Because of concerns about research priorities being set at NIH, Congress requested that a panel from the National Academy of Sciences (NAS) undertake a study of NIH funding patterns. Results of their 1998 study revealed large disparities in NIH spending according to disease category. This led to a recommendation by NAS that NIH should systematically consider data on the prevalence, death rates, and costs of different diseases in setting its research agenda and priorities (New York Times, 1998).
Historically, NIH funding for research on COPD has been extremely small in comparison to other diseases. Note in the table below the huge disparities in spending per death for COPD ($588), the 4th highest killer, versus funds allocated for HIV/AIDS, kidney and liver disease, and diabetes where prevalence rates are much lower and significantly fewer deaths occur each year.
NIH SPENDING PER DEATH (IN DOLLARS) FOR VARIOUS DISEASE CATEGORIES
| HIV/AIDS | Kidney | Liver | Diabetes | Cancers | Heart | Pneumonia/Flu | COPD |
| $43,206 | $13,414 | $6,756 | $4,856 | $4,723 | $1,160 | $750 | $588 |
We have obtained data regarding funding allocations from the NIH for 1999 through 2003 for a sampling of disease categories. Note in the table below the huge disparities in research dollars spent for COPD, the 4th highest killer, versus cancer, heart disease, and stroke, which are the three leading causes of death in the US. Spending levels for other lung diseases are also included so that readers can see the apparent low priority associated with COPD even among other respiratory diseases.
RESEARCH ALLOCATIONS (IN MILLIONS)
| | Cancer | Cardiovascular | Stroke | Lung Cancer | Asthma | Cystic Fibrosis | COPD |
| 1999 | 3,377.30 | 1,327.10 | 186.00 | 163.00 | 140.40 | 71.60 | 33.00 |
| 2000 | 3,856.60 | 1,500.30 | 206.50 | 180.70 | 158.00 | 80.90 | 35.56 |
| 2001 | 4,376.80 | 1,588.20 | 215.10 | 225.60 | 167.30 | 85.50 | 38.05 |
| 2002 | 4,929.80 | 1,477.00 | 64.40 | 259.00* | 144.10 | 47.00 | 40.60 |
| 2003 | 4,448.80 | 1,580.40 | 58.90 | 297.00# | 154.20 | 50.30 | 43.40 |
*projected
# requested
AN AGENDA FOR ACTION. We believe that the continuing rise in death and disability due to COPD in this country is distinct public health emergency. Millions of children under the age of 18 begin smoking every day. Approximately 15%--20% of those who smoke will eventually develop severely disabling COPD, and there are growing concerns about the harmful effects of our environment on lung function.
The National Heart and Lung Education Project (NHLEP) has pointed to the major reduction in heart attack and stroke as one of the greatest public health success stories in this country. This was accomplished by awarding massive research and public education funds to several governmental organizations, including NIH.
Why hasn’t the same thing been planned for COPD, the 4th leading cause of death in this country? If the Congress, the NIH and other agencies will commit to massive increases in research funding related to treatment, early detection, prevention, and education, the war against COPD can be won.
We strongly urge you to use your authority and powers to help bring about increased research funding for COPD and related lung diseases. Your help in this matter is of utmost importance.
