The National Cancer Institute's (NCI) funding has increased by 80 percent since 1998, while the budget for the National Institutes of Health (NIH) has doubled. This historic resource growth permitted a re-energizing of the entire biomedical research enterprise in unprecedented ways. The unprecedented growth in biomedical research provides an opportunity for exponential progress. This has allowed the director of NCI to issue a challenge: eliminate the suffering and death due to cancer by 2015. But as NCI continues its operations into fiscal year 2004, it does so without a clear picture of what resources will be available.

Presently, NCI and all of NIH operate under a continuing resolution (CR) that expires January 31, 2004. Congress included appropriations for the Department of Health and Human Services in an omnibus spending bill, which the House approved. The Senate is expected to vote on it January 20, 2004. (See Legislative Update.) If the omnibus bill is not enacted, NCI may work under the CR further into 2004.

The CR provides NCI $4.592 billion, the same level as in 2003. The omnibus bill, if enacted, would include the level requested by the president, which is $4.771 billion, or a 3.9 percent increase of $178 million. However, the bill includes two rescissions that would reduce the $178 million increase to approximately $150 million.

NCI must make challenging funding decisions - some interim - to maintain operations and issue grant and contract awards. In the research project grant arena, the non-competing commitments from prior competing awards necessitate an increase of more than 8 percent, or $113 million. NCI remains committed to fund these increases whether the final budget is at the flat CR or the omnibus bill level. This has a direct affect on our ability to fund competing awards. Therefore, interim grant pay-lines and funding levels for all NCI programs are being developed that will permit it to conduct its business until the picture clarifies.

Future indications are that NIH and NCI may not see the significant growth of the last five years continue. Hence, NCI must intensify its review of program portfolios to identify funds that can be re-deployed and to assure the research community that the discovery engine is maintained and discovery translation continues to move. The pace of scientific discovery in cancer has never been more exciting and, correspondingly, NCI has seen an increase in grant applications. More applications with exciting scientific proposals are coming forward just at a time when large increases to the NCI bottom line are unlikely.

Later this month, NCI will convene a retreat of the members of NCI's National Cancer Advisory Board, the Board of Scientific Counselors and the Board of Scientific Advisors to review various funding scenarios and to discuss future program funding in an effort to determine how best to apply NCI's resources so that the institute may achieve its 2015 goal.