The 2011 Budget Control Act requires most US federal military and civilian spending to be reduced by 8% to 10% in January 2013 (“sequestration”) and will increase personal and corporate tax rates and revenues substantially. By creating draconian penalties, the act was intended to prod Congress to reduce the federal deficit. Unless Congress alters the bill, spending reductions will affect many areas of medicine, particularly medical research.
The National Institutes of Health (NIH) budget would be reduced by $2.5 billion, or about 8.2%.1 Given that three-fourths of the NIH budget is committed to previously awarded grants, sequestration could affect predominantly new applications and young researchers. These budget reductions at the NIH and at other research agencies, such as $0.5 billion at the Centers for Disease Control and Prevention and $0.6 billion at the National Science Foundation (Table), will exacerbate tensions between large infrastructure projects (such as those that maintain public databases in genomics, clinical trials, and bioinformatics) and small investigator-initiated grants, which historically have been the primary source of new clinical insights.