Congressionally Directed Medical Research Programs: Background and Issues for Congress

Since fiscal year (FY) 1992, Congress has appropriated funds to the Department of Defense (DOD) explicitly for use in conducting medical research. This appropriation is also known as the Congressionally Directed Medical Research Programs (CDMRP). The U.S. Army Medical Research and Development Command, in coordination with the Defense Health Agency, administers the program using a competitive grant process. CDMRP funding is to be used only for medical research on congressionally identified medical research topics (e.g., breast cancer, gulf war illness, cancer, or other medical conditions). Both intramural (DOD) and extramural (non-DOD) researchers are eligible to apply for CDMRP funding, as long as applicants meet the requirements and criteria established by CDMRP grant administrators. DOD does not request CDMRP funding as part of its annual Defense Health Program (DHP) budget. Instead, Congress inserts CDMRP funding in the annual DOD appropriations act, typically under the Research, Development, Test, and Evaluation (RDTE) budget activities of the DHP and Department of the Army accounts. The explanatory statement accompanying the annual DOD appropriations act typically provides further congressional direction on how DOD is to spend CDMRP funding. Only Members of Congress may submit such requests for specific medical research topics and funding amounts to be included in CDMRP appropriations. A request is typically of interest to a Member or his/her constituency; requests may also be submitted on behalf of an advocacy organization. In general, the House and Senate use similar processes to solicit, receive, and consider Members annual funding requests for CDMRP. Since its inception, annual congressional appropriations for CDMRP have grown from $25 million in FY1992 to $1.4 billion in FY2020. In recent years, CDMRP funding has accounted for at least half of the DHP RDT and E account. CDMRP has supported over 50 unique research programs or topics.