The 20th century witnessed amazing advances in human health and longevity thanks to public health measures and medical research breakthroughs. Because of the National Institutes of Health (NIH), the United States has led the world in reducing the impact of scores of diseases. The achievements of NIH are burnished by bipartisan political support and the unwavering faith that Americans place in medical science. Fifty percent of the public believes we should be spending more on medical and health research, with an overwhelming eighty percent supporting basic research even if it brings no immediate benefits.

The Task Force for Aging Research Funding, a non-partisan alliance of foundations, disease advocates, patients, and activists, speaks to the public interest by monitoring and encouraging additional scientific breakthroughs. We present this annual report to Congress highlighting both recent advancements in medical research and new health technologies, and the need for increased funding for the National Institutes of Health.

This Task Force issued its first report to Congress in 1988. Since then, we have seen enhanced bipartisan support for medical research in the Congress and in the White House. Beginning in 1998, Republican and Democratic legislators set an audacious goal of doubling the funding for the NIH - from $13.6 billion in 1998 to $27.3 billion in 2003. As a direct result of this infusion of resources within the NIH, scientists have yielded a myriad of scientific achievements, which will further improve the longevity and the quality of lives for millions of Americans. Proof that research pays off is demonstrated by the clinical trial that showed a reduction in stroke of up to 80% among victims of atrial fibrillation, a common heart condition characterized by an irregular heartbeat, after using warfarin or aspirin, and the 60% increase in the five-year survival rate for people with cancer.

Very recent findings now show:

• Early detection of a protein in the blood - known as autoantibodies - may predict Lupus disease years before the disease is manifest, giving physicians and patients a head start on monitoring and reducing the impact of Lupus.
• Older smokers exhibit age-related mental decline five times faster than people who never smoked. Even among former smokers, mental decline occurred nearly twice as fast as in those who never smoked.
• Treatment with cardiovascular drugs called ACE inhibitors may also reduce dry eye syndrome, a common disorder in the elderly that can seriously impact quality of life.

Just as the U.S. is poised to reap the fruits its investment in NIH, continued funding progress has been seriously slowed. The annual budget boost for the current fiscal year dropped to 3%. The White House has recommended only a 2.6% budget enhancement for FY 2005. When higher rates of inflation in biomedical research are taken into the equation, along with significant funding increases for bio-terrorism research that are counted within the NIH budget, federal funding for disease research will actually decline in the coming fiscal year. In the professional judgment of the nation's leading research authorities, an 8-10% increase is needed for the NIH to take advantage of current scientific opportunities and to meet the goals of medicine in the 21st century.

Unpredictable and inconsistent budgeting for the nation's leading medical science enterprise poses a real threat to the future well-being of our people. Alternating boom and bust cycles in funding are highly destructive to good management of any enterprise. Funding stability and consistency is needed for success of multi-year research projects, for stable teams of research scientists, and for training and career development of new researchers.

The aging of the U.S. population provides the most cogent argument for tending to the long-range healthy growth and stability of the medical research enterprise. In 25 years the number of older Americans age 65 and older will double to more than 70 million seniors. The numbers of people age 85 and above will increase four-fold with the graying of the Baby Boom. People aged 100 or more - currently there are 70,000 - will increase 10 times before we are halfway through this century. This demographic tsunami will affect every institution and every community, and will touch all of us personally.

The most dramatic and costly impact of the longevity revolution likely will be felt on the troubled U.S. health care system. According to the Centers for Medicare & Medicaid Services, health care spending is increasing by nearly 10% a year and was $1.6 trillion in 2002. Imagine the cost increases when the leading edge of the Baby Boom moves into Medicare in 6 years if research has not reduced the incidence and impact of age-related diseases and disabilities.

• Cardiovascular diseases (CVD) including heart attack and stroke remain the country's No. 1 killer of men and women, causing nearly 40% of all deaths in the US, at a projected cost of $368 billion in medical expenses and lost productivity for 2004.
• As many as 4.5 million people currently suffer with Alzheimer's disease, a number expected to be as many as 16 million by 2050. Today's costs of care for Alzheimer's victims, upwards of $60,000 a year, will grow exponentially.
• Nearly 19 million adults have been diagnosed with depressive disorders, the leading cause of disability, costing the economy $43.7 billion in treatment and lost productivity.
• Vision impairment so severe as to require assistance in performing activities of daily living is one of the most feared limitations on personal independence. By 2020, an estimated 5.5 million Americans will suffer such visual impairment, with costs exceeding $50 billion a year.
• More than 18% of Americans over age 60 have diabetes with costs an estimated $132 billion - that's about 10% of all health care spending for one disease among older Americans!

A wealth of studies, as well as common sense, hold that reducing the incidence and severity of age-related diseases is a sound and effective strategy for reducing the future burden of disabilities among older people and the attendant great costs to the economy.

The debate over health care financing in Washington, DC, too often focuses narrowly on the cost of health care, rather than the cost of disease. Even modest reductions against diseases and the damage they do can yield impressive savings. For instance, it is estimated that delaying the onset of diseases of aging can reduce years of costly dependence on medical and long term care facilities. Thus, if current research efforts could postpone by just five years the onset of Alzheimer's disease, to name just one threat to the elderly, the nation would realize an annual savings of more than $50 billion! If declining capacities of Medicare beneficiaries to live independently could be stabilized over the course of a single calendar year, by targeting loss of mobility, memory, continence and sensory abilities, more than $27 billion additional monies could be saved.

But to delay symptoms of Alzheimer's and other age-related ailments will require new insights from the laboratory, and accelerated development of new therapies from clinical trials. Past investments in research have produced the healthiest, least disabled generation of older persons ever. More research leads to additional medical discoveries, new pharmaceutical products, and innovative assistive devices and technologies for better overall health and independence. Past advances from research have lowered the costs of illness by reducing the incidence or eradicating diseases, shortening hospital stays and diminishing the invasiveness of surgery.

Congress must now uphold the promise of medical research by restoring upwards momentum to the budgets of the National Institutes of Health and other health research agencies. In this report for 2004, the Task Force for Aging Research Funding details the costs and the cost-savings potential of health research in 26 categories, alphabetically arranged from "Aging and the Environment" to "Women's Health." The member organizations of this Task Force are ready and eager to work with and educate policymakers and staff on their opportunity this year to win appropriately higher levels of funding for medical research on behalf of a growing constituency for healthy aging in America.