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The US National Cancer Institute is prioritizing young investigators as it navigates its first funding decline in nearly a decade. 

By Heidi Ledford, 23 September 2024

For the first time in nearly a decade, the US National Cancer Institute (NCI) is grappling with a budget cut — with scant hope for a boost in the coming year.

The NCI’s budget of US$7.2 billion in fiscal year 2024 still secures its position as the world’s largest funder of cancer research. But it leaves the agency $96 million short of the previous year’s figure, largely owing to the end of programmes such as the first Cancer Moonshot Initiative, which were funded separately from the agency’s core budget.

And next year is unlikely to bring a reprieve. Thanks to a two-year agreement in the US Congress to limit the nation’s debt, it’s doubtful that the NCI will see a boost in 2025, says Jon Retzlaff, chief policy officer at the American Association for Cancer Research (AACR) in Philadelphia, Pennsylvania. “We’re likely going to be in this position again next year,” he says. “It’s very tough to go in and convince lawmakers that this is one area they can increase when, if they do that, they’ll have to cut many other programmes dramatically.”

That did not stop the NCI from setting an ambitious target of $11.5 billion for its 2026 budget proposal released on 4 September. But this was the same budget that the agency had proposed in its 2025 request. That’s unusual: institute directors often increase their proposed budget each year. (The NCI is part of the US National Institutes of Health, but submits a separate budget request, sometimes called a bypass budget, each year.)

“It felt like giving an even bigger number really wasn’t wise in this current era,” NCI director Kimryn Rathmell told a panel of NCI advisers during a meeting on 3 September. “We’re trying to signal that we get it. We understand that there is a financial reality, and we understand that there are real economic constraints facing our country.”

Behind the decline

The NCI’s shrinking budget does not mean that the agency has lost bipartisan support from US lawmakers, says Retzlaff. And the decline was not due to cuts to the agency’s base budget, but rather because special, separately funded programmes administered by the NCI have come to an end and were not replaced. These include the initial Cancer Moonshot programme funded by the 21st Century Cures Act, which was signed into law in 2016.

But over the past two decades, the steady growth in the NCI’s coffers has not translated into increased purchasing power, said Weston Ricks, director of NCI’s Office of Budget and Finance at the 3 September meeting. In absolute dollars, the NCI’s base budget rose from $4.6 billion in 2003 to $7.2 billion in 2024. But that increase translates to a 15% loss in purchasing power after factoring in the rate of biomedical inflation, a measure that typically outpaces overall consumer inflation, Ricks said.

Meanwhile, the number of grant applicants to the NCI has increased by 40% in the past decade, compared with 17% at other institutes and centres in the National Institutes of Health.

With all of this in mind, the institute must make some difficult decisions, Rathmell said. The agency will prioritize studies that could lead to new therapies over research intended to improve access to existing therapies. It will also favour research projects initiated by grant applicants, rather than grants that target specific subjects chosen by NCI officials.

And Rathmell pledged to work to hold steady the proportion of grants awarded to young investigators — an approach that the AACR supports, says Retzlaff. “That pipeline is the future of cancer research,” he says. “It needs to be a priority.”

(Sources: Nature)