While the use of complementary and alternative therapies has increased dramatically in the United States in the past few years, the amount of research into those therapies has not kept up the same pace. The first major response to the need for more research by the federal government occurred in 1992, when Congress established the Office of Alternative Medicine (OAM). A division of the National Institutes of Health, OAM was designed with three goals in mind: establishing an emphasis of rigorous scientific testing of CAM treatments; developing an infrastructure to coordinate and conduct research; and establishing a clearinghouse to deliver information to the public.
Since the OAM's inception, the amount of funding into complementary and alternative medicine has risen significantly each year. In its first year, it was appropriated just $2 million for CAM research, but that number grew steadily, reaching approximately $50 million in 1999 and nearly $70 million in 2000.
The OAM also received a major jump in status in 1998 when it was renamed the National Center for Complementary and Alternative Medicine (NCCAM). Under its new moniker, the NCCAM was given greater autonomy in deciding which research projects to pursue, as well as the ability to offer grants, hire and fire staff, and determine which types of health care providers could serve on advisory panels.
With the passage of House Resolution 4577 in December, the NCCAM's budget has been raised yet again. Funding for the Center for fiscal year 2001 has been expanded to $89.2 million - an increase of over $20 million compared to the previous year, and more than twice the amount originally requested by the Clinton administration.
Also known as the Consolidated Appropriations Act, HR 4577 was originally introduced brought to the House by Representative John Porter (R-IL), a senior member of the House Appropriations Committee, last June. The bill incorporates the provisions of several other resolutions, including funding for medical savings account plans, treasury appropriations and venture capital programs.
For complementary and alternative care providers, the most important provision of the Consolidated Appropriations Act comes from House Resolution 5656, which pertains to appropriations for the Departments of Labor, Education, and Health and Human Services. In the original version of the bill, legislators had asked for a modest budget increase of $9.8 million to a total of $78.8 million. Under text included from HR 5656 as part of the revised appropriations bill, however, the budget was increased significantly:
"Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, that the following sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2001, and for other purposes, namely:
National Center for Complementary and Alternative Medicine
For carrying out section 301 and title IV of the Public Health Service Act with respect to complementary and alternative medicine, $89,211,000."
In an accompanying report, members of the House Appropriations Committee detailed the NCCAM's mission and urged the center to "give priority consideration to funding post-graduate fellowships that train physicians in integrative medicine; that support research on strategies for implementing the teaching of integrative medicine in education curricula; and that support efforts to design medical school curricula on integrative medicine."
While the money being used for complementary and alternative medicine research in the U.S. is still quite moderate compared to money spent on other conditions and treatments (the National Cancer Institute's 2001 budget, for instance, is more than $3.75 billion), this year's funding still represents a nearly 45-fold increase in federal spending for CAM research in less than a decade. It also shows that the nation's legislators and policymakers are finally beginning to grasp the power of complementary and alternative medicine and its influence on how health care is delivered in the U.S.
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