We already know that sequestration may harm the nation's economy and trim job growth. But scientists say it could also have an adverse effect on the nation's health in the not-too-distant future.
Sequestration is slated to cut $1.6 billion from the National Institutes of Health's $30 billion budget this year. The cuts will force labs to cut research positions and, as President Barack Obama and NIH Director Francis Collins have warned, potentially hinder U.S. innovation. But those cuts could have lasting health effects, as a slowdown in funding leads to slowdowns in medical advancements.
The frustration is intense within the medical research community, which has been bracing itself for whatever sequestration has in store, even as it has watched Congress rush to keep air traffic controllers and meat inspectors on the job.
"They're looking for short-term fixes to short-term annoyances, but they're not looking out for the health and well-being of the American people," says Laura Reed, assistant professor of biological sciences at the University of Alabama.
The NIH has faced tight budgets for years. In the 1990s and early 2000s, the agency's funding grew strongly, sometimes by over $2 billion per year. But annual appropriations have held at around $30 billion since 2008, and over 80 percent of the NIH's budget goes toward funding research projects. The number of grants funded by the NIH has fallen from around 1-in-3 at the turn of the millennium to 1-in-6 now.
According to the NIH, its research supported 432,000 jobs in 2011, but cuts are already causing doctors and researchers to put a hold on hiring. Reed has recently scaled back her current research, deciding not to hire a graduate assistant. Multiply that out, and there are plenty of people vulnerable to sequestration cuts.
"We will be unable to give out hundreds and hundreds of grants that otherwise would have been funded" because of sequestration cuts, NIH director Francis Collins told reporters in February.
That could also make for lower employment coupled with less reliable science. For her project studying chronic pain, Christine Rini, research associate professor at the University of North Carolina, says that tight funding forced her to cut an entire control group from her research, making her results less conclusive than they otherwise would have been.
Beyond lower employment and less ambitious projects, scientists argue that sequestration could reduce U.S. competitiveness.
"Nothing's going to collapse overnight," says Peter Hotez, president of the Sabin Vaccine Institute and the dean of the National School of Tropical Medicine at Baylor College of Medicine. "I do worry that we're not going to see the effects of these cuts until it's too late, so that a decade from now we're going to say, 'Hey, where are all the young people going into science?'"
Hotez says that if students and researchers are discouraged by their prospects in the U.S., they will take their studies abroad. "You do have people going overseas, so for the first time in my knowledge you're seeing a reverse brain-drain back to China," he says. "I think it does slow down science, and it also means the major innovations — we're going to start seeing more and more of them come from the U.K., from Germany, from places like Singapore and China."
Politicians of both parties agree that sequestration is too blunt, in that it doesn't allow agencies to move the cuts from one area to another. Still, there are those who argue that the NIH is flush with frivolous spending, as it funds the kinds of projects that Congress members like to lambaste as evidence of flagrant waste. For instance, Sen. Tom Coburn's 2012 Waste Book, an annual publication from the Oklahoma Republican, highlighted an NIH study on whether watching TV reruns makes people happier and perceptions of sexual attractiveness among fruit flies..
Yet even if some government-funded studies can be considered wasteful (and, it should be noted, scientists working on such studies defend their work passionately), there is the very real potential that further cuts could delay treatments and cures for deadly diseases like cancer and heart disease.
Reed's work, for example, is on metabolic syndrome in fruit flies. While her study will not lead directly to a cure for obesity, it could lay the groundwork for future treatments for Type 2 diabetes.
"We're going to be in trouble in 10 years," she says. "Especially in emerging diseases like obesity and diabetes … we're just barely beginning to understand it, and if they cut off research of that basic biology, we're going to be left with no new strategies for dealing with it 10 years from now. Meanwhile, it's going to get worse."Still, it's not yet clear what, if anything, can be done to boost funding for science in the face of the sequester. It remains to be seen, for example, whether lawmakers would be willing to dole out more money. Congress helped the FAA keep flights on time, not by giving out more money, but by allowing shifts in funding — to make cuts with a scalpel and not an axe, as many have put it. Likewise, Congress kept meat inspectors from furloughs by shifting Agriculture Department funding.
The NIH says that handing the agency a scalpel would be welcome, but would not go far in easing the budget pain."NIH might be able to use some additional flexibility, but the size of the cut is too large for that to significantly mitigate the damage," says a spokesperson in an email to U.S. News.However, there is bipartisan support of increased medical research funding. President Obama has long been pushing against sequestration cuts to science funding, and Republicans, who are often painted as "anti-science," have shown a willingness to support more spending. Eric Cantor, for example, has proposed increased funding of medical research, albeit at the expense of social science research.
The NIH will soon be releasing more information on how cuts will be distributed. For now, universities are lobbying Congress to save their research projects, before the real pain of the cuts eventually kicks in.
"Our government affairs liaisons are very active in this space," says Barbara Entwisle, vice chancellor for research at UNC. "That's part of our role and their role to be constantly pushing this. We are in touch with our congressional delegation."
Entwisle does not hide her frustration at Capitol Hill for allowing sequestration to occur.
"What I thought the sequester was intended to do was to create pain that would lead to a grand bargain and a budget that would work for the country," she says. "They did the meat inspectors, and then the [air] traffic controllers. That was not my understanding of what the sequester was about."
Sequestration may not have created a grand bargain, but scientists hang onto a small hope that politicians will find a way to keep their projects alive. And if that doesn't happen, at least America's researchers won't have long waits on the tarmac as they seek out opportunities elsewhere.