Federal Investment in Research
While JDRF plays a significant role in the effort to cure, treat, and prevent type 1 diabetes (T1D), investment in research from the federal government is essential to meeting these core objectives of JDRF. JDRF continues to monitor the federal budgets of the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). These key agencies maintain significant influence on the advancement of core diabetes research and therapies. As such, JDRF supports the strongest funding levels possible for these agencies.
- The National Institutes of Health (NIH) is the government agency that administers federal funding for medical research across the country and around the world. On April 26, a sign-on letter was circulated by Senators Casey (D-PA) and Burr (R-NC) to the Senate Appropriations Committee, calling for maintaining a strong commitment to medical research funding at NIH. 52 Senators signed on to the bipartisan final letter, asking for strong NIH funding in FY14.
- Within NIH, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is the lead Institute for coordinating and conducting research to treat, prevent and cure type 1 diabetes and its complications. In addition to administering Special Diabetes Program (SDP) funds, which account for 35% of all T1D research at NIH, NIDDK (and other agencies within NIH) awards grants on a competitive basis with funding the NIH receives from Congress every year. The annual funding that NIH receives complements the money provided by the SDP, which was renewed earlier this year. Both the annual funding at NIH and the SDP are advancing critical research to cure, treat and prevent type 1 diabetes.
- The Food and Drug Administration (FDA) is tasked with assuring the safety, efficacy, and security of drugs, biologics, and medical devices, including the Artificial Pancreas technology, and other new diabetes treatments and devices. JDRF and the T1D community have a vested interest in the actions of the FDA and its funding levels as new treatments, such as the Artificial Pancreas, will require FDA review and approval before becoming available.
- The Centers for Disease Control and Prevention (CDC) impacts diabetes research in the areas of health statistics, surveillance, epidemiology, and informatics, which help track the disease. Specifically, the CDC and NIH are funding a 5-year, multicenter study, SEARCH for Diabetes in Youth, to examine the current status of diabetes among children and adolescents in the United States.
The Budget Process ‘in a nutshell’
Federal investment in research is determined by annual funding for federal agencies, known as ‘appropriations,’ through a series of negotiations between the President and the Congress. First, the President delivers the Administration’s budget proposal to Congress outlining federal spending priorities for the next fiscal year. Next, the House and Senate propose their own budget resolutions and determine annual discretionary spending (NIH, FDA and CDC) accordingly (known as ‘appropriating.’) Once appropriations bills have passed Congress, they are then sent to the President for final approval and signature, and are enacted into law. If a formal appropriations bill has not been signed into law by the end of the Congressional fiscal year (September 30th), Congress will often pass a Continuing Resolution (known also as a ‘CR’), a type of appropriations legislation to fund existing federal programs at previously funded levels, and the President signs it. Sometimes the CR is extended multiple times.
Budget Cuts and Sequestration
Over the past year, you may have heard the term ‘sequestration,’ which refers to across the board cuts in federal spending. A bipartisan majority of the U.S. Congress originally approved the use of sequestration (an accounting mechanism) in the Budget Control Act, in an effort to address deficit reduction and the debt limit during the summer of 2011. As mandated by this legislation, a ‘Super Committee’ of Members was formed by Congress to come up with at least $1.2 trillion in spending cuts over a 10-year period, by January 1, 2013, to address our national debt. Otherwise, sequestration (these across the board budget cuts) would go into effect, cutting discretionary spending and mandatory spending. Under the Budget Control Act, critical research agencies would be cut by 8.2 percent – NIH ($2.518 billion), FDA ($318 million), and CDC ($464 million) – while SDP funding would be cut by 7.6 percent, a loss of $11 million.
Since the passage of the fiscal cliff agreement, or the American Taxpayer Relief Act of 2012 (Public Law 112-240), sequestration was delayed March 1, 2013. (The fiscal cliff agreement included the renewal of the SDP for one year, at level funding of $150 million.) As a result of Congress’ inability to reach an agreement with the President to address sequestration, cuts are currently in effect, but the impact may not be realized in the immediate future given that federal agencies are implementing these cuts.
As a result, starting on March 1st, federal agencies funded by appropriations (discretionary programs) that are relevant to T1D were cut by 5 percent: NIH ($1.545 billion), FDA ($126 million), and CDC ($285 million). (The fiscal cliff agreement changed both revenues and spending; therefore, the percentages of the sequestration levels to mandatory and discretionary programs were adjusted from the reductions made under the Budget Control Act.) These cuts, should they continue, would likely result in fewer grants awarded and the delay of critical diabetes research advances.
JDRF’s top legislative priority, a multi-year renewal of the Special Diabetes Program (SDP), which falls under mandatory spending, is subject to a 5.1 percent cut, equal to $8 million lost (out of $150 million).