President Bush’s proposed fiscal 2008 budget includes an increase of less than 1% to the National Institutes of Health (NIH) budget overall, but a decrease of $9 million in the National Cancer Institute’s (NCI’s) budget, to $4.78 billion. The NIH comprises 27 institutes. NCI’s 2008 budget is roughly equal to how much it costs to wage war in Iraq for a fortnight.

As I have cited previously in this forum, NCI had to cut new grant awards by 29% last year. The next round of cuts this year, on top of the previous year’s cuts, will really hurt patients with rare cancers as well as small pharma and biotech companies.

The Coalition of National Cancer Cooperative Groups, founded 10 years ago, is a nonprofit group comprising all 10 of this country’s federally funded cancer cooperative groups, and it will have to make some deep cuts to its clinical research programs. Up to 95—or nearly half of the clinical trials they conduct annually—may have to be shut down or delayed this year. This would eliminate up to 3,000—out of 20,000—patient slots in clinical trials across all cancers, but mainly those for rarer cancers such as sarcoma, some childhood tumors, and head and neck cancers.

Elias Zerhouni, director of the NIH, refers to the current time period as the “post-doubling era” because it comes after the NIH budget doubled between 1998 and 2003.

So why so many cuts?

Zerhouni refers to the present situation as “the perfect storm” of “increased demand, inflation effects and flat budgets.” In 1998, NIH received 24,151 applications for new and competing research project grants. This year, the NIH expects to receive 49,000, more than double the number almost 10 years ago. Since 1998, the average size of these grants grew by about 40%, and NIH budgets have not kept pace with biomedical research and development inflation since 2003.

The cuts will take not only a human toll but will hurt drug developers as well. According to Richard Schilsky, chairman of a study cooperative called Cancer and Leukemia Group B Foundation, the reduction in patient slots for cancer clinical trials “can trickle down” to small pharma and biotechs “in a fairly negative way.”

Because the 10 cooperative groups in the coalition enroll nearly half the U.S. patients who participate in cancer trials, there will be a direct impact on drug developers, especially smaller companies with limited finances that make their investigational products available to the NCI for use in cooperative groups.