The NIH will see its budget grow by 6% or $2 billion for the remainder of the current federal fiscal year under a spending agreement reached by Republican and Democratic Congressional negotiators last night—reversing President Donald Trump’s proposal to slash spending for the agency.

Trump’s administration had proposed chopping the NIH’s budget by $1.232 billion for FY 2017, which ends September 30, in March—nearly 2 weeks after unveiling a budget outline that would slice the agency’s spending by 18% or $5.8 billion in FY 2018.

Instead, negotiators approved an “onnibus agreement” that will expand NIH’s budget to $34.1 billion, with spending increases included for various initiatives.

The largest hike by dollars, $475.8 million, will swell the budget of the NIH’s National Cancer Institute (NCI) 9%, to $5.7 billion. The largest percentage hike, 73%, will go toward the BRAIN initiative (Brain Research through Advancing Innovative Neurotechnologies), which will grow by $110 million to $260 million.

Other spending increases NIH would see in FY 2017:

  • Alzheimer’s disease research—up 40% or $400 million, to $1.39 billion;
  • Precision Medicine Initiative—up 60% or $120 million, to $320 million;
  • Combat Antibiotic-Resistant Bacteria—up nearly 4% or $12.5 million, to $333.4 million.

Each of NIH’s 27 Institutes and Centers would see budget increases under the Congressional agreement, while the agency would see an additional $162 million for renovation of the NIH Clinical Center’s E-Wing, as well as $12.6 million for the Gabriella Miller Kids First Research Act, enacted in 2014 and authorizing the NIH to spend $12.6 million each year for 10 years to support pediatric research within the agency’s Common Fund.

Budget-Shrinking IDeA

Trump’s administration called for shrinking FY 2017 spending by cutting research grant spending by $1.182 billion, and by saving $50 million through the elimination of new grants under the Institutional Development Award (IDeA) program, created in 1993 to broaden the distribution of states that receive NIH funding. The budget agreement will set aside $333.4 million for IDeA, an increase of $12.5 million.

IDeA awards grants to investigators at institutions in 23 states and Puerto Rico, where according to the NIH, the aggregate success rate for applications has historically been low. In those areas, IDeA grants also fund research in rural and medically underserved communities.

The budget agreement is further proof of the rare bipartisan support enjoyed by the NIH, and biomedical research spending more broadly. Four months ago, both chambers of Congress overwhelmingly approved—and Trump’s predecessor Barack Obama signed into law—the 21st Century Cures Act, which in part gave the NIH $4.8 billion toward three Obama administration research efforts: The “Cancer Moonshot” championed by former VP Joe Biden ($1.8 billion), the BRAIN initiative ($1.6 billion), and the Precision Medicine Initiative ($1.4 billion).

The budget agreement will continue to set aside $852 million for 21st Century Cures during FY 2017.

Still unsettled is whether the Trump administration can achieve NIH spending cuts in the 2018 federal fiscal year, which begins October 1. Trump’s NIH proposal for FY 2018—contained within his administration’s “America First: A Budget Blueprint to Make America Great Again”—would shrink the agency’s budget to $25.9 billion and prescribe a “major reorganization” of its 27 institutes and centers designed to “help focus resources on the highest priority research and training activities.”

That proposed reorganization includes eliminating the Fogarty International Center, whose activities include facilitating global health research by U.S. and international investigators and training scientists to address global health needs.

Status Quo for Public Health Preparedness Spending

The budget agreement also maintains spending at FY 2016 levels for several public health preparedness and response programs:

  • $660 million for Public Health Emergency Preparedness (PHEP), which funds state efforts to prepare for and respond to chemical, biological, radiological, and nuclear threats, as well as disease outbreaks and natural disasters;
  • $575 million for the Strategic National Stockpile of medical countermeasures, maintained and replenished by the CDC;
  • $511.7 million for the Biomedical Advanced Research and Development Authority (BARDA), which oversees advanced research and development of medical countermeasures for national preparedness efforts;
  • $510 million—$160 million above Trump’s request—for Project BioShield, through which the nation procures medical countermeasures against chemical, biological, radiological, and nuclear threats.
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