In 2008, more than half of the $29 billion budget at the National Institutes of Health will be spent on one thing: Research.

This $15 billion-plus in NIH support will come mostly in the form of grants—the crucial funding gifts that allow scientists and researchers, including many at Penn, to do the kind of basic scientific research that is essential to great advances in medicine.

The NIH will spend $186 million on Parkinson’s disease, $644 million in research on Alzheimer’s disease, $2.9 billion on HIV/AIDS and a whopping $5.6 billion on cancer.

And while that may sound like a lot, the reality is it just may not be enough.

In fact, Bill Andresen and Larry Bertuola make a good case that, because NIH funding has been flat for a half-decade, America is not only putting potentially life-saving research on hold, but also running the risk of losing some of its top young minds to countries more willing to support their work.

It’s a case that Andresen, associate vice president in the Office of Federal Affairs, and Bertuola, director of federal affairs, make on a regular basis to the nation’s top policymakers. As the University’s main points of contact to lawmakers in Washington, D.C., it is the job of Andresen and Bertuola to convince lawmakers that fully funding agencies such as the NIH and National Science Foundation is essential if universities like Penn are to make the discoveries that could one day lead to cures for diseases like Parkinson’s, Alzheimer’s, HIV/AIDS or cancer. But given the state of the economy and the prickly partisan atmosphere in D.C. these days, the job isn’t an easy one.

Q. Broadly speaking, what does your office do?
BA: Our office has three basic priorities. We represent Penn on Capitol Hill with members of Congress and the administration, as well as the various departments within the administration that have an interest in education policy. We are there to raise Penn’s profile in Washington, D.C. by bringing faculty to Washington and also taking policymakers and their staff from Washington up to Penn. We also assist students who are going to be interested in working in Washington find internships and help put together some programs for them.

Q. Do you “lobby” directly on Penn’s behalf?
BA: Well, this year we’re not doing earmarks. We’re not seeking them. But we lobby on behalf of increasing federal funding for the National Institutes of Health and the National Science Foundation, the Department of Energy and the Department of Defense, which would benefit all of higher education, including Penn, because it’s a leading institution. If budgets go up, Penn can compete very effectively for those dollars. I am chair for the Association of American Universities’ biomedical group, and so I take the lead on the NIH advocacy on the Hill for the 60-some members of the AAU.
LB: And I was past chair of the AAU task force on competitiveness and innovation. A big focus with that task force was on the physical and engineering sciences, and their correlated impact to enhancing the nation’s competitiveness and keeping America on the cutting edge. Those funds also bring forth the next generation of scientists.

Q. What is the funding situation like today?
BA: NIH funding has been frozen since 2003. It’s not increased since then, while the cost of medical research goes up about 4 percent per year. So with costs going up and funding flat, it’s basically a cut. If you’re a young researcher who is applying for a first-time grant from the NIH, the odds of getting it are about five percent now. It’s very, very hard for a smart young researcher with some new exciting idea to cure a disease to get a grant from the NIH. That’s discouraging to these researchers and so instead of going into research at universities, maybe they’ll go overseas where countries are setting up these huge research facilities and throwing around a lot of money, or they’ll go work for a pharmaceutical company or a biotech company and do more applied research, but not the basic kind of research that the NIH funds.
LB: With NSF and DOE, I guess you can say it’s a slightly better picture. But there’s a recognition that those areas have not been very robust either. There was legislation last year, the America Competes Act, which sought to double funding over the next decade for NSF and DOE, and this is all geared toward the competitiveness and education fronts. That bill was approved and signed into law, but that was an authorization bill, and the funding piece comes next. What has been proposed would be a nice increase, but that still has to work its way through the process.

Q. If this funding is so important, why is it frozen?
BA: Well, from 1997 to 2003, it was doubled. Certainly the war is an issue, if you ask people on the Hill. With the war, there’s just not enough money to go around. That’s a big part of it. There’s also the sense in the Congress that, ‘OK, NIH got its money—we already doubled it, so what more do you need?’ The problem is that the doubling of that funding is just starting to kick in now. That NIH-funded research is making remarkable progress in decoding the human genome and we’re on the verge of breakthroughs in a whole variety of areas where we’ll be able to intervene before a disease manifests itself with people. They’re just on the verge of some really remarkable breakthroughs at a time when money is getting harder to get.

Q. Do you find that sometimes policymakers don’t buy the argument that we are “on the verge” of these great breakthroughs?
BA: Sometimes people don’t understand. There’s this sense of, ‘We gave you all of this money, so why haven’t you cured anything?’ But the reality is we really are on the verge. It just takes years. You just don’t dial up a cure if you give people money. But we’re close to curing diabetes. We’re making remarkable progress in preventing Alzheimer’s disease. If you look at cancer, life spans for people with cancer are dramatically longer and cure rates are dramatically higher than even five years back because of the research that’s been done. We haven’t cured it yet but there are a whole new series of therapies that we’re very close to deploying that can combat cancer.
People also don’t understand that while the NIH budget is $29 billion a year, 85 percent of that goes back out to universities and researchers around the country. That creates jobs and it’s an important part of regional economies, particularly for a state like Pennsylvania where we have so many research institutions.

Q. Does the current political climate make your job difficult?
BA: Well, we have a big budget deficit and the Democrats who control Congress are insisting on a pay-go process, which means if you increase funding for NIH you have to cut funding somewhere else, so it’s problematic. Last year is a good example. The bill that funds the appropriation for the NIH passed Congress with a $1.1 billion increase in funding for the NIH. But President Bush vetoed it and … when the NIH increase was attached to an omnibus-spending bill, it ended up with just a $100 million increase. The reason that happened was that the money that could have gone to the NIH was then used to fund other programs. Part of this is that you have an administration that sets very tough spending limits and a congress that wants to pay for everything [via pay-go]. And when push comes to shove the President usually wins those fights.

Q. Although you represent Penn, I assume you work closely with your colleagues from other universities on these issues?
BA: Yes, we’re members of the AAU, which is made up of the top 60 research universities in the U.S. and Canada—58 in the U.S., two in Canada. We work closely on many of these issues. There are a growing number of universities that have Washington-based offices and work closely with our colleagues from places like Harvard and Princeton and Michigan. On issues like NIH funding, or student loans or Pell Grants, we all basically agree and so we advocate from the same place on those issues.

Q. Does the weak economy make your jobs harder?
BA: You know, it can’t help. When the economy is growing and tax revenues are increasing, there’s more money to go around. When it’s not growing and when tax revenues are down, then you have to make hard choices. Unfortunately, sometimes the choices that are made in Washington don’t always benefit the kind of basic research and science that we do at universities. Part of what Larry and I do, is explain to Congress why it’s so important to keep funding this kind of research. It’s because this leads to innovation, growth, jobs. It saves lives.

Originally published May 8, 2008