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Together we make the difference in Alzheimer's and related dementias research: NIH's FY 2020 bypass budget and progress report

Dr. Richard Hodes
Richard J. HODES,
Office of the Director (OD)

On Monday, July 30, I presented, on behalf of NIH Director Dr. Francis Collins, the Fiscal Year 2020 NIH Professional Judgment Budget for Alzheimer’s Disease and Related Dementias at the meeting of the HHS Secretary’s Advisory Council on Alzheimer’s Research, Care, and Services. The estimate—commonly referred to as a Bypass Budget—is based on scientific opportunities that NIH could pursue to achieve the research goal of the National Plan to Address Alzheimer’s Disease—to prevent and effectively treat Alzheimer’s disease by 2025. 

NIH estimates we will need a total of $2.393 billion in FY 2020 to keep us moving toward the 2025 goal. In FY 2018, funding for this research was an estimated (enacted) $1.9 billion. This latest Professional Judgment Budget estimates $876.7 million in additional funds needed relative to the FY 2019 President’s budget proposal—comprising $399 million to compensate for proposed reduced funding in FY 2019 and $477.7 million in additional investment. 

Developing infrastructures and partnerships 

This year, we discuss progress in building a national research infrastructure. We have new tools, technologies, and approaches—from supporting the ideas of individual investigators to the collection and analyses of vast amounts of data from populations worldwide. These advances are largely a result of unprecedented partnerships among government, advocacy groups, foundations, thought leaders, and pharma, biotech, and technology companies. 

This report describes our progress to date, new initiatives underway, and the type and cost of additional research in FY 2020 that will help move us toward the goal of effectively treating or preventing Alzheimer’s and related dementias (AD/ADRD) by 2025. Our efforts are broad and far-reaching. We are:

  • Enabling precision medicine research through advances in genomic sciences and deep molecular phenotyping of existing cohorts and the launch of new diverse cohorts
  • Using the open science research model of the Accelerating Medicines Partnership for Alzheimer’s Disease to hasten the discovery of the next generation of therapeutic targets and biomarkers
  • Creating new translational infrastructure programs to enable rapid sharing of data and research models and enhance research rigor and reproducibility
  • Developing emerging therapeutics in academic centers and in the small business community
  • Making advances in disease monitoring, assessment and care, powered by the revolution in mobile technology, which are helping us bring in people living with AD/ADRD, and their caregivers, as direct partners in research

Several efforts focus on “open science,” a participatory approach to research in which progress is accelerated by making research data, methods, and tools available to all qualified investigators. NIA has been taking a leadership role in promoting the broad availability of research data for quite some time. It’s particularly important that we continue to do so at a time when the rise of big data and new analytical approaches help us to better understand human wellness and disease in a person-specific manner. 

We cannot succeed in these efforts unless we engage the public and secure the commitment of people from all walks of life to participate in clinical research. With facilitation by the Alzheimer’s Association, in collaboration with private, academic and industry stakeholders, the broad strategy is to find ways to step up recruitment to clinical studies as a way to accelerate treatments for this devastating disorder. We are looking forward to launching this multi-pronged strategy by the end of the summer.

Expanding funding opportunities 

We’re also looking forward to supporting more AD/ADRD research projects in the months ahead. In the meantime, remember that you can see our current AD/ADRD funding opportunities now. We are seeking innovative, high-quality proposals in a wide range of areas. I’d also like to remind you that we’re posting information on concepts for new FOAs very soon after they’ve been cleared by our National Advisory Council on Aging. While these concepts are not yet FOAs, they do give you an idea of our research priorities. 

We also expanded our existing supplement program to invite existing grants not focused on Alzheimer’s to add an aim on Alzheimer’s to their awards. This year we invited all NIH Institutes to take part in the program. Nearly all of them did and we have received a very robust response to this effort. We hope it turns into new avenues to solve the challenging problem of Alzheimer’s disease and its related dementias.

Expanding the Alzheimer’s research community

With the recent increases in funding, NIH has been monitoring the capacity of the scientific community to offer even more high-quality research proposals to match. As part of this analysis, NIA has found that in FY 2015-2017, more than one-quarter of NIA’s Alzheimer’s and related dementias awardees were either new or early stage investigators and one-third were established investigators who were new to the field of AD/ADRD.

Together, we make the difference

Alzheimer’s disease and related dementias affect millions of people and their families. Advances in science and technology, along with increased financial support, have helped researchers better understand these diseases and identify potential ways to prevent and delay them. Thanks to the renewed commitment from the American public, the dedication of study volunteers and their families, and the relentless work of researchers and clinicians, NIH-supported researchers, and the AD/ADRD community at large, we have identified promising pathways to effective therapies. Together, we can make the difference.

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