NIH Funding Flows Slowly to Cancer Centers

Last year, National Cancer Institute (NCI)-designated cancer centers were worried about losing their statusopens in a new tab or window due to numerous delays in the grantmaking process.

More than a year later, leadership at these centers said the situation is more stable — but the funding is coming through much more slowly.

The Dartmouth Cancer Center in New Hampshire, for instance, finally had its comprehensive statusopens in a new tab or window approved and received the first year of funding for its 5-year grant last year, after a long delay.

But the funds for its current second year were delayed more than 7 months, according to the center’s interim director, Konstantin Dragnev, MD.

“The second year, which is the current year, we were supposed to get the notice of award for Dec. 1 funding and we received it maybe in very early July,” he told MedPage Today. “We operated for 7 months with a deficit that we are pretty certain will get covered. But you get nervous as you’re getting into negative balances. So you’re not cutting positions but you’re slowing doing the things you want to do.”

For instance, it’s “very difficult to hire somebody with a deficit,” he said.

Dragnev added that such delays are “all over the country. We are not unique in this.”

Jennifer Pegher, MA, MBA, executive director of the Association of American Cancer Institutes (AACI), which counts numerous NCI-designated comprehensive cancer centers among its membership, agreed that the funding situation has stabilized compared to the year prior.

However, she noted that a May survey of AACI cancer center members showed that delays in NIH awards across the board — not just for comprehensive status — continued through at least the spring.

Among 58 respondents, 86% reported some sort of delay in NIH awards, including 80% that were not provided with a reason for the delay, Pegher told MedPage Today in an email.

“AACI continues to call for robust, predictable funding increases for the NIH and NCI, and transparency regarding funding timelines and dispersal delays for cancer center support grants,” she said.

In late May, NCI Director Anthony Letai, MD, PhD, wrote in a blog postopens in a new tab or window that grant money was flowing, after delays due to the government shutdown and other changes at the agency — including a shift toward more multi-year funding, and a move away from paylines and toward “a more flexible model.”

NCI has not returned a request for comment from MedPage Today as of press time.

Dragnev noted that the shift to multi-year funding hits early-career investigators the hardest. Since it pays more grants in full, there are fewer grants overall, he said.

One symptom has been a huge increase in the number of applicants to those positions — sometimes as high as 600 or 700 applicants, when it used to be 200 or 300, he pointed out.

“It could mean people are nervous,” so they are doing more applications, or “there are fewer positions nationally,” he suggested.

Pegher said the current climate for early-career researchers is “a major concern for AACI cancer centers.”

“The cumulative impacts of an unstable funding environment include lower morale, recruitment challenges, and the very real threat that an entire generation of researchers — and their potential lifesaving discoveries — could be lost as a result,” she said.

Dragnev noted that at the recent clinical research meeting of AACI members, funding was a hot topic of discussion, and that “we are all seeing the same difficulties.”

While there’s an expectation that the current challenges could fade with a new administration, the uncertainty has left its mark on cancer research, and will be felt into the future, he said.

“This showed us there is nothing stable,” Dragnev told MedPage Today. “Over decades, the federal level was something that you can rely on. Now, you see within a month that can change dramatically. So this uncertainty will be a legacy for a long time.”

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