Yesterday, the Obama Administration announced that it wants to beef up the National Institutes of Health's (NIH's) investment in Alzheimer's disease research with $80 million in new funding in the president's budget proposal for 2013 that will be released next week. While that's not so surprising—there are always new initiatives in the proposed NIH budget, even in tight fiscal times—the Administration is also taking the unusual step of setting aside $50 million for Alzheimer's studies from this year's budget. The decision, which was made at a higher level than NIH, has set off a scramble to figure out where to find the money and how to spend it, according to NIH officials.
The Administration is reacting to the rising toll of Alzheimer's, which now affects as many as 5.1 million Americans and could strike 10 million by 2050, according to a press release yesterday from the U.S. Department of Health and Human Services. "We can't wait to act," the Department of Health and Human Services (HHS) Secretary Kathleen Sebelius said. The new money—on top of $458 million that NIH already expected to spend on the brain disorder this year - also responds to a new law that requires the government to come up with a National Alzheimer's Disease Plan to prevent and effectively treat the disease by 2025.
Congress will decide whether to approve the $80 million for next year, which NIH officials say has not yet been allocated to specific areas, as part of the appropriations process. (The Administration is also requesting $26 million for non-research programs such as supporting caregivers and raising public awareness.)
As for the $50 million from this year's budget, half will go to genomics studies, NIH Director Francis Collins said yesterday. According to Richard Hodes, director of the National Institute on Aging (NIA), so-called genome-wide association studies (GWAS) have found several new genetic risk factors that slightly raise the risk of Alzheimer's. But researchers hope to find rarer variants and explore why, for example, some people who carry the well-known APOE4 risk gene never develop the disease. The plan is to do exome and whole-genome studies using DNA from the same groups of Alzheimer's patients and healthy people that were part of the GWAS studies. Those cohorts give the initiative "a great head start and is why something like that could actually be done this year," Hodes says.
But exactly where the $25 million for genomics will come from "is being actively discussed," said Larry Thompson, spokesperson for the National Human Genome Research Institute (NHGRI). NIH hasn't had much time to plan, he said: "The Department [HHS] and White House said, 'We'd like to do an initiative on this,' and we said, 'OK, we will.' " One possibility is to add the project to the to-do list of NHGRI's $104 million-a-year genome sequencing program, which supports three big sequencing centers as well as smaller ones.
The other $25 million will "largely" fund Alzheimer's grant proposals at NIA and other institutes that scored well in peer review but just missed the funding cutoff, Hodes says. Some of the funding may also be awarded as supplements to existing awards. This plan is similar to how NIH spent much of the $10 billion in 2-year Recovery Act funding that the agency received in 2009 and had a few months to allocate. Hodes says a group of NIH institute directors will advise Collins about which specific proposals to fund.
The set-aside for Alzheimer's will mean less money—and fewer funded proposals—for research in areas other than Alzheimer's, Hodes said. He said that although $50 million out of NIH's $31.0 billion budget "is not very large" (it's 0.16%), at a time of record-low grant success rates, "There will undoubtedly be people who will be concerned."
"This is something that should happen only in the most exceptional of circumstances, and in this case the Administration has determined this urgency of Alzheimer's and its demographics to be such a circumstance," Hodes said. One reassuring point: because the $50 million is for 1 year only, it should not change the institutes' base funding level, he says.