House committee discusses diminished medical research budget, while Fauci talks to HIV prevention scientists

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While funding constraints divide science support, National Institute of Allergy and Infectious Diseases director says, “We really do have a lot to do.”


Dr. Anthony Fauci

 As members of a House subcommittee met this morning on Capitol Hill in Washington, DC to discuss allocations that will affect health, human services, education and training programs in the year ahead, Dr. Anthony Fauci addressed a group of HIV prevention researchers across the river in Arlington, Va. to review progress and work ahead. Fauci, who took his post at NIAID 31 years ago during the most daunting days of the U.S. AIDS epidemic, recalled the time when policymakers recognized what science could accomplish and doubled the institute’s spending over the five years between 1998 and 2003. They were years that led to much of what the scientists had come to discuss: the understanding that antiretroviral treatment can prevent, as well as treat HIV infection, and that biomedical responses could build on each other to turn the course of the epidemic.

But, Fauci noted, the numbers of dollars for research funding have been flat ever since — and cut by more than 20 percent in real terms, factoring in inflation.

And, he said, although how dollars will be distributed in the year ahead remains to be seen in final reports, and then votes, on House and Senate Appropriations bills, he has seen disquieting signs.

They included the observation by Sen. William Cassidy (R-La) that “we’re spending . . . almost $190,000 per HIV death, and we’re spending $6,700 per Alzheimers death . . .”  as well as a complaint by Rep. Andy Harris that spending on heart disease research added up to “a hundred times less per death” than spending on HIV research.

Fauci reiterated his response he had given Cassidy in March, when he replied, “When you’re dealing with an infectious disease that has epidemic and pandemic aspects to it that’s really a different story in some respects from other diseases which are equally as serious, as devastating and have impact on society, that don’t have the potential to actually be completely ended the way we did polio.”

The debate, however was only beginning then, Fauci told the scientists, “When you have ongoing constraints on resources, it really brings out the worst in everyone.”


Rep. Rosa DeLauro

On the other side of the river, the debate continued at a hearing of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies on allocations for fiscal year 2016,  as Rep. Rosa DeLauro (D-Conn.) offered an amendment that would add $3 billion to the proposed budget for the National Institutes of Health for a total of $34.2 billion.

She, too, remembered the years she had participated in doubling funding for biomedical studies, adding that as a survivor of ovarian cancer, she owes her own life to scientific advances. “We need to recommit ourselves to research,” she said.

Rep. Harris agreed that more money for research would be good, but said he disagreed with Rep. DeLauro’s approach, which he interpreted as allowing the NIH “to take the money and sprinkle it everywhere.”

Rep. DeLauro replied that the NIH might be well placed to set priorities. “One of the strengths of this committee,” she said, “is that we have left science to the scientists.”

In Arlington, Fauci described the NIAID’s HIV research priorities, selected he said, around the focal point of ending the HIV/AIDS pandemic. They are, he said, prevention research that includes vaccines, improvement of strategies to optimize treatment for HIV, continued research toward a cure, and research to address the illnesses that HIV brings with it that include cardiovascular disease and tuberculosis.

“We’re on the cusp of turning this thing around,” he said. “It’s not going to happen tomorrow. It’s not going to happen next year. But it’s going to happen.”

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