Last week, NCI leadership held an important retreat with members of the institute's primary advisory panels. This was the 3rd annual NCI Joint Boards Retreat, and together we grappled with how NCI programs can continue their pioneering innovative trajectory, given the current fiscal limitations facing biomedical research.

As the discussion at the retreat illustrated, the ongoing budget constraints will require difficult but creative choices. The retreat also reinforced for me, however, the resolve of staff and the community to take the necessary steps to ensure continued progress against cancer by accelerating the pace of discovery, development, and delivery.

The President recently signed the appropriations bill that provides funding for the Department of Health and Human Services (HHS) for fiscal year 2006. The bill includes $4.842 billion for NCI. However, after a government-wide 1 percent reduction, as well as adjustments made for recisions, assessments, and mandatory increases, NCI starts FY 2006 with fewer dollars than FY 2005, an amount that was already lower than the previous year.

The number of competing Research Project Grants (RPGs) awards for FY 2006 is expected to be approximately the same as last year, with an average cost equal to what it was in FY 2005. That said, paylines and grantee success rates will again decline.

We presented these tough fiscal realities at the retreat, which included the Board of Scientific Advisors, Board of Scientific Counselors, National Cancer Advisory Board, and the chairs of the President's Cancer Panel and the Director's Consumer Liaison Group. Acknowledging that declining budgets are likely for the near future, we sought the participants' guidance on a number of critical questions, and asked for their long-term perspectives on some of the most difficult issues facing NCI and the cancer research community.

We also had the opportunity to model alternative budget scenarios for FY 2007, assessing the inevitable trade-offs that occur at different target levels for RPGs, paylines, and individual program spending. We are being confronted with very difficult choices. So while many excellent initiatives will continue to be supported, others will have to be cut.

As expected, participants offered forthright suggestions for NCI to consider. For example, on the crucial issue of how to mitigate the impact of low RPG paylines, there was consensus on the need to protect and sustain new investigators applying for first-time R01 grants. They urged NCI to continue our practice of setting paylines for first-time grantees at levels above the average R01 grant.

One interesting idea is to require biomedical institutions to provide mentoring components as part of their new investigators' grant applications.

Most importantly, the advisors agreed to aid in a more in-depth analysis of strategies to ensure continued innovation in research, including how to better promote partnerships with industry and other outside groups, support training, and find new mechanisms to measure progress and evaluate programs.

I want to express the institute's deep thanks to these outstanding leaders for taking their valuable time to help ensure that NCI will continue to foster and advance the type of research that will improve and save lives. Because now more than ever, it is imperative that we continue to engage in careful planning, monitoring, and reporting of our efforts. Those relying on us to defeat this disease deserve no less.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute