The Sequester and its impact on Medical Breakthroughs

I believe that we are entering a new era of hope in medical research.  Seemingly every day we hear about new and exotic therapies that read more like science fiction than scientific reporting: immune cells are removed from our bodies and re-engineered to destroy cancer; patients are cured of AIDS by receiving bone marrow transplants; children are given vaccinations to prevent the development of cancers when they become adults; and massive genetic analyses are providing insight into the causes of disease and directions for developing the therapies of the future. 
It is therefore deeply concerning that in the midst of such promise and growth, we stand at the edge of a deep precipice of cuts to research funding.  The United State’s federal debt has ballooned into a number that is increasingly difficult to look at, and en lieu of rational fiscal policies and bipartisan compromise, Congress has instead backed itself into a corner called “sequestration.” 
Beginning in 1917, as part of a rarely discussed operational formality, federal budgets were limited by a pseudo-arbitrary debt ceiling.  Without much discussion, this limit has every year since been reached and subsequently raised.  In 2011, however, an impasse was reached wherein the national debt was suddenly decried as a threat to the nation’s future.  At the hand of overzealous small government advocates and divisive partisanship, the Budget Control Act was enacted, resulting in immediate federal budget cuts totaling $900 billion.  In conjunction, a “super committee” of congressional representatives was assembled and assigned the task of cutting $1.2 trillion from the national budget.  This exercise ended in failure.   
In the wake of this disappointment, the task of making the $1.2 trillion spending cuts has fallen to Congress.  In what has been termed the ‘nuclear option,’ failure to institute these cuts will result in sequestration, wherein draconian across-the-board cuts will be instituted automatically.  Sequestration is currently slated to go into effect March 1.
The primary medical research funding agency, the National Institutes of Health (NIH), risks disproportionate funding cuts if sequestration is permitted to occur.  The NIH’s budget has been neither adjusted for inflation nor increased in the last decade, an oversight unseemly in light of the increasing prevalence of preventable disease, the emergence of novel infectious disease, and the need for improved therapeutics for undertreated disorders.  To compound this flat-lined funding with budget cuts is shortsighted and reprehensible.  Furthermore, it is inefficient: the proposed 8% cut in NIH funding constitutes an inconsequential 0.08% of the federal budget.  The NIH funds our medical institutions, pays for our medical research, and supports graduate education for the future leaders in basic and clinical sciences.  To decry the failings of our educational system and urge for a larger, more competitive scientific workforce, while simultaneously gutting the NIH’s funding, is simply senseless.
Furthermore, the economic payoff from investment in scientific funding is disproportionately high.  Investment in biomedical research pays off in many ways: in many states, research facilities are a significant employer, which is invaluable in periods of high unemployment.  Development of new and improved medical therapies generates savings in the providing of medical care, a worthwhile aim when healthcare costs threaten many families’ savings.  Many pharmaceutical and private medical corporations, economic drivers and major employers themselves, received public funding in their nascent development.  The preparation of vaccines and treatments for emerging diseases is essential for guarding our national security against bioterrorism.  And, really, who wants to lose a loved one because the medication that could have treated them was halted mid-development due to lack of funding?
I urge everyone in America to stand up and demand that medical research not be subjected to these budget cuts.  To allow sequestration to proceed would be a thoughtless step backward, but it is within our power to demand of our elected officials that these cuts not be made.  Perhaps Barack Obama said it best, in 2009: “At such a difficult moment, there are those who say we cannot afford to invest in science, that support for research is somehow a luxury at moments defined by necessities.  I fundamentally disagree.  Science is more essential for our prosperity, our security, our health, our environment, and our quality of life than it has ever been before.” 

by: Alana Sharp, Penn Biomedical Graduate Student


Save the NIH from the Sequester!
On March 1st, sequestration will eliminate $1.6 billion from the National Institutes of Health (NIH) budget. The deadline is fast approaching, and Congress has failed to put forth any alternative plans for avoiding the drastic cuts sequestration would entail. As a biomedical graduate student, whose research and training are supported by the federally funded NIH, these cuts deeply concern me. Although many argue that spending cuts are necessary in an era when the country has amassed trillions of dollars in debt, austerity does not translate well to medical research nor to the well being of the general public. The amount cut from the NIH would save the federal government 0.042% of the national budget, but would have devastating effects on the economy, medical research, and the training of a new generation of scientists and medical doctors. Is the paltry amount of money saved really worth all that will be lost?
It is impossible to estimate how a loss of $1.6 billion would affect our lifespan, health, or quality of living. This money funds research that develops treatments for cancer, diabetes, and countless other diseases. Since 1962, NIH-funded research has played a role in the development of 153 FDA-approved drugs, vaccines, and new indications for currently approved medication. Furthermore, without the NIH, basic scientific discoveries that fuel new treatments will not happen. The basic research funded by the NIH is essential to designing the best drug treatments and therapies, but because they are long-term investments and do not guarantee a high profit margin, private industry is wary of investing its time and money in these projects. Thus, sequestration would both harm the NIH’s ability to promote new areas of discovery-based research and indirectly impact the NIH-dependent pharmaceutical industry.
Under sequestration, the NIH is slated to lose 5.1% of its annual $31 billion budget, a sum of $1.6 billion. This loss would have a devastating impact on the nation’s economy, as the NIH is a major source of employment and expenditures, and essentially acts as the base for the U.S. medical innovation sector. In 2011, the NIH contributed $61 billion to the U.S. economy, and supported over 432,000 jobs. In spite of the fact that government funding for health research and development has been stagnant over the past decade, the NIH has proven that the returns it generates are well worth the investment.
If the sequester takes effect, a substantial number of important research projects will be rejected simply due to lack of funding. Only the top 18% of research projects in the country acquire coveted NIH funds, which means that many worthwhile projects are already being cast aside. Under sequestration, the grant success rate would drop to 14%, at least 20,000 jobs would be lost, and 3 billion fewer dollars would be funneled into the economy. To put the $1.6 billion figure into even sharper perspective, this is double the amount currently invested in training grants and fellowships. Consequentially, many of our most talented young scientists will take their skills to other fields, or leave the country altogether, creating a lost generation of trained biomedical researchers and doctors.
Congress seems inclined to let the sequester pass, as a means to score political points for each party. Congress needs to be reminded that biomedical research is largely a non-partisan issue, and historically has been supported by both Republicans and Democrats. Both parties understand how biomedical research can reduce the cost of healthcare, and representatives from each political party have indicated that the NIH plays a crucial role in such endeavors. House Majority Leader Eric Cantor (R-VA) has said, “Doing what we can to facilitate medical breakthroughs . . . should be a priority. We can and must do better.” If Congress truly believes that federally funded advances in medical research are worthwhile, they should act quickly to ensure that the NIH is spared the results of sequestration. 
Spending cuts for federally funded medical research affect everyone to some extent, as most individuals have experience with a family member that has a chronic disease or illness. The most recent statistics collected by Research!America found that nearly 50% of Americans think the government isn’t investing enough resources in medical research, and 54% would be willing to pay slightly more in taxes provided their money went directly to medical research. I urge you to take this same passion and contact your congressmen about sequestration. The future of the NIH, the healthcare driven economy, and medical research in the U.S. depends on your support.


 By Ellen Elliot, Penn Biomedical Graduate Student

Check out our first op-ed piece! (Originally published at the Daily Pennsylvanian http://goo.gl/cZpwk)

HOW YOU CAN SAVE SCIENCE!!!


Two weeks is all that remains before the largest automatic federal budget cuts take place, which could have devastating affects for the Penn Community. If these automatic budgets cuts occur, expect Penn’s ability as a science innovator to be hampered as the sequester would slash billions from the National Institutes of Health (NIH), the National Science Foundation (NSF) and Graduate Medical Education (GME) programs-all programs that fund science research at Penn.

How could Congress and the President allow this to occur? The sequester was born out of two years of political fights over the national debt and federal spending habits. These automatic cuts were constructed as a nuclear option to force both parties into negotiations over federal spending, by having severe financial consequences if it was ever triggered. However the sequester mechanism was triggered in the fall of the 2011, as a bipartisan budget committee failed to compromise on how to rein in federal spending.

These automatic cuts call for equal across the board cuts to military and non-military agencies. With the recent Taxpayer Relief Act of 2012, the automatic sequester was delayed till March 1st, 2013, with the hope that a polarized Congress could figure out a solution.  At this point in time, non-military agencies are slated to lose $42.5 billion in funding, or roughly 5-6% of their budgets this year. Additional reports are now suggesting that Congress is also content to let sequester occur, which could have dire circumstances at Penn.

Penn biomedical research labs depend on funding from the NIH, which is slated to lose at least $1.6 billion this year-a savings of less than 1% of the federal budget! This would severely hamper the discovery of advances in basic and clinical science. Penn is a leader for cancer immunotherapies, thanks, in part, to Dr. Carl June’s Phase I clinical trial (NIH funded) that resulted in amazing regression of lymphoma in pediatric patients. Without the initial NIH investment, this trial would have been nearly impossible to conduct, as pharma companies deemed it too risky to invest in.  Breakthrough vaccine development has also occurred at Penn, as exemplified by Dr. Paul Offit’s pediatric vaccine to rotavirus, another example of research that would not have been possible without NIH funds. Thanks to the sequester, reduced NIH funding will have a chilling effect on new therapeutic development at Penn and possibly drive away talented individuals from scientific careers.

Reduction in NIH funding would severely impact the training of the next generation of biomedical scientists and could impact the U.S.’s position as a leader in innovation in the coming decades. In addition, Graduate Medical Education, or residency training, would also be hampered due to a 2% cut in Medicare and thus is a real concern for Penn Medical Students and Residents. This would also undercut the mission of the nation’s #1 Children’s Hospital. The National Science Foundation (NSF), which funds researchers in the Engineering Program and the School of Arts and Sciences, would also lose $300-500 million (5-6%) this year.   Collectively, these cuts have the potential to create a lost generation of newly trained scientists, engineers and clinicians.

In light of this information, the Penn community needs to tell Congress and President Obama how important this funding is to the viability of this institution and to Pennsylvania as a whole. Pennsylvania is one of the top 5 recipients of federal research dollars. The biomedical industry alone creates millions of dollars of revenue in the state and more than 350,000 jobs including those due to the ripple effect. Continued support of research is good for the university and it is a smart investment for the economy.  Obviously the sequester will be a job killer in this struggling economy.

We need you to act, in order to avoid the full severity of these automatic budget cuts. You can e-mail your Congressperson through this link- http://goo.gl/to9Pv

We also welcome to you to join the newly formed Penn Science Policy Group, to learn more about this issue.  This coalition of science graduate students and post-docs are contacting our Congressional leaders to promote the necessity of continuing to invest in American innovation. To learn about this group, email at penn.science.policy-at-gmail.com.

Welcome!

Welcome to the Penn Science Policy Group.  We are a group of scientists interested in the relationship between science and public policy, examining how both domains affect each other to shape our society.  

Our mission is:

1) To educate scientists about the process of science policy, namely how research and public policy can inform and guide each other.

2) To advocate for research and improve communication of science to the public.

3) To provide resources and training for scientists interested in developing a career in science policy.


We achieve these goals by discussing current issues in interactive monthly meetings, receiving career information from speakers and info sessions, and refining relevant skills through written and oral public communication.  

Whether you are planning a science policy career, or simply looking to stay abreast with important issues, we are here to help you learn about and navigate the field of science policy. 

For more information, please email penn.science.policy@gmail.com.

Thanks,
PSPG