Updates on Proposal to Increase Funds for Public Health and Medical Research in FY 2020

The House Labor/HHS Appropriations Subcommittee “marked up” its FY 2020 funding bill. This bill funds, among other programs, NIH and CDC. The full committee followed suit and ASM issued a statement, applauding appropriators for their efforts.
 
The bill summary can be found here. Highlights include:
  • $41.1 billion for NIH ($2 billion increase), with NIAID proposed to receive $5.808 Billion in FY 20. This is about a 5% increase over current levels.
    • The summary calls out HIV/AIDS research at $3.2 billion
  • $8.3 billion for CDC. $921 million above Fy 19; this includes PHPF transfers
  • Includes $140 million for the HIV initiative
  • $700 million for public health emergency preparedness cooperative agreements (increase of $25 million)
  • $123.4 million (increase of $25 million) for global disease detection efforts
 Here are some highlights from the Report language that accompanied the bill:
             
President’s HIV/AIDS initiative:
  • The report notes that the bill includes full funding ($140 million for CDC) for this new initiative, and also $500 million for HIV research, prevention and treatment ($149 million goes toward continued HIV vaccine and cure research)
 National Institutes of Health
  • Language supporting increases to the base budgets across I/C’s: The bill “includes sufficient funding to provide an across-the-board increase of approximately five percent for all Institutes and Centers (IC). The Committee is concerned that Congress has moved too far in the direction of targeted funding for specific initiatives, which has resulted in less funding being available for foundational research that may lead to unforeseeable scientific breakthroughs. This bill maximizes the across-the-board increase for all ICs, thereby ensuring a significant boost for the best peer-reviewed research across all scientific disciplines.
  • Extensive language on sexual harassment:  The Committee recognizes that recent events make clear that harassment occurs in all workplaces, including science and medicine, and that changing the culture that fosters sexual harassment will require sustained commitment and resources. The National Academies of Sciences, Engineering, and Medicine report released last year found that sexual harassment is rampant in the labs and institutions supported by NIH and American taxpayers. The Committee commends NIH for taking steps to remind institutions of the agency’s expectation that they implement and enforce policies for reporting sexual harassment and notify NIH when key personnel named on an NIH grant award have been removed because of sexual harassment concerns. However, as the funder of the vast majority of biomedical research conducted in the U.S., the Committee believes NIH must play a more active role in changing the culture that has long perpetuated the problem. The Committee directs NIH to require institutions not just to notify the agency when key personnel named on an NIH grant award are removed because of sexual harassment concerns, but also when they are placed on administrative leave for such concerns, and to submit to the Committee plans to implement measures that attend to harassment in extramural settings with the same level of attention and resources as those devoted to other research misconduct. The Committee also directs NIH to support research in the areas identified in the Report, including the psychology underlying harassment and the experiences and outcomes  of diverse groups when subjected to harassment. Additionally, the Committee directs NIH to collaborate with the National Academies to develop best practices for developing more diverse and inclusive cultures in the grantee research environments, including training individuals in institutions that receive NIH funds to recognize and address sexual harassment, and evaluating the efficacy of various sexual harassment training programs.
 
National Institute of Allergy and Infectious Diseases
  • Report language directs NIAID to spend at least $200 million of the $5.8 billion provided in the bill for the Institutes on research on a universal flu vaccine
  • Report language notes there is “sufficient funding” for continued research on AMR
  • On the threat of emerging infectious diseases: “The Committee recognizes the threat of Emerging Infectious Diseases (EID) from animals and urges NIH to support further research in disease mapping and forecasting in order to identify early warning signals for outbreaks of emerging diseases. The Committee directs NIH to include a progress report on the use of machine learning and validated mechanistic models to advance critical biomedical research, improve decision support for epidemiological interventions, and enhance human health in the fiscal year 2021 Congressional Justification.”
 
Centers for Disease Control and Prevention
 
  • Advanced Molecular Detection: “The Committee includes an increase of $2.5 million to support the dissemination of technologies to state and local health departments to advance the nation’s public health system.”
  • Antimicrobial resistance: Includes the following: “The Committee includes an increase of $5 million and recognizes the importance of addressing the problem of antibiotic resistant bacteria through a “One Health” approach, and by tracking resistance through local, regional, national, and global surveillance. The Committee encourages CDC to competitively award research activities that address aspects of antibiotic resistance related to ‘‘One Health,’’ including global surveillance, and research and development for new tools to counter antibiotic resistance among entities, including public academic medical centers, veterinary schools with agriculture extension services, and public health departments whose proposals are in line with CDC’s strategy for addressing antibiotic resistant bacteria. Furthermore, the Committee is pleased with CDC’s Antimicrobial Resistance (AMR) Challenge and its implementation of a ‘‘One Health’’ approach to encourage governments, private industries, and non-governmental organizations across the world to combat AMR.
  • Global health security: “an increase of $25 million to advance global efforts to detect epidemic threats earlier and  respond more effectively, and prevent avoidable crises. The Committee supports CDC’s work to protect global health security through the Center for Global Health, the National Center for Emerging and Zoonotic Infectious Diseases, and other programs that detect, prevent, and respond to infectious disease and other health threats. As emerging infectious diseases like Ebola and Zika represent profound challenges for our health system, the Committee supports continued and enhanced work in research and development aimed at creating new tools to respond to health threats at home and abroad. The Committee urges CDC officials to ensure that the importance of research and development to global health security is appropriately reflected in their international engagements.”
 
The next step for the House Labor HHS appropriations bill will be to go to the floor for consideration. We are hearing that the Senate Appropriations Committee will take up the bill in early June.