It’s not news by now that the proposed 2018 budget calls for a $2 billion cut to the NIH. But a specific line item in the proposed budget that still comes as a shock to the global public health community is the administration’s call to shut down the NIH Fogarty International Center (FIC).
Even for an administration already known for its unique approach to government, this development can only be deemed unusual, according to several sources contacted by CenterWatch. The FIC is lauded by leading experts as a juggernaut in the fight against everything from AIDS to Ebola, and from Zika to influenza. Such related outbreaks in the U.S. in recent years have been wildly publicized and frightened the general population at large.
“The FIC is such a small portion of the overall NIH budget that it raises the question of why it was proposed for elimination, especially in light of recent headlines about Ebola in West Africa,” Jennifer Zeitzer, director of Legislative Relations at the Federation of American Societies for Experimental Biology (FASEB), told CenterWatch. “This seems like a very bad time to cut back on the research that could help keep both Americans and our fellow citizens in the rest of the world safe.”
According to Christine Lubinski, vice president for Global Health Policy at the Infectious Diseases Society of America, the FIC’s contribution to the frontline fight against epidemics cannot be over-emphasized. In a webinar sponsored last week by the NIH, she said that the FIC supports the work of U.S. universities and medical centers. She noted that 80% of its budget is deployed to predict and contain future pandemics, as well as foster good will and U.S. leadership globally.
“The FIC provides a huge return for very little investment, compared to the cost of a public health response in every county in the U.S. once a threat ... starts to penetrate our borders,” David O. Freedman, M.D., an infectious diseases specialist and professor at the University of Alabama at Birmingham told CenterWatch.
Dr. Jennifer Miller, Ph.D., assistant professor in the Division of Medical Ethics and Department of Population Health at the NYU School of Medicine, echoed this concern. She said that the FIC funds over 500 medical and health projects at 100 U.S. universities related to diseases such as Ebola, Zika and AIDS.
“With globalization, diseases know no borders,” she told CenterWatch. “Health risks in developing countries can become health threats for the U.S. Protecting the American public requires attention to health developments and the spread of disease around the world, a main focus of the FIC.”
Realistically, it’s unlikely that closing of the FIC will ever see the light of congressional day. The program enjoys wide bipartisan support, as evident by recent public comments since the budget draft was released by the White House.
“You’re much more likely to die in a pandemic than you are in a terrorist attack,” said Representative Tom Cole (R-OK), according to Lubinski in her presentation. “I’d much rather fight Ebola in West Africa than in West Dallas.”
Senator Lindsey Graham (R-SC) called the NIH “a national treasure” in a tweet about the Trump administration’s proposed cuts in overall NIH-funding according to the Washington Examiner.
“[The FIC] represents only a sliver of the NIH’s budget, yet it has an outsized impact on the prevention and mitigation of outbreaks in the world,” said Representative Rosa DeLauro (D-CT), again attributed by Lubinski in her presentation. “Their work helps ensure diseases are quickly contained and never reach our country.”
It should also be noted that in the most recent spending bill, Congress ignored the Trump administration’s recommendations for NIH cuts and increased the agency’s funding by $2 billion through the end of the fiscal year.
CenterWatch reached out to the Office of Budget and Management about the proposed FIC closure and received a broad reply related to the NIH cuts.
“The budget pursues organizational changes across the NIH to make for a more efficient use of resources and focus on high priority research. The NIH has over 27 institutes and centers with duplicative administrations and research agendas,” Coalter Baker, deputy press secretary, Office of Management and Budget, told CenterWatch.
Much of the NIH’s academic work happens overseas in countries where many epidemics originate, such as India, China and the Congo. However, not all of the FIC efforts are related to communicable diseases.
Zeitzer with FASEB related a current FIC project with great implication in the U.S. currently underway in Brazil—an Alzheimer’s disease study. According to the Alzheimer’s Association, the numbers of Americans affected will more than double to 13.5 million by 2050, unless a treatment is discovered.
She said the FIC project involves the study and treatment of a concentered population of Brazilians predisposed to the disease.
“The FIC provided funding for training so that local researchers in Colombia could perform brain scans and genetic analysis on an extended family with hereditary, early-onset Alzheimer’s in rural Colombia,” she explained. “This work has already informed the development of a clinical trial of a drug manufactured in the U.S. that may help stop Alzheimer’s at its earliest stages.”
In the end, the NIH and FIC debate comes down to the stated values of the administration—and the country.
“Since the Trump administration supports ‘Making America Great,’ it should naturally support the FIC as an integral element of helping protect Americans from global health threats,” said Dr. Miller at NYU. “If the administration ends up cutting FIC funding, which I hope and suggest it doesn’t, it should clearly articulate how it will fill the resulting gap in global and public health protections.”
This article was reprinted from Volume 21, Issue 21, of CWWeekly, a leading clinical research industry newsletter providing expanded analysis on breaking news, study leads, trial results and more. Subscribe »