Alternative medicine and prostate cancer benefit from largest ever NIH increase
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1348 NATURE MEDICINE • VOLUME 4 • NUMBER 12 • DECEMBER 1998 NEWS The US Congress has approved the largest ever increase in funding for the National Institutes of Health (NIH)—a whopping 15 percent raise that takes the FY99 budget to $15.6 billion. The increase means that the NIH is on track to double its budget by 2003. NIH Direc- tor Harold Varmus says that the addi- tional $2 billion will mean “more of everything: more grants, and a lot of new initiatives.” In particular, the increase will mean more research into prostate cancer and alternative medicine. It is widely recognized that persistent and aggressive lobbying to increase sup- port for biomedical research was respon- sible for the substantial increase. “We have very strong advocacy on our behalf from a wide number of constituents,” Varmus told Nature Medicine. He said that he also appreciated that Congress largely resisted its usual urge to earmark money for specific studies and designated acade- mic centers. “Having the budget carved up like that is a very bad thing to do,” said Varmus, and added, “but we always listen to their guidance.” Such guidance this year included several strong recommen- dations. The first was that NIH make prostate cancer research a high priority. The FY99 Omnibus Appropriations bill states that “spending for prostate cancer research over the years has not kept sufficient pace with the scientific opportunities and the proportion of the male population who are afflicted with this disease,” and calls for accelerated spending in this field. Within the next six months, the NIH must present a report to Congress outlin- ing plans for prostate cancer research over the next five years. Another recommendation was that the institutes develop a full-scale initiative to find ways to prevent Alzheimer disease in those who may have a familial predispo- sition to it. While Congress “urged” NIH to act on these and other recommendations it did take one, more specific, action: to elevate the small Office of Alternative Medicine (OAM) to a Center—a move typically regarded as one step before becoming an Institute. In addition to its heightened sta- tus, the OAM will receive a $50 million budget, more than doubling its existing funds of $20 million, and an astronomical rise since its inaugural FY92 appropriation of $2 million. Of the new budget, not less than $20 million must be spent on peer- reviewed research grants. Tom Harkin (Dem., Iowa) a well- known believer in alternative medicine, who was responsible for establishing the OAM through a congressional mandate in 1991, was also behind the FY99 OAM changes. And as if to reinforce the virtual re-birth of alternative medicine within NIH, it must change its name to the National Center for Com- plementary and Alternative Medicine (NCCAM). Incum- bent director Wayne Jonas will leave the center at the end of this month to return to the army having completed his three- year military detail, and his replacement is expected to be announced on January 1st 1999. In fact, NCCAM is a shining example of how acutely tuned Congress is to the mood of the public when making spend- ing decisions. According to a study pub- lished last month (JAMA 280, 1569; 1998), four out of 10 Americans used alternative medicine therapies in 1997 and visits to alternative medicine practi- tioners have increased by 50 percent from 1990, now exceeding visits to all primary care physicians. Moreover, Americans spend around $21.2 billion on services provided by alternative practi- tioners. Despite the presence of alternative medicine within the Office of the Direc- tor on the Bethesda campus, many believe that Varmus and other NIH offi- cials merely tolerate work in this area and are reluctant to embrace it alongside tra- ditional biomedical research. But Varmus dispelled such rumors. “Two years ago I’d have been unhappy about this [man- date], but now we’re ready for it,” Varmus said. “We know what needs to be done in the area of high quality research. We are set- ting up this new center, and we’re recruiting a new direc- tor. We want to get someone open-minded, but also a skilled clinical trialist who understands how you test therapies.” All of the NIH institutes will share the $2 million bounty. Each gets a minimum 10 percent raise, but the biggest institutes come out ahead: these include the National Cancer Institute (15 percent increase); the National Human Genome Research Institute (22); and the National Institute of Allergy and Infec- tious Diseases (16). NIAID director, Anthony Fauci, said that his institute would focus more resources on the problems of emerging microbes, tuberculosis and malaria. It also plans to draft a major initiative on immunological tolerance, with specific applications to organ transplantation. Other areas include autoimmune diseases, HIV vaccine development, and protection against bio-terrorism. “It’s hard to start a lot of programs in one year, but I think we can do it,” said Varmus. KAREN BIRMINGHAM, NEW YORK & MARLENE CIMONS, WASHINGTON, D.C. Alternative medicine and prostate cancer benefit from largest ever NIH increase German coalition overlooks biomedical science A “doubling of investments in the fu- ture” was one of many promises made by Germany’s Social Democratic Party (SDP) before their landslide victory in the October election. Yet four weeks later, neither public health nor R&D were among the top priorities in the coalition treaty signed by Helmut Kohl’s successor Gerhard Schroeder. Pre-election pledges of doubled investment have withered to “clear increases.” The treaty, intended to serve as Germany’s political road map into the next millennium, focuses naturally on the most serious problem that faces the country—unemployment. But although “sustainable economic growth by inno- vation” is a phrase used throughout the document, nowhere is it linked to R&D, a coupling that governments of other de- veloped nations see as a route to eco- nomic prosperity. The treaty makes no mention of financial commitments to the Ministry of Science and Education headed by Edelgard Bulmahn (SDP) or to the Ministry of Health under the direc- tion of Andrea Fischer (Green Party). Nevertheless, optimism prevails at Germany’s basic research grant agency, the Deutsche Forschungsgemeinschaft (DFG). Bulmahn has served as chair for the parliament’s Science committee in recent years, and is seen as “competent and knowledgeable,” according to DFG- spokeswomen Eva Streier. On Bulmahn’s appointment, the head Sheila Foran © 1998 Nature America Inc. • http://medicine.nature.com © 1998 Nature America Inc. • http://medicine.nature.com
Transcript of Alternative medicine and prostate cancer benefit from largest ever NIH increase
1348 NATURE MEDICINE • VOLUME 4 • NUMBER 12 • DECEMBER 1998
NEWS
The US Congress has approved thelargest ever increase in funding for theNational Institutes of Health (NIH)—awhopping 15 percent raise that takes theFY99 budget to $15.6 billion. Theincrease means that the NIH is on trackto double its budget by 2003. NIH Direc-tor Harold Varmus says that the addi-tional $2 billion will mean “more ofeverything: more grants, and a lot of newinitiatives.” In particular, the increasewill mean more research into prostatecancer and alternative medicine.
It is widely recognized that persistentand aggressive lobbying to increase sup-port for biomedical research was respon-sible for the substantial increase. “Wehave very strong advocacy on our behalffrom a wide number of constituents,”Varmus told Nature Medicine. He said thathe also appreciated that Congress largelyresisted its usual urge to earmark moneyfor specific studies and designated acade-mic centers. “Having the budget carvedup like that is a very bad thing to do,” saidVarmus, and added, “but we always listento their guidance.” Such guidance thisyear included several strong recommen-dations.
The first was that NIH make prostatecancer research a high priority. The FY99Omnibus Appropriations bill states that“spending for prostate cancer researchover the years has not kept sufficient pacewith the scientific opportunities and theproportion of the male population whoare afflicted with this disease,” and callsfor accelerated spending in this field.Within the next six months, the NIHmust present a report to Congress outlin-ing plans for prostate cancer research overthe next five years.
Another recommendation was that theinstitutes develop a full-scale initiative tofind ways to prevent Alzheimer disease inthose who may have a familial predispo-sition to it.
While Congress “urged” NIH to act onthese and other recommendations it didtake one, more specific, action: to elevatethe small Office of Alternative Medicine(OAM) to a Center—a move typicallyregarded as one step before becoming anInstitute. In addition to its heightened sta-tus, the OAM will receive a $50 millionbudget, more than doubling its existingfunds of $20 million, and an astronomicalrise since its inaugural FY92 appropriationof $2 million. Of the new budget, not lessthan $20 million must be spent on peer-
reviewed research grants.Tom Harkin (Dem., Iowa) a well-
known believer in alternative medicine,who was responsible for establishingthe OAM through a congressionalmandate in 1991, was also behindthe FY99 OAM changes. And as ifto reinforce the virtual re-birthof alternative medicine withinNIH, it must change its name tothe National Center for Com-plementary and AlternativeMedicine (NCCAM). Incum-bent director Wayne Jonaswill leave the center at theend of this month to returnto the army having completed his three-year military detail, and his replacementis expected to be announced on January1st 1999.
In fact, NCCAM is a shining exampleof how acutely tuned Congress is to themood of the public when making spend-ing decisions. According to a study pub-lished last month (JAMA 280, 1569;1998), four out of 10 Americans usedalternative medicine therapies in 1997and visits to alternative medicine practi-tioners have increased by 50 percentfrom 1990, now exceeding visits to allprimary care physicians. Moreover,Americans spend around $21.2 billion onservices provided by alternative practi-tioners.
Despite the presence of alternativemedicine within the Office of the Direc-tor on the Bethesda campus, manybelieve that Varmus and other NIH offi-cials merely tolerate work in this area and
are reluctant to embrace it alongside tra-ditional biomedical research. But Varmusdispelled such rumors. “Two years ago I’d
have been unhappy about this [man-date], but now we’re ready for it,”Varmus said. “We know what needs
to be done in the area of highquality research. We are set-ting up this new center, andwe’re recruiting a new direc-
tor. We want to get someoneopen-minded, but also a
skilled clinical trialist whounderstands how you testtherapies.”
All of the NIH instituteswill share the $2 million bounty. Eachgets a minimum 10 percent raise, but thebiggest institutes come out ahead: theseinclude the National Cancer Institute (15percent increase); the National HumanGenome Research Institute (22); and theNational Institute of Allergy and Infec-tious Diseases (16).
NIAID director, Anthony Fauci, saidthat his institute would focus moreresources on the problems of emergingmicrobes, tuberculosis and malaria. It alsoplans to draft a major initiative onimmunological tolerance, with specificapplications to organ transplantation.Other areas include autoimmune diseases,HIV vaccine development, and protectionagainst bio-terrorism.
“It’s hard to start a lot of programs inone year, but I think we can do it,” saidVarmus.
KAREN BIRMINGHAM, NEW YORK & MARLENE CIMONS, WASHINGTON, D.C.
Alternative medicine and prostate cancer benefit from largest ever NIH increase
German coalition overlooks biomedical scienceA “doubling of investments in the fu-ture” was one of many promises made byGermany’s Social Democratic Party (SDP)before their landslide victory in theOctober election. Yet four weeks later,neither public health nor R&D wereamong the top priorities in the coalitiontreaty signed by Helmut Kohl’s successorGerhard Schroeder. Pre-election pledgesof doubled investment have withered to“clear increases.”
The treaty, intended to serve asGermany’s political road map into thenext millennium, focuses naturally onthe most serious problem that faces thecountry—unemployment. But although“sustainable economic growth by inno-vation” is a phrase used throughout the
document, nowhere is it linked to R&D,a coupling that governments of other de-veloped nations see as a route to eco-nomic prosperity. The treaty makes nomention of financial commitments tothe Ministry of Science and Educationheaded by Edelgard Bulmahn (SDP) or tothe Ministry of Health under the direc-tion of Andrea Fischer (Green Party).
Nevertheless, optimism prevails atGermany’s basic research grant agency,the Deutsche Forschungsgemeinschaft(DFG). Bulmahn has served as chair forthe parliament’s Science committee inrecent years, and is seen as “competentand knowledgeable,” according to DFG-spokeswomen Eva Streier.
On Bulmahn’s appointment, the head
Sheila Foran
© 1998 Nature America Inc. • http://medicine.nature.com©
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