Do You Get What You Pay For? Maybe Not.
You will be greatly surprised that I have issues with the new administration. Most are not directly relevant to the blood community, but one certainly is. The Tr*mp administration proposes an 18 percent decrease in the taxpayer-funded budget at the National Institutes of Health (NIH)-a decrease of $5.8 billion. As one who has reviewed many transfusion medicine grant applications for NIH, I can promise you that the best fundamental science being done in our discipline is paid for by NIH. Adding insult to injury, the Fogarty International Center, whose sole purpose is support of international health, is specifically targeted.
One can argue the greatest short-term security threats to the U.S. are from the panoply of emerging and reemerging infections, about which we read daily and obsess over in transfusion medicine. Additional cuts, beyond the NIH budget, are requested from the Department of Health and Human Services' emergency preparedness programs-cuts that span many agencies. Lastly, lifting budget sequestration requirements on the Department of Defense (exclusively) amounts to future cuts to these critical programs of undetermined magnitude.
Without assuming there are political motivations congruent with Tr*mp's denials of settled science and best evidence, what will be the impact of pillaging these programs that have historically enjoyed bipartisan support?
- A squandering of US world leadership in the generation of biomedical knowledge that advances individual and population health here and worldwide;
- A throttling back of the economic engine fueled by biomedical research. Jobs will not be created when new industries that should have been spawned by the fruits of basic research are not born. Global sales of the products and services invented to enhance and extend productive lives will not materialize when basic, ap-plied, and clinical research are underfunded;
- Limitation of training for the next generation of biomedical scientists, both here and internationally;
- Erosion of our preparedness for health emergencies of national and international scope-Ebola, chikungunya, Zika, and pandemic flu should resonate with the blood community and they do not respect international borders.
America First indeed. If I could put my taxes in escrow, withholding them until this plays out, I would do so. I prefer not to go to jail so…. We are lucky (maybe not) that the budget is written by Congress, not the White House. Please look beyond our transfusion medicine silo and your party lines, and call, write, e-mail, text, telegraph, or scream at your representatives and senators. Tell them that voting to cut these kinds of investments in America's and the world's future will cost them your support in two years. For me, this is a litmus test, and I hope for you as well.
Louis Katz, MD; Chief Medical Officer; firstname.lastname@example.org