When President George W. Bush gives his State of the Union Address on Tuesday evening, he's more likely to talk about the soaring cost of health care than another pending crisis in medicine: the severe budget cuts for biomedical research.

In 2006, the National Institutes of Health (NIH), the country's major funding agency for biomedical research, will face a budget cut for the first time since 1970. Scientists worry that the cuts could devastate research programs, stifle innovation, and discourage the next generation of researchers.

"We're facing a serious crisis that may end up culling some of the very best people out of the biomedical research enterprise," says Jack Feldman, a biologist at the University of California, Los Angeles. "There will be people who lose all funding or have gaps in funding so they can't maintain the infrastructure they've built."

The NIH will get $28.6 billion in fiscal 2006, a $35 million reduction from last year. The government had previously agreed to an increase of $206 million for the year, but that was wiped out with a bill that cut funding for discretionary spending by 1 percent across the board.

Overall, U.S. spending for research and development in fiscal 2006 totals $134.8 billion, a 1.7 percent increase over 2005. However, 97 percent of this increase is earmarked for defense weapons development and human space exploration technologies, according to an analysis by the American Association for the Advancement of Science (AAAS), a nonprofit organization based in Washington, DC. That leaves most agencies with cuts or modest increases falling short of inflation, according to AAAS.

The cuts could be particularly painful for NIH and biomedicine. While the agency's budget doubled between 1998 and 2003, in the last two years, its funding has barely kept up with estimated inflation in the cost of biomedical research. The new budget effectively wipes out the gains since 2003, according to AAAS.

With the new cuts, scientists expect only one in ten grants to win funding, versus about three out of ten at the height of the NIH budget in 2003. Some worry that this crunch will discourage scientists from doing the most innovative kinds of research. "In order to get funded, you will need to write a perfect grant," says Loren Frank, a professor of neuroscience at the University of California, San Francisco. "That means showing everything you propose is likely to work -- and that's what innovative research isn't."

"There were great opportunities unleashed by the doubling of the budget [between 1998 and 2003]," says Bruce Bistrian, president of the Federation of American Societies for Experimental Biology (FASEB), a coalition of research societies based in Bethesda, MD. "When you dramatically withdraw support, it has a disproportionate effect on the young, who don't have the wherewithal to weather the storm."