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Trump’s proposed budget is out. Among all the cuts – because you have to cut in order to increase defense spending while simultaneously giving the rich a tax cut – among all these cuts is one that people with ME should take very personally. NIH’s budget will be cut by 18% or $6 billion in fiscal year 2018, if Trump’s budgets passes as is. The proposed budget also calls for a reorganization of NIH’s Institutes, but offers little detail.

This is nothing short of disastrous. NIH is the largest source of biomedical research in the world. NIH scientists discovered the bacteria that causes Lyme disease. They demonstrated the effectiveness of the first drugs used to treat AIDS. The biomedical research enterprise in the United States is built on NIH as its foundation. Cutting that foundation by 18% will be catastrophic for human health.

In addition, more than 80% of NIH’s budget goes out the door to fund academic biomedical research, largely in the United States. How will researchers do their research? I guess they’ll have to do 18% less of it. But it won’t just affect those researchers’ salaries paid by their grants, or the purchase of equipment (I wonder what will happen to the businesses that supply that equipment?), or the training of doctoral and post doctoral students. It will affect American universities, research hospitals, and other research institutions.

The university system is dependent on indirect costs tacked on to grants. Indirect costs are a percentage added to a grant by the university. It covers the costs associated with university infrastructure, like buildings and administration and libraries. If NIH’s budget is cut by 18%, then NIH will fund substantially less academic research. And if substantially less academic research is being funded, then American universities are stuck holding the bag. Because universities will still have buildings and staff and libraries, but a big chunk of that cost will not be covered by the indirect costs normally charged to grants. Trump’s budget may cut taxes for the rich, but it’s one hell of a tax on our universities.

If the negative impacts of such a dramatic cut to NIH are that easy to identify, why is Trump proposing to do it? Apart from Trump’s desire to increase defense spending while cutting taxes, the Administration’s director of the White House Office of Management and Budget offered this explanation: “We think there’s been mission creep” at the NIH, he said. “We think they do things that are outside their core functions.”

Ok, but so what, right? After all, it’s not like NIH spends a whole lot on ME. Just $7.6 million in 2016. So who cares if NIH has a funding cut, right?

Are you prepared for an 18% reduction in ME spending?

I’m not. For one thing, the first year of funding for the new Collaborative Research Centers is set aside in this year’s budget. But all bets are off going forward. Like many other RFAs, the one for ME Centers explicitly states, “Future year amounts will depend on annual appropriations.” So it is possible that future years of funding could be cut or eliminated.

It’s common sense to conclude that if NIH’s budget is cut by 18% next year, every program and RFA and grant pool will be severely cut. NIH will make far fewer grants, and that will hit everybody hard.

But that could even be a best case scenario. After all, if I’m NIH and my choice is between an HIV/AIDS study and an ME study, there are a lot of reasons why I’m going pick HIV. Biodefense? Flu? Alzheimer’s Disease? Epilepsy? Spinal cord injury? Osteoporosis?

We’re not winning out against those diseases now. Do you really think that NIH will say, well, we should spread that 18% cut around evenly across the board. Do you expect that this cut will be applied fairly? Is any university going to support a faculty member who wants to apply for an ME grant instead of . . . basically any other disease?

ME research is stigmatized now. ME research is on a starvation diet now. What happens in any system when resources become more scarce? The weakest members of the system lose. And they lose hard.

Whatever your political views or affiliations, whatever you think of the current Administration, if you want to protect research funding then you have to make your voice heard. Call your Representative today. Make sure he/she knows that you support NIH funding and ask him/her to do the same.