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Vol. LXV, No. 6
March 15, 2013
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To Stop a ‘Self-Inflicted’ Wound
Mikulski Visits NIH, Hears Impact of Sequestration

On the front page...

Sen. Barbara Mikulski (r) speaks against damaging effects of sequester on NIH’s patients and grantees.

Sen. Barbara Mikulski (r) speaks against damaging effects of sequester on NIH’s patients and grantees.

U.S. Sen. Barbara Mikulski (D-MD), the senior senator from Maryland and chair of the Senate appropriations committee, came to NIH on Feb. 20 with one goal: stop sequestration, the federal government’s automatic budget-cutting mechanism set to take effect on Mar. 1.

“We talk a lot about threats to the United States,” said Mikulski. “We fear foreign predators and terrorism, we fear foreign competition, but we are about to [bring upon ourselves] a self-inflicted wound.”

Mikulski’s NIH tour was the second within a 2-week span by a member of Congress’s senior chamber. Sen. Ben Cardin (D-MD) held a Town Hall meeting here on Feb. 8. The senators’ visits were an effort to bring attention to the potential devastating effects of what Mikulski called “a meat-ax approach” to cutting funds across every agency. NIH, which she renamed the “National Institutes of Hope,” would take a $1.5 billion hit.

Continued...

“We’ve got to stop the sequester—hands across the aisle, hands across the dome,” she said.

Who Pays?

NIH director Dr. Francis Collins, opening a press conference with Mikulski in the South Lobby of the Clinical Center, welcomed the discussion on “the importance of biomedical research and how it advances our knowledge about health and how to overcome disease, and how the NIH investment is a powerful economic engine in addition to an engine of discovery and how possible cuts from sequestration will have far-reaching negative effects on all of these things.

“When NIH funding is cut,” he stressed, “it’s felt not just here in Bethesda, but in every state around the country and even around the world…So who’ll pay the price of this looming across-the-board cut? Ultimately patients and families who are counting on us to find those next promising cures and treatments.”

Mikulski (c) visits NINDS’s Dr. Daniel Reich (r) and NIA’s Dr. Susan Resnick (l) in the Nuclear Medicine Research Facility with NIH director Dr. Francis Collins (second from r). There, she was briefed on the latest advances in neuroimaging and the fight against Alzheimer’s disease. Long-time NIH grantee and 2009 Nobel Prize winner Dr. Carol Greider talks about the harmful effect automatic federal budget cuts will have on the next generation of biomedical scientists.

Mikulski (c) visits NINDS’s Dr. Daniel Reich (r) and NIA’s Dr. Susan Resnick (l) in the Nuclear Medicine Research Facility with NIH director Dr. Francis Collins (second from r). There, she was briefed on the latest advances in neuroimaging and the fight against Alzheimer’s disease.

Long-time NIH grantee and 2009 Nobel Prize winner Dr. Carol Greider talks about the harmful effect automatic federal budget cuts will have on the next generation of biomedical scientists.

Young Research Careers in Jeopardy

Mikulski estimated a potentially disastrous financial impact on 15,000 Marylanders who either work at NIH or benefit from the research funding at other Maryland institutions such as Johns Hopkins University or the University of Maryland.

Backing that claim in person at the event was Nobel laureate Dr. Carol Greider, who offered a view of sequestration from the perspective of an NIH-supported researcher.

Currently chair of molecular biology and genetics at JHU School of Medicine, Greider has been an NIH grantee for the past 23 years. She said the 15 faculty members of her department—“outstanding scientists who have made some of the fundamental discoveries in modern biology”—have also been funded by NIH for more than 20 years.

Arizona resident Felicia Sanchez, who is participating in a research study here, tells her “miracle” recovery story—made possible, she noted, by doctors at NIH

Arizona resident Felicia Sanchez, who is participating in a research study here, tells her “miracle” recovery story—made possible, she noted, by doctors at NIH.

Photos: Ernie Branson

By far the hardest hit by the budget slash, however, will not be the senior scientists, Greider pointed out.

“The bulk of funds in my research branch goes to support young people who work in the lab—young people who I’m training to be the next generation of scientific leaders,” she said. “Now I see the training of these bright young students as truly being in jeopardy if the NIH funding further declines.

“Given that my work on telomeres was really far outside the mainstream research, I’m not sure that in the current climate we have for research funding that I would have received funding to be able to do the work that led to the Nobel Prize…Breakthroughs come from young scientists and this group is in jeopardy today…For the first time in all of the years I have been chair of the department, we have a projected budget deficit…Even before talk of sequestration, things have been hard.”

Collins confirmed that sequestration would mean that “hundreds of grants will not get paid” and training grants will be cut. Every institute and center will take a 5.1 percent cut in its funding.

“This is not a spigot that you turn off and then turn on again blithely. If we lose the talents of this up-and-coming generation with all of their dreams and vision, they’re not coming back…Right now we have a hard time convincing people getting into this field that there’s a career path for them. What biomedical research desperately needs is a stable trajectory. What we’ve had instead has been a rollercoaster of ups and downs, and mostly downs.”

NIAID director Dr. Anthony Fauci (l) and NCI director Dr. Harold Varmus greet Mikulski. Clinical Center director Dr. John Gallin chats with the senior senator from Maryland after her remarks in the CC’s South Lobby. Visibly moved, Mikulski accepts a token of appreciation from Sanchez, who thanked the lawmaker for her strong support of NIH research and patients.

NIAID director Dr. Anthony Fauci (l) and NCI director Dr. Harold Varmus greet Mikulski.

Clinical Center director Dr. John Gallin chats with the senior senator from Maryland after her remarks in the CC’s South Lobby.

Visibly moved, Mikulski accepts a token of appreciation from Sanchez, who thanked the lawmaker for her strong support of NIH research and patients.

Patient Impact, ‘All the Possibilities’ in Peril

It was, however, the story of Felicia Sanchez, a 23-year-old Clinical Center patient from a small town in Arizona, that provided the most vivid visual of NIH’s mission. Sanchez first came to NIH 3 years ago at age 21 after her doctors told her there was nothing more they could do for her severe infection with coccidioidomycosis, or Valley Fever. They could not diagnose the reason she could not clear her disseminated infection, and they forecast probable death from it in months or weeks.

“I thought to myself, ‘What am I supposed to do—just go home and wait to die?’ and my doctors said you go to NIH,” recalled Sanchez, who said she was immediately fascinated by the enormous Clinical Center. “All the possibilities—that is what NIH gave me. NIH gave me medicines and treatments that insurance wouldn’t cover, that hospitals back at home couldn’t give me…Within a month they made me better.”

In the medical board room, Mikulski is welcomed by NHLBI director Dr. Gary Gibbons (l) and ORWH director Dr. Janine Clayton Austin, as Collins looks on.

In the medical board room, Mikulski is welcomed by NHLBI director Dr. Gary Gibbons (l) and ORWH director Dr. Janine Austin Clayton, as Collins looks on.

Sanchez recovered well enough to go home and enjoy her life. Two years later, however, her neurosurgeon in Phoenix gave her another dire prediction. She’d soon be paralyzed from the waist down and probably never be able to walk again—unless she had surgery.

Sanchez recalled his exact words: “He said, ‘It would be a miracle to fix this,’ and the only thing I could think was, ‘I need to go to the NIH.’ So I came to the NIH and I’m walking perfectly without the surgery…I don’t know what I’d do without the doctors and research and scientists here. I wouldn’t be here without them…I would just be a memory to family and friends, a young girl’s life cut short because of the unknown.”

Mikulski Has a Plan

In order to stop the drastic cuts for 2013, lawmakers and President Obama must come up with $85 billion. Mikulski said she has a plan “that if it were passed today, we could all breathe easier tomorrow.” She and several colleagues have developed what she called a “balanced approach” that features 50 percent in revenue (“implementing the ‘Warren Buffett rule,’ which requires millionaires to pay at least the same tax rate as their secretaries; and “plugging loopholes for sending jobs overseas”) and 50 percent in strategic cuts (federal farm subsidies, and “Department of Defense, once troops have returned from the war”).

As reporters asked whether the sequester would offer any flexibility about which specific programs take the greatest funding cuts, Mikulski likened the situation to the Titanic disaster:

“You’re on a ship that’s sinking. Flexibility is like asking which deck do you want to be on—all you can do is be on a different deck, but you’re still heading down. What we need to do is not hit that iceberg.”


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