We are just 7 months into the $1 trillion in automatic federal budget spending cuts known as sequestration, and the impact on scientists in all areas of research is already so great, some say its full effects may be irreversible. The ASCO Post recently interviewed ASCO President
Clifford A. Hudis, MD, FACP, and others about the effects of sequestration on cancer research.
The Budget Control Act of 2011 required the National Institutes of Health (NIH) to cut 5%—or $1.55 billion—of its fiscal year 2013 budget, which was already at its lowest inflation-adjusted appropriations level in more than a decade. Enactment of the legislation prompted Francis Collins, MD, PhD, Director of the NIH, to call 2013 the “darkest ever” year for the agency in an interview with The New York Times.1
While the original reduction to the NIH budget was expected to result in more than 700 fewer research grants, failure by Congress to pass new legislation setting funding levels for fiscal year 2014—which led to a government shutdown on October 1—could mean that the reduction in new grants could balloon to over 1,000 as the NIH absorbs an additional 2% budget cut.
According to a Fact Sheet issued by the NIH earlier this year,2 the loss of revenue is delaying progress in medical breakthroughs, including the development of more effective targeted cancer therapies, a universal flu vaccine that could be effective against every strain of influenza without the need for an annual shot, and a delay in the development of better treatments for common and rare diseases.
Unprecedented Funding Reduction
A survey of cancer researchers conducted by ASCO in August shows the devastating consequences of multiyear stagnation in federal cancer research funding coupled with sequestration on U.S. cancer research.3 According to the survey results:
- More than 75% of respondents said cuts to NIH or NCI funding have impacted their ability to conduct oncology research.
- More than 44% have had to look for nonfederal sources of funding to replace sequestered funds.
- More than 38% have reduced their time spent on research.
- More than 35% have had to lay off or terminate lab or clinical staff.
- More than 28% have closed or participated in fewer federally funded clinical trials.
- Nearly 27% have postponed the launch of a clinical trial.
- More than 23% have had to limit patient enrollment on a clinical trial.
“We’ve just never seen this kind of withdrawal of federal support before,” said ASCO President Clifford A. Hudis, MD, FACP, who is Chief of the Breast Cancer Medicine Service and Attending Physician at Memorial Sloan-Kettering Cancer Center and Professor of Medicine at Weill Cornell Medical College in New York.
“Federal funding of the NIH in the post–World War II era was a unique American accomplishment,” he continued. “It supplemented and supported the for-profit business world in the development of scientific advances for the greater good. Now, at the individual investigator level, these funding reductions present a real long-term problem, because once scientists, postdoctoral fellows, technicians, and support staff are gone, they may go into another industry, and our shared investment in their training in cancer research is perhaps gone for good.”
Losing U.S. Scientists to Other Countries
Scientists may be contemplating not just transitioning their talents to another field, but fleeing the country altogether. In a large survey by the American Society for Biochemistry and Molecular Biology (ASBMB) of over 3,700 scientists from all 50 states,4 nearly one in five respondents said they were considering moving to another country to continue their scientific career.
According to the survey report, Unlimited Potential, Vanishing Opportunity, while the United States globally invests more real dollars in research and development than any other country, in terms of percentage of gross domestic product (GDP), the nation is reducing its investment in scientific research. Of the 10 countries investing the most money in scientific research—China, Brazil, South Korea, India, the United Kingdom, France, Japan, Germany, Russia, and the United States—only the U.S. has reduced its investment in scientific research as a percentage of GDP since 2011.
“First off, the U.S. is still number one in global science and innovation, but the gap is closing,” said
Benjamin Corb, Director of Public Affairs for the ASBMB. “The concern I have is that we still train the overwhelming majority of scientists throughout the world. Students come to our universities because they are some of the best on the planet. Young scientists get their training through an NIH or National Science Foundation grant, so we are funding them to become the next generation of innovators. For young scientists to take their education and training that we paid for and go to another country and compete against us is disheartening and frightening.”
Loss of Young Investigators
Roland L. Dunbrack, Jr, PhD, Professor at the Institute for Cancer Research at Fox Chase Cancer Center in Philadelphia, agrees that the greatest problem facing researchers now is sequestration. A researcher in computational structural biology, Dr. Dunbrack’s current research is focused on the protein structural bioinformatics and protein structure prediction in cancer biology. Last year, Dr. Dunbrack applied for two NIH grants; one, a continuation of an existing grant, was approved, but the other was not.
“The NIH cut the number of new grants it funds by about 20% from 2012 to 2013. My grant probably would have been funded if it were not for the sequester. The loss of that funding cuts my lab budget by 50%,” said Dr. Dunbrack. “I’ve had to lay off a couple of postdoctoral fellows who were productive; I would have kept them if I had the funding.”
According to Dr. Dunbrack, the budget impasse in Congress and continuing funding uncertainty is taking its greatest toll on young investigators just starting their careers. “I was lucky that my first grant came along when the NIH budget was increasing in 2000. Now I’m 50 and in the middle of my career, and I have had some accomplishments. But if you are just starting out, the climate is tough. I know students at universities here in Philadelphia who are having trouble finding labs to work in because so many are having funding difficulties,” said Dr. Dunbrack. “I have tenure, but if I can’t pay between 40% and 50% of my salary from a grant, I could lose my job. So there will be fewer labs, fewer investigators, and cancer research will decrease significantly.”
Slowdown in Cancer Advances
In the current environment, what research is undertaken may be less risky, resulting in fewer advances. “It is hard for scientists who can’t count on a steady revenue stream to build out research programs and make commitments to staff,” said Dr. Hudis. “What that means is that over time there can only be a more and more conservative approach to taking risk—that is to say, advances will come more slowly.”
According to the ASBMB report, since private companies and organizations have neither the funds nor the desire to supplement the funding gaps caused by sequestration, once laboratories shutter their doors and scientists look to other countries for investment, it may be impossible to regain America’s position as a global leader in research and innovation.
“In the 1960s and 1970s, we were going to the moon on a regular basis. We couldn’t do that now—not only because we don’t have the technology, but because we don’t have the brainpower. I worry that the same thing will be true in other industries and [scientific endeavors] in the future,” said Mr. Corb.
Taking Action
On September 18, 2013, ASCO, the American Association for Cancer Research, and more than 100 other medical research institutions and advocacy organizations joined together in a Rally for Medical Research Hill Day to urge Congress to make medical research a national priority. To keep the momentum going, ASCO has made it possible for members to take continued action through its Alert Congress Today (ACT) Network at asco.org/advocacy/making-difference.
By joining the ACT Network, ASCO members can e-mail legislators directly from the website and stay current on important legislation and emerging public policy issues affecting oncology. Updated information about sequestration’s impact on cancer care can also be found on the ASCO in Action Web pages (asco.org/advocacy/news). ■
Disclosure: Drs. Hudis and Dunbrack reported no potential conflicts of interest. Mr. Corb reported no potential conflicts of interest.
References
1. Lowery A: Budget battles keep agencies guessing. NY Times, September 4, 2013.
2. National Institutes of Health: Fact sheet: Impact of sequestration on the National Institutes of Health. June 3, 2013. Available at www.nih.gov/news/health/jun2013/nih-03.htm. Accessed October 9, 2013.
3. American Society of Clinical Oncology: Impact survey: Federal funding cuts to cancer research. September 2013. Available at www.asco.org/sites/www.asco.org/files/results_of_asco_federal_research_funding_survey.pdf. Accessed October 9, 2013.
4. American Society for Biochemistry and Molecular Biology: Nondefense discretionary science 2013 survey: Unlimited potential, vanishing opportunity. Available at www.asbmb.org/uploadedFiles/Advocacy/Events/UPVO%20Report%20V2.pdf. Accessed October 9, 2013.
