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Lack of NIH funding threatens future progress

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Five years ago, the medical community was riding a wave of financial goodwill on the crest of double-digit budget increases for the National Institutes of Health. The appointment of radiologist Dr. Elias Zerhouni as NIH director in 2002 raised the imaging community’s expectations (DI SCAN, 5/15/2002 Senate confirms Zerhouni,). Today enthusiasm has cooled and expectations have turned south, as stagnant NIH budgets since 2003 have failed to keep pace with inflation.

Five years ago, the medical community was riding a wave of financial goodwill on the crest of double-digit budget increases for the National Institutes of Health. The appointment of radiologist Dr. Elias Zerhouni as NIH director in 2002 raised the imaging community's expectations (DI SCAN, 5/15/02 Senate confirms Zerhouni,). Today enthusiasm has cooled and expectations have headed south, as stagnant NIH budgets since 2003 have failed to keep pace with inflation.

At the European Congress of Radiology, Zerhouni encouraged radiologists to develop imaging-based in vivo biomarkers, image-guided interventions, and microsampling for disease characterization. Reality arrived on Capitol Hill last week, however, when representatives of nine preeminent scientific and medical institutions in the U.S. explained to Congress how perennially flat NIH funding has halted promising research in midstride. They warned that, if left unaddressed, these problems could undermine U.S. global leadership in biomedical research.

"When scientists have to spend most of their time trying to get funded, caution wins out over cutting-edge ideas, creativity sacrifices to convention, and scientific progress gives way to meetings and grant applications," said Dr. Robert Siliciano, a professor of medicine, molecular biology, and genetics at the Johns Hopkins University School of Medicine.

Siliciano coauthored a 21-page report detailing NIH funding issues for Congress, working with colleagues from the University of California, Columbia University, Harvard University, Johns Hopkins University, Partners HealthCare, University of Texas at Austin, Washington University in St. Louis, University of Wisconsin - Madison, and Yale University.

The NIH budget has been on the ropes since 2003, growing a meager 2% each year from 2003 to 2005 and remaining flat from 2005 to 2006. Its actual buying power has shrunk 8% under the weight of inflation, according to the report. A small increase approved by Congress in the 2007 budget would be all but wiped out by the Bush administration's proposed 2008 budget, which continues the downward spiral in inflation-adjusted dollars.

The report argues that research momentum gains have slowed and may, in some cases, be lost, if flat funding continues. Today, eight of 10 research grant applications are unfunded, according to the report. The National Cancer Institute can fund only 11% of research project grant applications it receives.

Progress in imaging relies heavily on the budgets of individual components of the NIH. Among the projects funded in recent years were the design, development, and implementation of data collection procedures by the American College of Radiology Imaging Network, operation of the In Vivo Cellular and Molecular Imaging Center at Stanford University, and the development of low-cost digital x-ray detectors using liquid crystals at Sunnybrook and Women's College in Toronto.

Suffering the most are young researchers. In 1970, the average recipient of a first grant was 34.2 years old; today this average recipient is 41.7 years old.

"Our product is not just our technology or medical breakthroughs," said Brent Iverson, Ph.D., distinguished teaching professor in the chemistry and biochemistry department at the University of Texas at Austin. "Our College of Natural Sciences alone puts 1000 undergrads in research situations in labs, most with NIH funding. That is a catalyst for creating innovative new scientists."

Senior scientists fear that young people will turn away from science because the funding situation is so bleak. Scientists report that many of the brightest young minds no longer see the promise of a career in science, choosing law, business, and other professions. Losing young scientists today will cost the U.S. a lot later, the report warns.

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