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THE WALL STREET JOURNAL THURSDAY, FEBRUARY 4, 1999 Clinton Strikes Out on Health Research The president's budget this week boasts of the Clinton commitment to biomedical research by generously funding the National Institutes of Health budget. It "renews the commitment" that the president made to vastly expanding biomedical research. This funding, the administration notes, has "made the United States the world leader in medical research." If you buy that rhetoric then you can accept the president's definition of "is"-as i Politics & People L By Albert R. Hunt in there "is no sexual affair" -or "alone" -as in whether he was "alone" while having oral sex. The truth is the president has beaten an unconscionable retreat in his NIH budget. last year, prodded by outside gr~oups like Research America, a bipartisan group of legislators committed themselves to doubling the health-research budget over the next five years. The first installment was a 15% hike to $15.1 billion for the current fiscal year. In signing that legislation, the president praised it as a "critical downpayment" for his 21st-century research fund for America, and while he proposed a 50% hike over five years, he indicated support for doubling that budget. In the 2000 budget, however, he seeks only a 2% increase, not even enough to keep pace with inflation; this would be the smallest Increase in the NIH budget this decade. Health-research experts say this budget would stifle the NIH's momentum, lessen the prospects for major breakthroughs in the next decade, leave scores of promising grant proposals unfulfilled and discourage bright young from entering the biomedical research short period of time. As a general rule, fiel - that's a legitimate concern, though it The proposed NIH budget signals "a rarely bothers politicians when they're cease fire in the war agajnst cancer, rushing to fund highway spending or a Parkinson's, Alzheimer's and other dis- pork-laden defense projects. eases," complains Sen. Connie Mack (R., But in the case of NIH, these fears are Fla.). In a rare agreement with his conser- unfounded. Most of the grant applications, vative colleague, j)emocrat Tom Harkin of according to peer-review participants, are Iowa calls the Clinton proposal "corn- worthy. Yet through most of this decade, pletely inadequate to fund potential new only a about a quarter were funded; with breakthroughs." increased appropriations, that level has The president is playing a political me. The day after his budget was released, he met privately in Boston with Ted Kennedy and several health-research advocates and, defensively, explained that other than tax cuts and defense spending the NIH is the only area where sufficient Republicans support generous increases Thus, he suggested, the research money would ultimately be there anyway. The problem is that last year he sought an 8.5~ raise and the end result was almost 15% With the president comlng in so low this year, it may be very hard to ratchet it up another 15% hike. Moreover, this administration's rhet oric on research invariably exceeds its commitment. In health research, payoffs are longer term. The most appreciative constituencies are those that benefit from discoveries which usually are years away. Medical scientists charge this is an especially bad time to be stingy. "This is one of the unique moments in biomedical research where we're on the verge of exciting developments," says Dr. William Brinkley, head of a federation of medical biologists and Vice President of Graduate Sciences at the Baylor College of Medicine. The only catalyst for these advances are NIH grants. Some conservatives and even experienced lawmakers like Pete Domenici question whether the NIH can efficiently absorb massively higher expenditures in a risen to slightly over 30%. Experts insist it is very easy to maintain high quality at those rates. John Porter, an Illinois Repubilcan congressman, who chairs the House Appropriations subcommittee dealing with NIH, says that based on extensive research, there is "resounding" evidence the money would be spent wisely. But under the Clinton budget, he estimates some 1,500 proposed grants from medical centers around the country will be denied. More than a few researchers with existing grants wouldn't be able to cover inflationary adjustments. And the cutbacks would be a disincentive to young scientists to get into this field. Potential breakthroughs are real. Re- searchers in the areas of cancer, diabetes and AIDS, where extraordinary progress has been made, see bigger possibilities on the horizon. In brain-related areas, the Charles A. Dana Foundation forecasts "major advances" in treating Huntington's disease, Alzheimer's, Lou Gehrig's disease and Parkinson's, as well as the development of new drugs for strokes and spinal cord injuries. It's a good bet that more than a few of any advances will emanate from NIH grants. These are real investments. A major Duke University study a few years ago dm(~~i?nIgstmraat;~r ~ among the elderly If that trend accelerates, the potenh.ai savings in Medicare costs are substantial. ~ I;~~acrtMhaesti;veeasrtn~nldt. ~ ~ bw%hsindhetha~An~eer(~raanl spending on basic medical and spience research: "By the end of the 199O~ America will have added fl million ne~ jobs while the European Union, with e third more population will have he said. "We have the same savings rate, the same education levels and It's not that we're smarter; our advantage is that America makes the Investment in basic science." A federal budget, with all its limitations and flaws, is a partial roadmap of a society's priorities. A number of Mr. Clinton's initiatives-the efforts to deal with Social Security, funding for more teachers-are laudable; arguably too there Is a case for some tax cuts in this booming econom~ Ut none are more important than conti~~mg a major and bold effort to fund research for medical breakthroughs that will make us a much healthier and more productive society. Here the Clinton b~dget fails miserably.