It took little work from Francis Collins, director of the National Institutes of Health, and five of his agency chiefs to convince members of the House Subcommittee on Labor, Health and Human Services and Education at a May 17 hearing that sustained taxpayer investment was needed to ensure the U.S. remains the leader in biomedical research.
Almost all members of the subcommittee, Republicans and Democrats alike, rejected the idea of cutting the NIH's fiscal year 2018 funding by about $6 billion — a proposal made by President Donald Trump on March 16.
"Investment in NIH has been the key driver in making the United States the world leader in biomedical research and has led to vast improvements in life expectancy and quality of life," said Rep. Tom Cole of Oklahoma, the subcommittee's Republican chairman.
The NIH is the primary funding source in the U.S. for basic medical research, supporting 2,500 universities and research institutions across the nation, Cole said.
"Investing in the NIH creates jobs, because biomedical research is a driver of economic growth," said Rep. Rosa DeLauro, D-Conn., ranking member on the subcommittee.
Collins said for every dollar spent by taxpayers to support the NIH, $8.38 is returned over eight years to the U.S. economy.
NIH funding also supports 379,000 jobs in the U.S. directly, "and those are high-quality, high-paying jobs," Collins said.
"But if you consider the whole ecosystem that builds upon NIH discoveries, that's about 7 million jobs, including in the biotech and pharmaceutical industry," he said.
"We have an amazing engine for discovery," Collins said, noting the U.S. biomedical enterprise has been called a "miracle machine, because it produces miracles."
"But you don't want to put some sand in the gears," he said.
Collins warned that China has read the U.S. playbook.
"They want to become us, and I don't blame them," he said. "But we should be sure that we're still us."
Rejecting Trump's cuts
Collins praised lawmakers for approving the added $2 billion for the NIH's fiscal year 2017 budget, which went against Trump's recommendation to cut $1.2 billion in the agency's funding.
DeLauro also noted that Trump is seeking to eliminate the NIH's Fogarty International Center, which supports and facilitates global health research conducted by U.S. and international investigators, builds partnerships and trains scientists to address global health needs.
Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, emphasized that the scientists currently conducting the phase 2 trial of the agency's Zika vaccine in places such as Peru were trained at Fogarty.
The healthcare workers who helped stop the 2014-2015 West Africa Ebola outbreak from spreading too deeply into Mali and Nigeria were also trained at Fogarty, he said. More than 28,600 people were infected in Guinea, Liberia and Sierra Leone and more than 11,300 died during the Ebola outbreak.
Fauci also noted that the vaccine that will be distributed, if necessary, to address the current Ebola outbreak in the Democratic Republic of Congo — Merck & Co. Inc.'s V920 — was tested in NIH-sponsored trials in west Africa.
A Merck spokeswoman told S&P Global Market Intelligence the company was standing ready to ship V920, which has not yet received regulatory approval, to the DRC if it is requested and protocols are approved.
Cutting indirect expenses
About the only lawmaker at the hearing who voiced support for Trump's budget cuts was Rep. Andy Harris, R-Md., who actively campaigned to replace Collins.
Collins' tenure as NIH director, which lasted the full eight years of the Obama administration, was extended by Trump on an indefinite basis.
Harris quizzed Collins about why 30% of the NIH's grant money goes towards covering indirect expenses, which are research institutions' costs for operating their facilities and purchasing equipment.
He pointed out that many nonprofits' grants include only about 10% for covering indirect expenses.
"It sounds like there's a different standard for the American taxpayer," Harris said. "Why should we pay more?"
The Trump administration estimated covering research institutions' indirect expenses comes to about $6 billion — the amount the president wants to cut from the NIH's fiscal year 2018 budget.
"If we freed up this $6 billion, we could fund thousands of more grants," Harris said.
But fellow Republican, Rep. Mike Simpson of Idaho, said "the problem is, you're not funding thousands of more research projects if at the same time you're cutting the budget by $5 billion or $6 billion."
"So we need to be clear what we're talking about here," Simpson said.
Collins said that if the NIH does not cover the indirect expenses, many universities would have to halt their biomedical research.