After a one-year delay, Congress has passed the 21st Century Cures Act, which includes new funding totaling $4.8 billion for the National Institutes of Health (NIH), $500 million for the Food and Drug Administration (FDA) to bring novel drug therapies and medical devices to market more quickly, and $1 billion to fight the growing opioid crisis. The NIH funding includes $1.8 billion for Vice President Joseph Biden’s “Cancer Moonshot,” $1.6 billion for President Obama’s BRAIN initiative, and additional money earmarked for precision medicine. The Cures Act funding is separate from, and in addition to, annual NIH budget increases. It comes on the heals of a $2 billion increase in NIH funding last year, the largest increase in a decade. If the trend continues, it could result in a need for additional research infrastructure in the form of renovations and new construction.
NIH estimates it will be able to support a total of 36,440 research project grants in FY 2017 alone, an increase of 600 above FY 2016, including a total of 9,946 new and competing grants. Approximately 81 percent of NIH resources are dedicated to external funding available to more than 30,000 individuals at over 2,500 universities, medical schools, research facilities, and hospitals.
“This is nothing but good news,” says Mark C. Wells, AIA, assistant dean for facilities and the University of Wisconsin School of Medicine and Public Health. “Any support we have for our research is good news. Pretty much a complete tower of the Wisconsin Institutes for Medical Research is cancer research.”
“We have a very significant and robust drug development program at MD Anderson Cancer Center,” says Jeffrey Ellard, M.S., manager of research facility strategic planning at University of Texas MD Anderson Cancer Center. “If we can tie in with FDA being able to move things forward, all the better.”
Cancer Research Leads Funding
According to NIH documents, “NIH will pursue new cancer vaccine technology, investigate novel diagnostic tests that detect tumors through simple blood tests, and expand access to clinical trial data in an effort to reduce the number of people who develop cancer and improve outcomes for those who do. These funds will also be used to invest in the Vice President’s Exceptional Opportunities in Cancer Research Fund, ensuring that resources are available to pursue investigations, at academic sites or public-private partnerships, worthy of potential breakthrough status.”
Like many institutions MD Anderson has been working to find efficiencies in the way it allocates research space. It has succeeded in freeing up 20 percent more space for program growth, and to date, all of that space has been accounted for—half is already being utilized, and the rest is committed to ongoing recruits.
The Cancer Moonshot originated at MD Anderson before it became a national initiative, says Ellard. Any additional funding for cancer research “has a downstream effect on our facilities,” he says. “More research requires more people and more equipment. That drives how we allocate and utilize space.”
“We are looking now at super-recruits, who are highly funded, very productive, and who bring lots of people and lots of equipment,” he says. “They are bringing 15 to 20 people—post-docs, lab staff, and maybe junior faculty—plus they hire a half-dozen faculty as part of their program.”
MD Anderson encourages its researchers to take advantage of its robust core program, largely funded by substantial NIH cancer center support grant, says Ellard. “We might have to beef up that core, and that is going to require more space.”
Development is also under way on the clinical side. In 2016, University of Chicago Medicine won state approval for a 190-bed cancer center, expected to be completed in three years following a multi-phase gut renovation of an existing facility.
Technically, the cancer center will be a purely clinical facility, but patient treatment informs their research by allowing them to do more clinical trials, says Scott DeBlaze, director of space planning and real estate management at the University of Chicago Medicine and Bioscience Division and the Pritzker School of Medicine. “I would have guessed that we would have called ourselves translational from the beginning.”
“Translational” medicine is becoming more the rule than the exception. “Our vice provost, who is responsible for our space, says ‘everything is translational,’ says MD Anderson’s Ellard. “We do have basic science facilities, but even those are considered translational; the lines have really been blurred.”
Personalized Medicine and Computational Research
Personalized medicine, which is heavily rooted in cancer treatment, is reliant on computational capacity, or “big data.” The University of Chicago, for example, has spent the past several years investing in server farms and infrastructure to handle data its researchers generate.
This summer, Vice President Biden visited one of their data-crunching centers to give a talk. “Cancer tends to be the 100-pound gorilla in the room, and this data is mainly used for cancer research,” says DeBlaze. “His visit is symbolic of the fact that there’s this growth happening here. It was exciting to see him.”
Investments in the past year have focused less on the physical space and more on software to increase capacity. “You can’t really put your hands around it, but there is a level of excitement that I haven’t heard in the past,” says DeBlaze. “We’ve made enormous strides in how they collect and analyze data, the way they can attach that to people and analyze the trends.”
In 2016, University of Chicago Medicine was awarded a five-year, $45 million NIH grant for personalized medicine to be shared with the University of Illinois Chicago, and Northwestern University. The grant is for a longitudinal study similar to the population studies University of Chicago has been conducting, but on a much larger scale, says DeBlaze. “It relates very well to the other types of work we’re doing,” he says.
Wisconsin Institutes for Medical Research (WIMR) at the University of Wisconsin School of Medicine and Public Health is undergoing a $20 million expansion for genomics and personalized medicine. The new space is located adjacent to the cancer research labs and directly above the clinical space.
“Personalized medicine is the future,” says Wells.
Looking to the Future
It is still unclear what the Trump administration’s plans are regarding continued funding for biomedical research, but researchers and the facilities administrators who support them are remaining cautiously optimistic.
“We are in discussions now about our response (to the funding increases),” says Ellard. “We are just beginning to have preliminary discussions for what this means, what new program do we need to think about, what continuing programs can this support. Our response right now is how can we best use our current space.”
MD Anderson has two eight-story research buildings, about 150,000 nsf each, that are slated for decommissioning as part of a long-term capital plan; the goal is to replace them with a more efficient single building. “That’s out at least 10 years,” says Ellard. “Maybe this funding will push that forward.”
“MD Anderson relies on this kind of funding to move the research forward,” says Ellard. “Our president is very optimistic. We’re moving forward with the assumption that this is a great opportunity.”
“The best way to describe it is, if we were in a bathtub, we hit the bottom and are now starting to come up the other side,” says DeBlaze. “We’re not as high as we were prior to the big fall-off, but we feel very good about the fact that we’re coming out of that long stay at the bottom. There’s a light at the end of the tunnel.”
By Lisa Wesel
