Disease Advocacy and the NIH Budget
Rachel Best (U of M, PSC)
Monday, 3/13/2017, 12:00 pm. ARCHIVED EVENT
Location: 6050 ISR - Thompson
Recent decades have seen a dramatic expansion in social movements, interest groups, and lobbying targeting specific diseases. As disease campaigns multiplied, so have fears that they would skew government spending. Critics worry that diseases compete with each other for research funding, stalling the growth of the NIH budget. These fears assume that disease lobbying is effective and that diseases compete in a zero-sum game; I test these assumptions using quantitative and qualitative data on 61 diseases over 23 years. In fact, disease lobbying was sometimes effective, but primarily during times of budget growth. Instead of a zero-sum competition between diseases, medical research competed with other federal spending priorities, and the search for cures won out over more redistributive and politically controversial programs. Moreover, disease advocacy's effects on the NIH budget went beyond funding increases, creating pressure to judge funding by disease categories and align the budget with mortality data. These findings suggest that the political effects of advocacy are more complex than generally acknowledged.
Rachel Best is an Assistant Professor of Sociology at the University of Michigan. She studies political responses to social problems, focusing on inequalities created by advocacy and culture. Her book manuscript, The Empathy Epidemic: Disease Campaigns in America, argues that when Americans come together to fight social problems, we focus our largest efforts on diseases. Fighting one disease at a time has unintended consequences for health policy.