A look inside the National Cancer Institute budget process: implications for 2007 and beyond.

Despite what may be one of the most difficult times in the long and distinguished history of the NIH, the National Cancer Institute’s (NCI) commitment to its mission of advancing cancer research cannot falter. Federal deficits resulting from a host of unanticipated fiscal pressures in the years since September 11, 2001—the wars in Afghanistan and Iraq, increased investments in national defense, research directed at bioterrorism, hurricane Katrina, and the threat of pandemic flu—have collectively placed significant stress on the resources available for and assigned to support the country’s biomedical research enterprise. In facing these fiscal challenges, the NCI has a unique opportunity to streamline its approach, increase clarity on its long-term goals, and set the stage for biomedical research to flourish in any financial environment. The biggest challenge, and the foremost driver of uncertainty to the biomedical research community, is the discretionary portion of the annual Federal budget appropriation supporting the NIH. The amounts and allocations of those funds have been the topic of discussion at scientific meetings, in the editorial pages of peerreviewed journals, in the national media, and among patient and professional organizations as well as researchers and administrators at academic centers across the country. This attention to stewardship of the budget has permeated the biomedical research community. It is for these reasons that it is important for the entire cancer community to better understand the stresses on the budget and, more specifically, the process the NCI is using to optimally invest in science and to sustain the momentum brought about by the doubling of the NIH budget. The cancer community can only benefit from an open discussion of the factors that influence the budget, and the processes and procedures the NCI has instituted to effectively manage its resources.