February 8, 2008

President Bush Releases FY09 Budget

President Bush released his proposed Fiscal Year 2009 budget this week. The President's budget release marks the beginning of the annual budget/appropriations cycle and it is the Congress that will ultimately allocate funding levels for all federal health research and services programs.

The Administration's budget provides increases in defense, homeland security and physical science programs, while cutting or flat funding programs of interest to the respiratory community. The proposed budget would freeze funding for the National Institutes of Health (NIH) at the FY08 level of $29,479, with no inflationary adjustment. Some institutes across NIH will receive a small increase, including the National Heart, Lung and Blood Institute (NHLBI), National Institute of Allergy and Infectious Disease (NIAID) and the Fogarty International Center (FIC). The Centers for Disease Control (CDC) would receive a cut of about $475 million, and most CDC programs would receive a cut or flat-level funding, including the domestic tuberculosis (TB) control program.

RESEARCH

Bush Proposes to Cut VA Research Program

The FY09 budget proposes $442 million for VA research, a cut of $38 million (-7.9%) over current year funding. For several years, the Administration has recommended cuts in the VA research budget. Congress has generally ignored the Administration proposal and provided increases for the VA research program. In related news, the President's budget proposals 38.7 billion for VA medical care, an increase of $2 billion (+5.5%) over current year funding. The below chart contains funding inform for key federal respiratory-related programs.

ATS Comments on OHRP Action

This week, the American Thoracic Society joined several sister societies in a letter to Department of Health and Human Services Secretary Michael Leavitt expressing concerns with the Office for Human Research Protection's (OHRP) decision to suspend a critical care quality improvement trial. The letter notes that OHRP's underlying regulations are confusing and do not adequately reflect the changing nature of three different types of activities: a) research, b) quality improvement, and c) research on quality improvement.

The letter recommends OHRP; 1) develop a more specific, less inclusive definition of "human research" that is consistent with the Common Rule, but that does not include quality improvement efforts that pose little or no risk to the patient, 2) need for IRB approval and the need for informed consent should be based on risk to persons and not based on a vague definition of "human research", and 3) recognize that there are projects that meet the definitions of both "human research" and "quality improvement" and these projects should also be evaluated based specifically on the risks to human subjects.

The American Thoracic Society was joined by the American College of Chest Physicians, Society of Critical Care Medicine, American Association of Critical-Care Nurses, and the Society for Hospital Medicine.

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