The White House's budget blueprint for 2018 has proposed to decapitate NIH funding by USD5.8 billion in 2018, which triggered many bipartisan protests and resistance.

However, President Donald Trump has decided advance the plan by slashing USD18 billion off this year, including USD1.2 billion off the National Institutes of Health's budget - affecting research grants and other health and education programs.

The overall cut also included a reduction of USD314 million from the Centres for Disease Control and Prevention's budget, reducing occupational safety and public health preparedness grants, as well as domestic and global HIV/AIDS programmes. Additionally, mental health block grants would also be cut by USD100 million and the Teen Pregnancy Prevention Program will only receive USD50.5 million - half of what it currently receives.

The cuts are part of a reduction in spending, reportedly offsetting the USD30 billion in supplementary increases in defense spending, as well as the expenditure on the border wall with Mexico.

Trump has been under pressure to fulfil the promise to begin construction immediately; however, to appease his congressional penny pinchers Trump has reallocated budgets - at the cost of public health and impeding scientific advances.

Cuts to NIH funding will impede scientific advances and loss of high-wage jobs

Competition for NIH grants has always been tough and funding has not increased much over the past decade. In addition, the cost of research is steadily increasing, and with an ever-growing pool of PhDs competing for a relatively smaller pile of grant money, this budget cut would drastically hinder scientific advances.

To put into perspective, 30% of NIH grant applications were approved in 2000, whereas today, approximately only 17% are approved.

According to Matt Hourihan, who analyses budget issues for the American Association for the Advancement of Science (AAAS), when the NIH's 2013 budget got cut by 5% during the budget sequestration, 700 individual grants out of approximately 9,000 were cut.

The advanced 2017 cut would also put NIH in a similar situation, limiting their ability to fund new grants, which also affects the livelihood of researchers rely on funding from the NIH or NSF to pay their salaries and fund their project. With the federal government funding 60% of all scientific research, this would mean fewer opportunities for potential PhDs to kickstart their careers.

But Tom Price, the Secretary of Health and Human Services said on 29 March that the NIH budget is plagued by unnecessary expenses.

“I was struck by one thing at NIH,” Price said, “and that is that about 30% of the grant money that goes out is used for indirect expenses, which as you know means that that money goes for something other than the research that’s being done.”

He has repeatedly suggested the reduction of "overhead" costs such as lab equipment and utilities that the NIH pays universities to direct more funds towards actual research.

Loophole in budget resolution can allow for Trump's proposal

But how is Trump able to cut NIH funding in a fiscal year that is already underway?

Congress ultimately decides government spending, but Trump has veto power over Congress. A budget resolution is also only passed by the end of April, so with the new proposals, the spending cuts can apply for the remainder of the fiscal year.

This method of budget planning was implemented as a full, new budget for any fiscal year takes too much time and debate to form, therefore Congress often keeps the previous year's budget framework in place by a continuing resolution - a temporary measure with a shorter shelf life.

Come April, Trump will have the authority to pass the continuing resolution, which he could overwrite if his budget request is not met.

Bipartisan lawmakers and research and health groups reject proposal

However, it is still possible that the cuts will not happen as research and health groups such as the American Public Health Association and American Society for Biochemistry and Molecular Biology (ASBMB) and bipartisan lawmakers are rejecting the proposal.

“The president continues to put the health and well-being of Americans in danger to move forward a so-called ‘hard power budget,’ even while leaders from his own party view investments in biomedical research as critical to the nation’s security,” the ASBMB said.

Particularly after the bipartisan success of the 21st Century Cures Act which raised the NIH budget by USD4.8 billion over a decade, asking the representatives to vote against the institute they just funded will be difficult. MIMS

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Sources:
http://www.vox.com/2017/3/28/15094420/trump-cut-medical-research-nih-wall
http://www.nbcnews.com/health/health-news/trump-proposes-slashing-medical-research-year-too-n739761
https://www.statnews.com/2017/03/28/budget-nih-cuts/
https://www.statnews.com/2017/03/29/tom-price-nih-budget/