As you begin work on the fiscal year 2025 Defense Appropriations Act, we write to thank you and encourage you to continue your support for the critical and highly successful Congressionally Directed Medical Research Programs (CDMRP) at the Department of Defense (DoD). While the CDMRP funds research to protect the men and women who serve in our Armed Forces, military families, veterans, and civilian populations from a wide range of medical conditions and health challenges, many of these programs are also directly related to preparedness and response to global pandemics. We therefore encourage you to increase funding for these critical programs by five percent plus inflation (approximately $123 million increase), to ensure that our country is prepared to meet current and future public health-related threats and challenges to our national security. An increase in funding is particularly vital to mitigate the impact of inflation on the purchasing power of individual CDMRP programs, particularly those programs that have been flat funded for several years.
The highly innovative research portfolio supported by the CDMRP fuels scientific discovery by funding high-impact research not sponsored by the National Institutes of Health (NIH), the Department of Veterans Affairs (VA), and other federal agencies. Many of the programs’ award mechanisms propel the exploration of revolutionary ideas and concepts. Programs focus on the potential of having a significant impact upon both their respective fields of research and the health and well-being of the men and women in the U.S. Armed Services. CDMRP awards grants to study many of the conditions – including kidney and pancreatic cancers and melanoma – added by the PACT Act as VA benefit presumptive service-related health conditions.
Defense health research programs are worthy of continued federal support for the following reasons:
- Directly relevant to DoD-prevalent conditions: The medical research programs at DoD directly impact the health and lives of the U.S. military, their families, veterans and the public. Programs provide groundbreaking research on psychological health, Gulf War Illness, respiratory health, burn pits and other toxic exposures, spinal cord injury, and hearing and vision loss, and newer conditions such as Long COVID. Research also focuses on existing and emerging infectious diseases that may threaten operational readiness and health security, and why diseases like ALS, multiple sclerosis and Parkinson’s disease occur at greater rates in those who have served in the military. CDMRP has also funded orthopedic research that has resulted in new limb-sparing techniques to save and restore functions of injured extremities, as well as outcomes research benefiting injured warfighters in need of orthotic and prosthetic devices. Equally important, this disease-specific approach includes important medical research programs related to several forms of cancer (breast, blood, colorectal, bladder, brain tumors, lung, ovarian, prostate, stomach, liver, esophageal, rare and childhood cancers), autoimmune diseases and other disorders (like neurofibromatosis and tuberous sclerosis complex) that have led to breakthroughs on nerve regeneration, traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).
- Complementary – and not duplicative – of other federal research: Defense health research program grants neither duplicate nor supplant NIH or VA research efforts, but rather enhance those efforts. They fund highly innovative projects – support that is typically unavailable through other federal programs. For example, programmatically- related VA research funding is only available to VA employees (at least 0.625 full-time equivalent). CDMRP funds the best-qualified proposals from researchers and research teams at top research universities and medical centers. The NIH and DoD medical research portfolios have symbiotic relationships, allowing NIH-funded basic research to serve as a foundation for ground-breaking, disorder-targeted research at DoD. NIH and DoD program officers meet regularly to ensure collaboration and prevent duplication.
- Cutting-edge and focused on cures: While the NIH funds high-quality basic biomedical research, the defense health research programs provide essential emphasis on and support for finding innovative cures or new therapies for medical conditions. For several disorders, DoD breakthroughs have led to new clinical trials, new drug products, and novel procedures that are making a difference in the everyday lives of affected patients and families. For example, research funded by DoD led to the development of two treatments for tuberous sclerosis complex approved by Food and Drug Administration. The ALS Research Program is supporting translational research and has developed four potential treatments for the disease, for which an effective treatment currently does not exist. Enclosed is a detailed white paper providing many examples of breakthroughs by the various CDMRPs that have benefitted active-duty warfighters, veterans, military families, and civilian populations.
- Agile, adaptable, and collaborative: Each of the separate programs is guided by a specific vision and mission statement, which in addition to incorporating Congressional direction, reflect rapid change in knowledge, address research gaps, and prevent duplication. Annual funding prevents out-year budget commitments, which in turn further enhances programmatic flexibility. Many DoD programs identify, develop and fund collaborative and consortium-based research, helping to bring unique, interdisciplinary, inter-institutional, collaborative efforts to bear on complex medical research issues unlikely to be solved though the inherent limits of individual researchers.
- Competitive and unique peer review process: While Congress allocates funding through the annual Defense Appropriations Act to specific medical conditions, it does not direct the programs’ dollars to specific researchers. These programs utilize an efficient multi-tiered process that includes multiple stages of peer review, including two levels of formal peer review of final proposals. Proposals are scored in a number of key areas such as scientific merit and impact for patients and the military, providing a robust comparative basis for helping accomplish the program’s mission of finding and funding the best research related to these important medical conditions.
- Consumer review: All defense health research programs incorporate the full and equal participation of consumer reviewers at every stage of the multi-tiered review process – a novel and valuable practice in medical research funding. Consumers – people actually affected by the disease or medical condition – help ensure the program’s funded research will have the greatest impact on those who are affected. Consumer reviewers also help inform and educate their disease advocacy communities and others.
- Generating economic growth across the United States: Research activities promote job growth and encourage long-term economic development through innovation. It has been estimated that for every dollar awarded in biomedical research grants, more than $2 of additional business activity is created. Defense health research grants are awarded to universities and institutes in every state in the country.
In short, the well-executed and efficient programs within the defense health research programs demonstrate responsible government stewardship of taxpayer dollars and benefit current and former military service members, the general patient population, and our nation’s economy.
Perhaps most importantly, DoD’s innovative approaches to funding biomedical research have led to several significant breakthroughs and achievements, contributing to national security and the health and welfare of U.S. Armed Forces personnel and their dependents. Continued federal funding will only build on these successes.
Lastly, we encourage timely enactment of the fiscal year 2025 Defense Appropriations Act, to ensure continuity in the defense health research programs. We recognize the continuing challenges you must face to move appropriations bills through the “regular order” process. However, we must continue to maintain continuity in investment in this important research to ensure that our nation is prepared for future pandemics and other public health challenges that threaten our current military populations and their families, as well as veterans and the general civilian population.
Therefore, the undersigned respectfully request your support increasing the appropriation for defense health research programs by five percent plus inflation in the FY 2025 Defense Appropriations Act.
Sincerely,
ALS Association
American Academy of Allergy, Asthma & Immunology
American Academy of Neurology
American Academy of Ophthalmology
American Association for Dental, Oral, and Craniofacial Research
American Brain Tumor Association
American Cancer Society Cancer Action Network
American College of Obstetricians and Gynecologists
American College of Rheumatology
American Epilepsy Society
American Gastroenterological Association
American Society for Gastrointestinal Endoscopy
American Society of Hematology
Amputee Coalition
Aplastic Anemia and MDS International Foundation
Arthritis Foundation
Asbestos Disease Awareness Organization
Asthma and Allergy Foundation of America
Beyond Celiac
Bladder Cancer Advocacy Network (BCAN)
Cancer ABCs
Case Western Reserve University School of Medicine
Celiac Disease Foundation
Child Neurology Foundation
Children's Cardiomyopathy Foundation
Children's Tumor Foundation
Cholangiocarcinoma Foundation
Christopher & Dana Reeve Foundation
Coalition for National Security Research (CNSR)
Coalition to Cure CHD2
Connect Melanoma
CSNK2A1 Foundation
CURE Epilepsy
CureHHT
Debbie's Dream Foundation: Curing Stomach Cancer
debra of America
Defense Health Research Consortium
Dravet Syndrome Foundation
Duke Health
Duke University
Dup15q Alliance
Epilepsies Action Network (EAN)
Epilepsy Alliance America
Epilepsy Foundation
Epilepsy Leadership Council
FD/MAS Alliance
Fight Colorectal Cancer
Glut1 Deficiency Foundation
GO2 for Lung Cancer
Immune Deficiency Foundation
Infectious Diseases Society of America
International Myeloma Foundation
Johns Hopkins University & Medicine
Kidney Cancer Association.
KidneyCAN
Koolen-de Vries Syndrome Foundation
Lennox-Gastaut Syndrome (LGS) Foundation
Living Beyond Breast Cancer
LUNGevity Foundation
Lupus and Allied Diseases Association, Inc.
Lupus Foundation of America
Lupus Research Alliance
Lymphoma Research Foundation
Malan Syndrome Foundation
Melanoma Research Foundation
Michigan State University
My Kool Brother
National Alliance for Eye and Vision Research
National Alliance of State Prostate Cancer Coalitions
National Brain Tumor Society
National Fragile X Foundation
National Organization for Rare Disorders
National Scleroderma Foundation
Neurofibromatosis Network
Neurofibromatosis Northeast
NF Midwest
North American Spinal Cord Injury Consortium
Pandemic Patients
Parent Project Muscular Dystrophy
Pediatric Epilepsy Research Consortium
Penn State University
PKD Foundation
Project 8p Foundation
Prostate Cancer Foundation
Prostate Health Education Network (PHEN)
Pulmonary Fibrosis Foundation
PURA Syndrome Foundation
Rare Epilepsy Network (REN)
Research!America
Ring14 USA
SHEPHERD Foundation
Sjogren's Foundation
Society for Women's Health Research
Society of General Internal Medicine
Society of Gynecologic Oncology
Solve M.E.
St. Baldrick's Foundation
STXBP1 Foundation
SynGAP Research Fund
SYNGAP1 Foundation
Texas A&M University Health Science Center
Texas NF Foundation
The Buoniconti Fund to Cure Paralysis
The Cute Syndrome Foundation
The Fibroid Foundation
The Foundation for Peripheral Neuropathy
The Leukemia & Lymphoma Society
The Miami Project to Cure Paralysis
The Michael J. Fox Foundation for Parkinson's Research
The Prostate Cancer Clinical Trials Consortium (PCCTC)
The Society of Thoracic Surgeons
TSC Alliance
University of Colorado Anschutz Medical Campus
University of Iowa
University of North Carolina System
University of Pittsburgh
University of Rochester
Vasculitis Foundation
Veterans for Common Sense
VHL Alliance
Washington State University
Weill Cornell Medicine
ZERO Prostate Cancer