Over the past 10 years, US public investment in health research has been erratic. This recent pattern reverses decades of increasing support, initiated by the conviction and persuasiveness of visionary leaders such as Mary Lasker and Sidney Farber and realized through the continued commitment of legislative champions of biomedical science. Between 1999 and 2003, congressional appropriators doubled the budget of the National Institutes of Health (NIH) from about $15 billion to nearly $30 billion. The nominal budget then remained flat for the next 5 years, until the American Recovery and Reinvestment Act (ARRA) injected another $10 billion over 2 years, 2009-2010, a financial pulse that has since dissipated.
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