were heart transplantation, anticoagulant and antithrombotic therapy, cardiopulmonary bypass, and the links between dietary fat, cholesterol, and atherosclerosis.

Cardiovascular disease, however, remains America’s No. 1 killer and new projections show that by 2030, 40 percent of the population will have some form of the illness. The epidemic of obesity in our youth is already beginning to have an effect on the burden of cardiovascular disease and is slowing and reversing the favorable trends in mortality. Moreover, with the Baby Boomer generation aging, it’s no surprise that congestive heart failure and stroke are the fastest-growing forms of cardiovascular disease. These are highly debilitating conditions and progress made towards an effective treatment or cure in my lifetime is critical. Unfortunately, NIH cuts may make that improbable even for my own children.

Put simply, research is an investment in our nation’s future. We have an obligation to our country, our patients, and future generations to fund medical research at levels that will improve health, spur innovation, and grow our economy. The NIH has been referred to as the “Crown Jewel of the Federal Government.” Members of Congress that hold this view—including the 212 Republican and Democratic members who signed letters of support for the NIH—must find ways to protect this investment from the devastating impact of the sequester.

Gordon F. Tomaselli, M.D., is president of the American Heart Association and chief of the division of cardiology at The Johns Hopkins University School of Medicine. Image courtesy of Baltimore Sun/Amy Davis.

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