A Love Letter to the NIH

The National Institutes of Health is a National treasure

“We cannot be a strong nation unless we are a healthy nation. And so, we must recruit not only men and materials, but also knowledge and science in the service of national strength.”

-President Franklin Delano Roosevelt, 1940, at the opening of the National Institutes of Health.

In President Roosevelt’s address for the opening of the National Institutes of Health, which you can watch here, FDR spoke of the service to humanity that we can provide through groundbreaking medical science. He shared that as we invest in defense, we must also invest in health. FDR shared his vision “to do infinitely more” for the health of all people with “no distinctions of race, of creed, or of color.”

NIH shared this address on the occasion of its 80th anniversary in 2020. During a recent visit to the NIH campus in Bethesda, Maryland, outside of DC, our hosts, Drs. Armstrong and Gilbert from the Neuro Oncology Branch, walked us by the first building to open at NIH. The same building that is featured in Roosevelt’s 1940 address. That building is now called, appropriately, “Building 1.” The history and near-century-long dedication to improving people’s lives through science are palpable on the NIH campus. The NIH, and note, Institutes, plural, include 27 separate institutes, each leading ground-breaking research in their fields. NIH has advanced science in untold ways.

More than its outcome, the NIH is a beacon of America’s leadership in the biomedical sector. Doctors and researchers from around the world apply to work on projects at the NIH, and the NIH has helped to scale population health around the world by preparing global researchers to take the lessons home from NIH to advance science in their countries of origin.

The NIH runs some of the most advanced and experimental clinical trials on the planet, and NIH shows up when the private sector simply won’t. Take brain cancer as an example. I know this well because I’ve been traveling to DC and advocating for increased medical research funding through the National Institutes of Health and National Cancer Institute since 2017. The National Cancer Institute, or NCI, is one of the Institutes under the NIH umbrella. American history trivia: President Richard Nixon helped shape the NCI into its present form with his legislation, the 1971 Cancer Act.

For treatment-resistant diseases like brain cancer, it can be challenging to fund research and trials in the private sector because the chances for developing a drug candidate that provides a durable treatment effect, achieves FDA approval, and makes it to market are slim, and the process is long, often met with experimental failures. In other words, brain cancer research is high risk, high reward, and it’s not many companies who want to take the risk.

I don’t want to make it sound too dire. Indeed, nonprofit advocacy groups, philanthropic foundations, academia, and venture capital often partner to fund research and clinical trials, but private sector funding falls much shorter than for other more manageable diseases. The NIH provides funding for these recalcitrant diseases, like brain cancer, that prioritizes health over shareholder value.

But don’t take the NIH as a federal, Washington, DC thing. The NIH has intramural and extramural funding mechanisms. Intramural funding stays at the Bethesda campus, and extramural funding goes out to states for research grants. Want to guess what the split is? More than 80% of NIH dollars are extramural, meaning that while these are federal dollars, they fund researchers, labs, and institutions across the US, contributing to employment and economic development in states. For example, in my home state of Indiana, during the federal fiscal year 2023, Indiana University School of Medicine investigators received over $243 million in National Institutes of Health research funding.

Innovative research and economic development projects like the Indiana Biosciences Research Institute (IBRI) are made possible, in part, becuase of the talent and research made possible in Indiana through NIH grants.

To put the NIH budget in perspective, the US Defense budget is on the order of $800 billion. Billion with a B. The NIH? Their budget is around $50 billion. Feel free to read that sentence again: $800 billion for defense; $50 billion for health. That’s quite the difference.

Making the economic case for continuing groundbreaking medical research is not difficult. Everything from lost productivity for people who become disabled by their conditions and can no longer work, to the cost of disability paid through the Social Security Administration, and impacts to military readiness, health is a social phenomenon.

I’ve met with dozens of members of Congress over the past eight or nine years, and I’ve developed strong partnerships across the aisle. I tell people often, “Brain tumors have no party.” People from different political parties, including Senator John McCain, Senator Ted Kennedy, and President Biden’s son, Major Beau Biden, have died from brain cancer. And while we’re on the topic, I’ve shared the stage at brain cancer awareness events with speakers as politically diverse as Senator Ed Markey and Senator Lindsey Graham.

In this spirit of nonpartisan pursuit of health, I am deeply concerned about President Trump’s indefinite suspension of NIH activities.

We live in an overwhelming media environment of sensationalism, click-bait headlines, and outrage-drive ratings. I want to tell you from an everyday American with a wife and three kids, living a normal, middle-class life in the Midwest who was diagnosed with brain cancer out of nowhere as an otherwise healthy 34-year-old that my community does not merely benefit from NIH research, it’s the largest funder of research on the planet to support our community. Many of our patients are treated at NIH because of their innovative research and clinical care.

President Trump, brain tumors have no political party, and as President Roosevelt said 85 years ago, “We cannot be a strong nation unless we are a healthy nation.” I ask that you reconsider the suspension of activities at the NIH.