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13784Liver disease research funding

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  • claudine intexas
    Feb 3, 2004
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      NATAP - www.natap.org

      Liver disease research funding
      News From NIH

      Hepatology
      Volume 39, Issue 2, February 2004

      Jay H. Hoofnagle. Liver Disease Research Branch Division of Digestive
      Diseases and Nutrition National Institute of Diabetes and Digestive
      and Kidney Diseases National Institutes of Health Bethesda, MD

      From Jules Levin: This article was published in the February issue of
      the journal Hepatology, and makes reference to the Action Plan for
      Liver Disease Research. A new committee met about 2 months ago to
      devise the Plan. The Plan is supposed to be submitted to Congress
      soon, and the Plan is supposed to be implemented in 2005. The Plan is
      intended to increase research activities at the NIH in liver disease.
      Of question is where the needed funding will come from to support
      expanded research. We should track progress of this Plan. The
      research initiative does not necessarily directly address care and
      treatment issues for HCV/HIV coinfected patients nor for HCV
      monoinfected patients. Other Important issues are left unaddressed by
      the proposal to increase research such as testing and counseling,
      access to treatment, special support services such as adherence
      programs, and education for patients, service providers, and medical
      providers.

      Article Text

      The National Institutes of Health (NIH) has just completed a period
      of unprecedented growth. Beginning with the base year of 1998,
      supporters in the United States Congress have championed and achieved
      a doubling of the total NIH budget allocation in 5 years. This
      increase followed a period of almost 15 years during which the NIH
      budget grew at a pace that was barely more than the rate of
      biomedical inflation. The doubling required budgetary increases of
      14% to 17% per year and propelled the NIH budget from a total of
      $13.7 billion in 1998 to $27.2 billion in 1993. This increase
      affected all components of the NIH budget, all institutes, and all
      areas of medical research.

      Funding in liver disease research represents approximately 1.4% of
      the total NIH budget and is spread among 16 of its 27 institutes and
      centers. Growth was modest during the mid-1990s, averaging 8% per
      year. During the past 5 years, however, funding in liver disease
      research has more than doubled, rising from $179.9 million in the
      index year of 1998 to an estimated $377.7 million in the recently
      completed fiscal year of 2003, which represents a tripling since 1993
      and more than a doubling since 1998.

      The final budget figures for fiscal year 2003 have not yet been
      completed and await the official coding of grant portfolios by the
      separate institutes and centers that support liver disease-related
      research grants. Analysis of the current portfolio, therefore, is
      based on the grants funded in fiscal year 2002. The 2002 budget of
      $348.5 million funded a total of 1,646 grants, agreements, contracts,
      fellowships, and awards in liver disease research. The largest
      numbers of grants were in viral hepatitis and infectious diseases
      (477), liver cancer (418) and basic cellular and molecular biology of
      the liver (254). Fatty liver disease (alcoholic and nonalcoholic)
      accounted for 128 grants, and drug- and toxicant-induced liver injury
      for 108. Fewer numbers of grants were coded in the specific areas of
      pediatric liver disease (40), genetic liver disease (39), liver
      transplantation (35), complications of chronic liver disease (28),
      autoimmune liver disease (23), gall bladder disease (13), and
      biotechnology and bioengineering (14). These codes, which are being
      used in support of the development of the Action Plan for Liver
      Disease Research
      (http://www.niddk.nih.gov/fund/divisions/ddn/ldrb/ldrb_action_plan.hm),
      are somewhat artificial and represent the major focus of the grants
      or awards, many of which focus on multiple and overlapping areas.
      Thus many of the basic research grants that deal with bile acid
      metabolism or cholestasis could also be coded as gallstone- or
      pediatric liver disease-related. Similarly, grants dealing with
      hepatic fibrosis might also be coded as relating to complications of
      chronic liver disease or viral hepatitis. An important shortcoming of
      the current coding system is that each institute or center is
      responsible for coding its portfolio of grants, and many have
      different definitions for liver-related research and different
      approaches to coding. Thus, studies of iron absorption and metabolism
      may not always be coded as related to the liver and hemochromatosis;
      and studies of neurological injury in Wilson's disease may not be
      coded as liver-related. These shortcomings notwithstanding, the
      analyses of the budget and current portfolio demonstrate the depth
      and breath of liver disease research funding by the NIH.

      In the special area of viral hepatitis and infectious diseases, 279
      of the 477 grants and awards (58%) were related to hepatitis C and 89
      (19%) were related to hepatitis B. While 25 grants (5%) were coded
      primarily as dealing with HIV infection and liver disease, another 44
      grants related to hepatitis B or C had components that included
      studies of HIV-infected patients.

      Thus the period of doubling of the NIH budget has been accompanied by
      a more than doubling of liver disease research funding. For the liver
      disease research community, it is important to respond to this
      increased Federal commitment to liver disease-related research with
      real progress in our understanding of liver diseases and better means
      of their diagnosis, prevention, cure, and control.




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