Questions About ARPA-H Budgetary Oversight Continue

Robert L. Ferris, MD, PhD

Director

Hillman Cancer Center

University of Pittsburgh Medical Center

Pittsburgh, PA

Because of federal budgetary constraints and priorities in Washington, DC, we are entering a time of major risk and negative impact on the National Cancer Institute (NCI) via the flat National Institutes of Health (NIH) budget, which may result in cuts to cancer research funding across the board. At a time when numerous groundbreaking advances are on the cusp of discovery, funding becomes needed for various endeavors such as new target identification, biomarker development, and the clinical translation of new drugs for patients with cancer. Despite past success, progress is at risk. With the declining NCI budget of $8 billion, this represents a relatively modest cost considering the potential return on investment, when compared with the vast $2 trillion federal budget. The new NCI director, Kimryn Rathmell, MD, PhD, along with the leadership, is actively working to maintain funding, budget permitting.

An additional $1 billion or more that could go toward the NIH/NCI system is now funding the Advanced Research Projects Agency for Health (ARPA-H) initiative. Perhaps this initiative could be a hopeful bridge to offset some of the reduced budget of NCI funding. This may be sufficient for translation and validation of biomarkers, or even clinical application in the next decade. However, decisions on how the funding is allocated in the newly created ARPA-H initiative and how investigators are funded, with results monitored and reported, have yet to be determined.

National scientific discovery and biomedical research directly impact the oncology field, given the need for novel therapies and intellectual property. Leaving prioritization and research funding to the pharmaceutical industry can only go so far. Priorities may not always align with the unmet needs of underrepresented groups, nor always result in the best scientific discoveries, as they align more with commercial interests of a company. Biotechnology advances and pharmaceutical translation of preclinical science in the United States has benefited humanity and lessened disease worldwide. Whether the pharmaceutical industry can retain scientific progress is unlikely, given that its primary business does not always prioritize scientific discovery of new targets.

The annual Hill Day is on May 16, 2024, which is organized by the Association of American Cancer Institutes and centers around the United States. We must advocate with our legislators and find alternative methods of support to drive the oncology field forward.