As House prepares cuts for NIH, Rathmell urges Senate to protect funding in FY25
NCI Director Kimryn Rathmell joined the NIH director and four other institute directors in a May 23 Senate subcommittee hearing to craft the Labor-HHS spending bill for fiscal year 2025.
The White House’s budget request for NIH includes $48.3 billion for the research agency, without ARPA-H, of which $7.84 billion would go to NCI. This would be an increase of $871.5 million to the overall NIH budget in FY25 compared to FY23. Of that amount, $522 million—nearly 60%—is slated for NCI (The Cancer Letter, March 15, 2024).
However, on the day the NIH institute and center directors addressed the Senate appropriators, the House Appropriations Committee approved its subcommittee allocations for FY25 funding that recommends cutting non-defense program funding by 6%.
The House subcommittee on Labor, HHS & Education—which covers NIH funding—is among those that would receive “significant cuts of 10-11%,” according to the House Appropriations Committee’s press release.
“Unfortunately, Republicans are now again insisting on cutting funding for domestic programs, including, in Labor, HHS,” Sen. Tammy Baldwin (D-WI) said in an opening statement. “That’s putting consistent, meaningful increases for NIH in peril. I’m deeply concerned that that will put us on a path of stagnating funding for NIH.”
NCI’s 10-year streak of a consistently rising budget ended with FY24. The institute received a total appropriation of $7.22 billion, only a slight bump compared to its $7.1-billion budget in FY23 (The Cancer Letter, Sept. 22, 2023).
At the Senate hearing—amid discussions of bird flu, long COVID, and Alzheimer’s disease—questions for NCI’s Rathmell centered on health equity.
“There are 14 states, including my state [of West Virginia], that do not have an NCI-designated cancer center,” said Sen. Shelley Capito (R-WV). Similarly, Sen. Cindy Hyde-Smith (R-MS) said the University of Mississippi is her state’s only academic medical center working toward NCI designation.
Both senators asked Rathmell how NCI can improve cancer treatment and access to clinical trials in more rural states.
Beyond the NCI-designated cancer centers, Rathmell responded, more than 2,200 sites across the U.S. host clinical trials and comprise NCI’s National Clinical Trials Network. She also highlighted the National Community Oncology Research Program, which includes more than 1,000 practices supporting clinical research within community settings.
“But we know that it’s not enough,” Rathmell said. “So, we’ve engaged a group to work across agencies and with community centers to look at our capacity-building opportunities.”
Those agencies include Veterans Affairs, the Indian Health Service, and the Centers for Medicare and Medicaid Services, she said.
And for smaller health centers that lack resources to run clinical trials, Rathmell said NCI has piloted a Virtual Clinical Trials Office, which has been described as a new opportunity for the Virtual Research Nurse Program.
“I think that will democratize the ability to bring clinical trials a lot further,” she said.
Rathmell further emphasized that working within a flat budget would constrain NCI’s ability to create new granting initiatives that could help improve community capacity for cancer research.
“That’s where the reinvigorated Cures Act would bolster our infrastructure for clinical trials,” she said. “We’re looking at a future where we think that clinical trials could be much more available to patients everywhere.”
The Senate Appropriations Committee has not yet approved FY25 budget allocations, but they are anticipated to clash with the House’s priorities.
“Agreeing to the draconian cuts proposed by our House Republican colleagues on the other side of the capitol would be devastating for biomedical research,” Sen. Baldwin said. “It would set back years of progress made towards curing disease and weaken America’s competitiveness, particularly against China—and we just can’t let that happen.”
