We’ve seen them this year. We see them every year. The faces of Americans wearing ribbons, bracelets and pins climbing the steps on Capitol Hill on the way to tell Congress they must do more. The scientists testify before committees about the threat of losing the best minds in science to other countries. They state, “We are on the verge of discovering, treating and developing cures for diseases that plague our nation.” Then, with a shake of the head an earnest plea, “The National Institutes of Health needs predictable and sustained funding.”

Earlier this year, the House Labor, Health and Human Services and Education (LHHS) appropriations subcommittee proposed a $1 billion increase to the NIH budget. The Senate LHHS Subcommittee proposed a $2 billion increase to the NIH budget. Moreover, by an overwhelming bipartisan vote, the House approved the 21st Century Cures Act (H.R. 6) proposing the creation of a mandatory funding stream over five years for NIH to support groundbreaking and innovative research initiatives. It is clear there is robust and bipartisan support to provide vital funding for the nation's biomedical research enterprise, but right now those are just promises—a talking point in a congressman’s campaign speech, a whisper of hope for someone seeking a cure for their disease. Congress must deliver on those promises and take the necessary steps in the upcoming months to secure increased funding for NIH.

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Unfortunately the current austerity frame dictated by the Budget Control Act of 2011 makes it essentially impossible to increase funding for the NIH without deep cuts to other public health programs. President Obama and many members of Congress oppose legislation that locks in sequestration this fiscal year. The research community, as part of the larger public health sphere, also fears if deep cuts to other public health programs move forward, we will not have the workforce, drugs or infrastructure to bring the results of our research to light. Thus, absent a budget deal to raise the caps on discretionary spending, there is a real possibility the NIH and other public health programs will receive flat funding for another year, further crippling the biomedical research enterprise. 

There is a way for Congress to support a bipartisan priority like biomedical research. Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderConservative groups aim to sink bipartisan fix to 'surprise' medical bills GOP threatens to weaponize impeachment witnesses amid standoff Trump's trial a major test for McConnell, Schumer MORE (R-Tenn.) and Patty MurrayPatricia (Patty) Lynn MurrayConservative groups aim to sink bipartisan fix to 'surprise' medical bills Democrats request briefing on intel behind Trump's embassy threat claim Democrats ask if US citizens were detained at border checkpoints due to Iranian national origin MORE (D-Wash.) are working now on a legislative package aimed to support innovation to provide healthier lives for Americans. That bill, similar to the 21st Century Cures Act (H.R. 6), could create a temporary mandatory funding stream to support the research conducted at NIH to help bolster support for the institute and centers that make up the NIH. The majority of these institutes and centers, are funded today below pre-sequester, FY12 funding levels resulting in success rates for scientists applying for grants to drop to historic lows and slowing progress towards potential cures and life-saving treatments for diseases.

There may be a simple solution. Create a seven-year mandatory funding stream to support investigator initiated research grants at all 27 institutes and centers at the NIH. The funding would ramp up to allow the scientific enterprise to build capacity but also ramp down to ensure there is no funding cliff at the end of the seven years. The 7-year window carries the NIH through the capped spending environment created by the BCA, and ends with the expiration of the BCA caps. The mandatory funding would disappears when appropriations process can – ideally – finally return to regular order and made investments free of the BCA spending caps. This would allow investments in the NIH to come without the need to cut other vital public health programs. Finally, the fund provides money to the NIH's Common Fund, the existing mechanism within the NIH allowing the NIH director his discretion to fund specific programs without necessitating cuts to other areas of research.

Supplementing regular NIH appropriations with mandatory funding is not a long-term solution. However, until Congress takes action to raise the caps to allow for more sound fiscal decisions to be made, mandatory funding may be the only way for Congress to bridge the gap. It’s time for Congress to deliver on its promises to fund critical biomedical research and improve the health of all Americans.

Corb is the director of public affairs for the American Society for Biochemistry and Molecular Biology and Mullen is the director of government affairs for the American Association for Dental Research.