WASHINGTON _ National Institutes of Health (NIH)Director Harold Varmus has made a reasoned plea forguaranteed funding for biomedical research that wouldinsulate his scientific enterprise from the vicissitudes ofthe annual budget reconciliation process.

In the prestigious Shattuck Lecture delivered to theannual meeting of the Massachusetts Medical Society andpublished in the Sept. 20, 1995 New England Journal ofMedicine, Varmus said the budget battles of the past twoyears have convinced him that "the government and thepublic should find a secure stable fiscal base for theNIH."

Under Varmus's plan, "the NIH would be guaranteed abudget not less than that of the previous year, with aninflationary increment determined on the basis of the ratioof inflation in medical research and development."

Varmus stressed that "this plan would not createentitlements for individual scientists or scientificprograms." But entitlements is the word that sprang tomind in Congress. "Varmus is putting NIH on the samefooting as Social Security and Medicare," a key aide tothe House Appropriations Committee told BioWorldToday. "I don't think too many Americans thinkbiomedical research is more important than ensuring asafe supply of food and drugs or stalking an outbreak of alife-threatening communicable disease," said the aide.

Guaranteed funding for NIH would demand that otherprograms be cut. "Would Varmus cut defense or raisetaxes?" asked the House aide, who requested anonymity.

Rep. John Porter (R-Ill.) who chairs the House Labor-Health and Human Services (HHS) appropriationssubcommittee that handed NIH such a substantial budgetincrease this year, said that the mechanism suggested byVarmus is flawed. "I share Varmus's goal to protect NIHfrom cuts in funding but to create an entitlement for NIHwould expose the agency to more political risks," he toldBioWorld Today.

"Funding NIH through an entitlement would take it out ofthe jurisdiction of the House and Senate Labor-HHSappropriations subcommittees, two of the agency's moststalwart advocates. In addition, as is common inentitlement programs, the ceiling may become the floor,meaning that NIH would have to forego any fundingincrease because its budget is guaranteed," Porter said.

Varmus appears to ignore the desire among conservativesin Congress to re-think the nation's spending prioritiesincluding a possible reduction in biomedical research."Every federal program competes for funding these days.That's how things are accomplished in this budget-drivenpolitical environment," said Nick Cavarocchi, president,CR Associates, a Washington lobbying firm thatrepresents many voluntary health agencies.

Attempts to expand NIH's budget in the past year haveseemed "quixotic at best," said Varmus. He askedrhetorically if biomedical research would be better servedby "optimizing scientific activities in the steady stateenvironment."

NIH already has accommodated to a certain extentchanging the political realm, attaining what Varmusdescribed as the "steady state. In the steady state, newgrants can be funded only when old grants expire, newfaculty can be hired only when older faculty retire, andnew NIH programs can begin only when other programshave ended."

Varmus argued that "any attempt to plan substantialchanges in the way science is practiced and supportedmust inevitably weigh stability against competition."

Despite Varmus' observation that the NIH may haveentered a steady state, NIH's budget next year will befatter than most federal agencies. NIH did "very wellcompeting in an extreme environment," said the Housecommittee staffer, referring to the wholesale re-thinkingof domestic spending priorities that continues in thisconservative Congress.

NIH was granted a 5.7 percent funding increase in theHouse-passed fiscal 1996 funding bill for theDepartments of Labor and Health and Human Servicesthat includes funding for NIH. That increase is above theinflation-adjusted budget for NIH submitted by theClinton administration. n

-- Michele L. Robinson Washington Editor

(c) 1997 American Health Consultants. All rights reserved.