UCSD neurosurgeon rallies broad national support in fight to save research funding

SAN DIEGO — Forty-five professional associations and societies representing a broad range of medical specialties from anesthesiology to urology are backing a letter written by a UC San Diego neurosurgeon. The letter calls for the National Institutes of Health to rescind a controversial cap on indirect cost payments that significantly increase the value of federal research grants.

While the letter states that planned cuts carry “unintended consequences that threaten the sustainability of US biomedical research,” putting the nation at a competitive disadvantage to the efforts of other nations, especially China, the letter invites collaboration “to advance solutions that ensure transparency, fairness, and our continued excellence on the global stage.” The American Medical Association is the biggest name among the 45 organizations that signed the letter, with others such as the American Academy of Emergency Medicine and the American Psychiatric Association also in the mix.

The letter follows a less-detailed, single-page request on Feb. 25 by an even broader group of U.S. organizations and individuals calling for Congress to back off on the current NIH funding attacks.

Concern follows guidance published on Feb. 7 by the NIH Office of the Director to more than 300,000 researchers at more than 2,500 universities, notifying them that all new and existing grants would include a 15% cap on indirect payments. These reimbursements defray ancillary expenses for shared buildings, equipment and other physical improvements and for administrative activities such as project accounting and personnel management.

These reimbursements add nearly 30%, on average, to NIH grant awards, but many research organizations have negotiated significantly larger levies. The negotiated rate at UCSD, according to the university’s website, is 59% for on-campus sponsored research and 26% for work performed off-campus.

All told, UC San Diego receives more than $100 million per year in indirect cost reimbursements, and every research university in the nation is working to determine what they will need to cut if the cap takes effect. Though the change was to begin immediately, lawsuits stopped the change before it could be implemented. On Wednesday, a federal judge extended an initial restraining order, according to the Associated Press.

With further action stalled for the moment, there is time for researchers to explain — to decision-makers and the public — why these extra reimbursements are critical for research rather than just overhead that should be reduced significantly.

Dr. Alexander Khalessi, chair of neurosurgery at UCSD, also chairs the Washington committee of two different professional organizations in his specialty, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

His seven-page letter, including 38 footnotes, was written on behalf of those two organizations. It makes the case that reimbursements for indirect costs are a critical part of the nation’s world-leading biomedical research efforts. These funds help pay for shared resources from laboratories inside university buildings to the salaries and benefits of workers who administer clinical trials, filing the endless paperwork required by government oversight programs.

In an interview Thursday, he referenced a real-world example.

“In our department, we collect tumor tissue from every case we operate on,” he said. “We know how destination labs will ultimately use that tissue, but our tissue bank is used as a shared asset when labs apply for follow-on grants.

“Indirect cost reimbursements are what actually allow us to develop these kinds of assets.”

And having shared assets such as tissue banks available in a university environment, he added, has a spillover effect, providing foundational resources for young scientists, especially postdoctoral researchers, as they explore innovative ideas of their own while simultaneously helping more-established investigators pursue grant-funded investigations.

“If the goal is to shift to individual project awards alone and reduce the absolute investment, then it actually eliminates our ecosystem’s ability to be tolerant of risk, because you’re going to be living award to award in a way that dramatically contracts your time horizon,” Khalessi said.

Some, he noted, believe that private industry, which often relies on public-funded basic research to underpin private invention that results in billion-dollar drugs, can and should take up the slack. However, the neurosurgeon says that research universities, because of their significant taxpayer support, provide infrastructure for basic research before it is clear that ideas will produce products.

“Sometimes the questions we need to ask aren’t specifically tied to a commercial product or a specific disease or use case,” Khalessi said.

Khalessi said he was surprised that such a constellation of professional organizations signed on to his letter in the roughly three weeks that have passed since the NIH memo announced the incidental funding cap. These organizations, he noted, generally had to get approval from their boards before they could offer their support.

“I didn’t think that, in such a compressed timeline, such a large group of stakeholders would come together,” Khalessi said. “I think it’s an example of the system working and it shows, in my mind, the sort of broad impact that stable NIH funding is felt to have.”