Proposed Budget Spells ‘Good News’ for NCI

WASHINGTON--President Clinton has asked Congress to appropriate nearly $2.8 billion for the National Cancer Institute (NCI) for fiscal year 1999, and the Administration wants to increase funding for cancer research at the National Institutes of Health (NIH) by 65% over the next 5 fiscal years.

The President’s budget seeks $14.789 billion for the NIH in FY 1999, which begins Oct. 1. This represents an increase of $1.150 billion, or 8.4%, over the current fiscal year. The $2.776 billion Mr. Clinton proposed for the NCI would increase its current budget by $229 million, or 9%. The NIH budget request also seeks $1.731 billion for AIDS research, an increase of 7.7% over current spending.

Vice President Al Gore announced the Administration’s 5-year plan for NIH cancer research a few days before the proposed 1999 budget went to Capitol Hill. The plan calls for raising the total NIH cancer budget to $4.8 billion in FY 2003 from the $2.914 billion set for FY 1998.

NCI Big Winner

Ninety percent of the proposed increase would go to the NCI, and the remainder would fund new and enhanced activities in at least 12 other institutes. These include brain tumor studies at the National Institute of Neurological Disorders and Stroke, oral cancer work at the National Institute of Dental Research, and studies at the National Human Genome Research Institute.

"Even as we are balancing the budget and making tough cuts across the board, we must invest more in the war against cancer," the Vice President said. He noted that advances in detection, diagnosis, and treatment at NCI and other institutions helped lower overall cancer mortality by 2.6% from 1991 to 1995, and he called the proposed 65% hike "the single largest increase in cancer research ever."

In a statement, the NCI said that the new funding would have "great potential to improve early detection and diagnosis of cancer; speed the discovery and development of new cancer drugs and devices; dramatically increase adult participation in clinical trials [see article on page 5 about the Administration’s plan for Medicare to cover patient-care costs of trials]; and provide all cancer patients and their caregivers with easy access to the latest information on treating their disease."

NCI deputy director Alan Rabson, MD, outlined the institute’s proposed new budget at a meeting of the National Cancer Advisory Board and called it "very good news." Research project grants (RPGs) will continue to increase as a total share of the NCI budget, he said. At $1.335 billion, these grants are up more than $111 million (9%) and account for 48.1% of the total NCI budget request.

"For competing RPGs, we show an increase of almost 25% between FY 1998 and FY 1999," Dr. Rabson said. These will jump to $345.916 million from $277.401 million.

Total research grants, including such areas as cancer education, cooperative clinical research, and minority biomedical support, would reach $1.692 billion, in FY 1999 or 61% of the proposed NCI budget.

The President’s request also seeks $443 million for intramural research. This is a 5% increase in funds, but a decrease in the intramural program’s share of the total NCI budget--to 16% from the current level of 16.6%.

Research and development contracts also gained in dollar amount, from $187 million currently to $200 million in FY 1999 (6.8%), but lost in percentage, declining to 7.2% from 7.4% now.

Cancer Prevention Gains

Cancer prevention and control funding rose in the proposed budget to $278 million from $255 million now, an increase of 9%.

Dr. Rabson said that funding for the management and support of research is lagging behind NCI’s needs. The President’s budget calls for nearly $105 million in FY 1999, an increase of $3 million or 3% from the current funding, although the total NCI budget would rise three times that if Congress approves the President’s request.

"The Congress over the past few years has shown considerable interest in holding down administrative expenses across the government, and NIH has not been spared," Dr. Rabson said. "We will continue to seek new and innovative ways to conduct our business, but it is becoming harder to do our tasks."