Association of American Cancer Institutes

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1 Association of American Cancer Institutes Statement by the Association of American Cancer Institutes on Fiscal Year (FY) 2016 Appropriations for the Department of Health and Human Services Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Committee on Appropriations, U.S. House of Representatives Testimony submitted by: Barbara Duffy Stewart, MPH, Executive Director (412) , The Association of American Cancer Institutes (AACI), representing 94 of the nation s premier academic and free-standing cancer centers, appreciates the opportunity to submit this statement for consideration by the subcommittee. AACI submits this request for the Department of Health and Human Services budget for the National Institutes of Health (NIH) in the amount of at least $32 billion for FY 2016, including a proportional increase of $5.32 billion for the National Cancer Institute (NCI). AACI thanks Congress for its enduring commitment to guaranteeing quality care for cancer patients, as well as for providing researchers with the resources that they need to develop better cancer treatments and, ultimately, to find cures. The partnership between the federal government and our nation s cancer centers is mutually beneficial, and cancer centers continue to make strides in biomedical research thanks to the support of the federal government. Without such support, research projects with the potential to discover breakthrough therapies would not be possible. The President s FY 2016 budget request for the NIH is $31.3 billion, $1 billion (3.3 percent) above the enacted FY 2015 level. This includes $5.098 billion for the NCI. In his budget blueprint, the President also outlined the Precision Medicine Initiative, which includes an investment of $215 million: $130 million would be provided to the NIH to support a national research component; $70 million to the NCI to support additional cancer genomics research 1

2 efforts; $10 million provided for the Food and Drug Administration (FDA) to support regulatory efforts related to precision medicine; and $5 million to the Office of the National Coordinator for Health Information Technology for data privacy and interoperability efforts. While the President s proposed budget would allow for more competing Research Project Grants (RPGs), direct budget cuts in 2011 and 2013 continue to impact labs nationwide. If Congress fails to act, sequestration will impair biomedical research in FY 2016 and for years to come. Ongoing budget constraints continue to drive promising young scientists to research opportunities abroad or outside of the biomedical research community. Veteran researchers have been forced into early retirement, and many labs coping with decreased funding have had to prioritize research projects. The threat to America s standing in research and development is threatened with each dollar slashed from the NIH budget. With each cut, cancer centers are challenged to provide infrastructure resources necessary to support their labs, and the failure to keep pace with the biomedical inflation rate will limit AACI members ability to provide well-functioning shared resources to investigators who depend on them to complete their research. For most academic cancer centers, the majority of NCI grant funds are used to sustain shared resources that are essential to basic, translational, clinical and population cancer research, or to provide matching dollars which allow departments to recruit new cancer researchers to a university and support them until they receive their first grants. Center infrastructure is expensive and it is not clear where cancer centers would acquire alternative funding if NCI grants for these efforts continue to dwindle. Research Support Has Diminished but Cancer Continues to Plague America Since 2003, the NIH budget has dropped 24 percent ($6.5 billion), when accounting for inflation in the cost of biomedical research. The outlook has been just as damaging for the NCI, 2

3 with its budget cut 26.4 percent ($1.2 billion) since The President s FY 2016 proposal falls far short of the inflation rate of 2.4 percent, a figure that NIH projected for the FY 2016 Biomedical Research and Development Price Index (BRDPI). AACI cancer centers are at the forefront of the national effort to eradicate cancer. The cancer centers that AACI represents house more than 20,000 scientific, clinical and public health investigators who work collaboratively to translate promising research findings into new approaches to prevent and treat cancer. Making progress against cancer is complex and timeintensive. However, the pace of discovery and translation of novel basic research to new therapies could be quickened if researchers could count on an appropriate and predictable investment in federal cancer funding. Flat funding to the NIH continues to impede advances in biomedical research and also undermines cancer centers ability to: conduct and support multidisciplinary cancer research; train cancer physicians and scientists; provide state-of-the-art care; and, disseminate information about cancer detection, diagnosis, treatment, prevention, control, palliative care, and survivorship across our communities. With excitement mounting about the scientific opportunities ahead and our potential to leverage the resulting advances to help our fellow citizens, now is not the time to retreat from fully funding the NIH and NCI. The broad portfolio of research supported by NIH and NCI is essential for improving our basic understanding of diseases and has considerably improved Americans health. A sound investment by the federal government in biomedical and cancer research over the past two decades has led to incredible advances in our understanding of cancer, and to new ideas that have the potential to accelerate that progress faster than ever before. Cancer is one of the leading causes of death and disability in the United States. This 3

4 year, more than 1.6 million Americans will receive a cancer diagnosis and more than 589,000 Americans will lose their lives to cancer. Despite these alarming numbers, they represent progress. The five-year relative survival rate for all cancers diagnosed between 2002 and 2008 is 68 percent, up from 49 percent between1975 and In addition, cancer death rates have dropped 11.4 percent among women and 19.2 percent among men over the past 15 years. 1 The improvement in survival reflects both improvement in diagnosing certain cancers at an earlier stage and better treatment. Our country has contributed to a steady decrease in the mortality rate for cancer. More Americans than ever are living through and beyond a cancer diagnosis and the potential for accelerating progress against cancer is greater than ever. 2 However, cancer incidence worldwide is expected to increase from 12.8 million new cases in 2008 to 22.2 million in The NCI estimates that 41 percent of individuals born today will receive a cancer diagnosis at some point in their lifetime. 3 The time for predictable federal funding for the NIH is now. Conclusion The NIH estimates that the overall costs of cancer in 2013 were $263.8 billion: $124.6 billion for direct medical costs (the total of all health expenditures) and $139.2 billion for indirect mortality costs (due to lost productivity due to premature death). 4 Even as the cost of cancer continues to rise, investment in cancer research could one day significantly reduce or even eliminate the health and economic burdens that cancer imposes on all Americans. Failure to keep pace with the biomedical rate of inflation will only hinder our nation s cancer center 1 American Cancer Society. Facts and Figures, American Cancer Society. Facts and Figures. 3 Cancer Trends Progress Report 2011/2012 Update, National Cancer Institute, NIH, DHHS, Bethesda, MD, August 2012, 4 American Cancer Society. Facts and Figures. 4

5 researchers from generating future knowledge that will aid in the prevention, detection and treatment of cancer. AACI joins with our colleagues in the biomedical research community in recommending that the subcommittee recognize the NIH as a critical national priority by providing at least $32 billion in funding in the FY 2016 Labor-HHS-Education Appropriations bill, including an equivalent percentage increase in funding for NCI. This funding level represents the minimum investment necessary to avoid further loss of promising research. A sound federal investment in our nation s NCI-designated cancer centers and emerging academic cancer centers will continue to accelerate progress and promote future advances that will ensure a healthier, more productive future for the benefit of all cancer patients. This is an important moment in America s commitment to finally defeat the more than 200 diseases we call cancer and to ultimately transform cancer care for the millions of men and women touched by cancer. 5

The HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA)

The HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) Written Testimony for the Record to the House Subcommittee on Labor, Health and Human Services, Education and Related Agencies regarding FY 2018 Appropriations for HIV/AIDS Programs Submitted by Dr. Wendy