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TOO MUCH FLEXIBILITY?
NIH Common Fund Concerns Some in Cancer Research Community
People who pay attention to legislation are eyeing the recently signed NIH Reform Act of 2006. It may allow the NIH director to move money from the institutes to the so-called common fund for projects that transcend institutional boundaries.
"The central concern is that ... the reauthorization act and the philosophy behind it will cause more money to be shunted away at a time when the rest of the cancer-directed efforts are being restricted," said Robert Young, M.D., president of Fox Chase Cancer Center and chair of the National Cancer Institute Board of Scientific Advisors.
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Young isn't opposed to funding initiatives that transcend institutions. Obesity is a good example of an appropriate project, since it affects heart disease, diabetes, and cancer. However, earlier drafts of the bill stated that adding money into the common fund would happen only when there were increasing budgets. So only when the NIH budget went up would 50% of the increase be moved over to the common fund, up to 5% of the total budget. "That's a pretty good strategy. It meant the institutes would not be hurt," Young said.
That language is gone from the final text, which is silent about how money gets moved and in what time frame. And there is no requirement for line items for budgets of categorical institutes. All the money is targeted to the NIH. "All that makes people very anxious about providing the necessary flexibility for leadership of the cancer institute."
NIH Director Elias Zerhouni told the Wall Street Journal on January 31 that he recognizes the NIH budgets are tight and likely to remain so for the next couple of years. Therefore it will take "multiple years" for the fund to grow to 5% of the overall budget.
Part of the worry among the institutes is that just a small portion of an institute's budget is available for any kind of flexible spending, since most is tied up in multiyear grants. At NCI, 85% of the budget is already committed to extramural research, leaving 15% to cover utilities, space leases, government employee salaries, and any new initiatives. Whatever goes to the common fund comes out of that smaller 15%. "Each institute with a relatively flat budget has really been feeling the pinch on that flexible part of the budget," Niederhuber said.
The expectation is that NCI will start with $122 million less than it had in fiscal year 2006, according to Young, with $42 million shunted into the common fund for multi-institution initiatives. This change is having a significant impact already, Young said. "The clinical trials program is cutting 2,600 patients out of clinical trials. Thirty-five phase III trials won't be conducted. The national cooperative groups are eliminating programs."
Some relief may be in sight, but it's too soon to tell. In late January, the House passed a bill giving NIH an inflationary increase instead of flat funding, but whether the Senate and president will agree with this offering is not clear. Final decisions were expected by February 15 when the current temporary appropriation expired.
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