On March 16, 2017, President Trump submitted his budget entitled, “America First” with a proposal to cut the 2018 National Institutes of Health (NIH) budget by 18.3%.
Critics subsequently and vehemently predicted that the results of such cuts to biomedical science agencies could cripple cancer research. My recent reading of what this proposed federal budget reduction would entail left me speechless. I knew it was bad, but not this bad. If I tried to summarize what colleagues have said about the magnitude of this potential catastrophe, some facts might be lost in translation. So I’ll just share a few items from my reading.
American Association of Cancer Research:1
“At a time when extraordinary progress is being made against cancer and many other diseases, these draconian cuts would set research back for decades and also threaten the careers of an entire generation of young investigators working in labs and clinics all over the country who are committed to improving public health and saving lives.”
American Society of Clinical Oncology:2
”When we are on the cusp of tremendous advances in cancer care, the United States can’t turn back the clock on research that will benefit millions of Americans with life-threatening diseases and their families.”
The Lancet Oncology:3
“Basic research, the cornerstone of all cancer advances, will slow to a crawl, fewer grants will be funded leading young researchers to leave the country or research altogether, fewer NCI trials will be launched, fewer patients enrolled, and fewer advances in cancer prevention and treatment.”
“Were the blueprint be embraced by Congress, cancer prevention, screening, diagnostic testing and survivorship research would be severely curtailed.”
The New England Journal of Medicine:4
”It is the first time a president has proposed a cut of this magnitude since the NIH received its first appropriation in 1938.”
”The NIH plays a pivotal role in the US medical innovation sector as the world’s largest funder of biomedical research.”
“Research advances supported in large part by the NIH have led to reductions in mortality due to the leading causes of US deaths, including heart disease, diabetes, stroke, and cancer.”
”Under Trump’s proposal, AHRQ [Agency for Healthcare Research and Quality] would be enveloped into NIH, and it’s $479 million budget would be eliminated. AHRQ-funded research has contributed to a 21% reduction in hospital-acquired conditions since 2010, averting 3 million adverse events and saving 125,000 lives. AHRQ estimates these improvements have generated $28 billion in savings.”
“The NIH is already operating on a slim margin, with funding that has essentially flat-lined since an expansion period under the Clinton administration when the budget doubled over 5 years.”
Missing in this commentary is the acknowledgment of three important stakeholders who will be impacted by this potential massive change: patients, families, and the nurses who care for them. It is time for us to speak up “from the trenches” of cancer care.
Within this proposed future paradigm, patients will die with increasing frequency, lacking new knowledge on how to treat their malignancy, and manage their symptom distress. Families will continue to struggle on their own with the overwhelming demands of caregiving. Nurses will be forced to administer “conventional” interventions in the absence of hope extended to patients that is often generated by new therapies.
It is time to speak up—and loudly—to avoid the impending apocalypse.
American Association for Cancer Research. AACR Strongly Opposes the Draconian Cuts to Medical Research Proposed in President Trump’s FY 2018 Budget. 2017 Mar 16.
American Society of Clinical Oncology. President’s Budget will Devastate U.S. Research Enterprise. 2017 Mar 16.
Furlow BF. Proposed US Government budget cuts would ‘devastate’ cancer research. Lancet Oncol. 2017 Mar 23.
Katz IT, Wright AA. Scientific Drought, Golden Eggs, and Global Leadership—Why Trump’s NIH Funding Cuts Would Be a Disaster. The New England Jourmal of Medicine. 2017 Mar 29.
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