J. Evan Sadler, MD, PhD
Throughout my career, funding for biomedical research has been tight at times, but science in the United States has remained vibrant, and these short dry spells have not prevented remarkable advances in basic knowledge and clinical care. Why should the current contraction in federal research support be different?
Maybe it won’t be. In the face of declining funds, NCI, NHLBI, and NIDDK have used a variety of tactics to protect the number of investigator-initiated research grants. The NIH budget doubled between 1999 and 2003. Since then, total NIH appropriations increased from $27.1 billion in 2003 to $30.9 billion in 2011, which in constant dollars represents a decrease of 7 percent. A further decrease of at least 1 percent is expected for the next fiscal year, the first time in 45 years that the NIH budget will decrease in current dollars. To make available funds go further, all noncompeting awards have been cut 1 percent and annual inflationary adjustments limited to 2 percent. NCI has been more aggressive, decreasing noncompeting awards by 3 percent from the previous year, cutting new awards by 17 percent, and decreasing support for cancer centers by 5 percent. Nevertheless, between 2003 and 2010 total research grant funding at these three Institutes — all key for hematology research — decreased 8 percent in constant dollars from $6.4 billion to $5.9 billion, and the number of funded research grants decreased 6 percent from 15,444 to 14,736.
These numbers are disappointing, but a deeper look uncovers trends that could be even more disruptive. For example, the success rate for new R01 applications — the fraction actually funded — is a leading indicator, because new awards comprise only about 10 percent of all R01 grants and several years would be needed to see much change in the total number of funded grants. From 2003 to 2009, the success rate for new R01 applications declined 22 percent (NIDDK), 27 percent (NCI), and 30 percent (NHLBI). Across all three Institutes, the total number of new R01 awards has decreased 18 percent since 2003, a much steeper decline than the 6 percent decrease in the number of all funded research grants. If this trend continues, the total number of R01 grants will eventually fall to the same extent.
The lengthening odds of receiving a new research award hits young scientists particularly hard, and NIH has tried valiantly to keep them in the pipeline. Thanks to adjustments in scoring, newly trained scientists and established investigators have essentially equal success rates for R01 funding. Unfortunately, young scientists do not enjoy some practical advantages of maturity. For the last decade, renewal applications have had about twice the success rate of new R01 applications. This fact is not surprising; good research results make for strong renewal applications. However, scientists can’t submit renewal applications before they win their first awards. In addition, to be eligible for preferential scoring as an “Early-Stage Investigator,” applicants must be within 10 years of completing their terminal research degrees or medical residencies. During the past few years, the average first-time R01 awardee has become older and now is about 42 years of age, by which time many investigators are bumping against the time limit to qualify as “Early Stage.” These pressures significantly reduce the chance of making the transition to independent research support.
Judged by the acquisition of independent research support, it takes more than 40 years to train successful biomedical scientists, but failure to hit that critical funding benchmark can divert them
permanently from basic research. Unless the NIH budget can be stabilized, those of us trying to sustain the career development of young scientists will have to be extraordinarily creative to prevent the loss of this precious human capital, which could disappear almost overnight and require many years to replenish.
What would be the consequences of failure? Several recent analyses have concluded that NIH-funded research has been spectacularly rewarding in terms of return on investment, job creation, and the development of innovative treatments for disease.1,2 Basic research is the engine of discovery. Without it, translational and clinical research run out of raw material and become exercises in futility. Faced with tough budgetary choices, we should not inadvertently cede our leadership in medical discovery, which is the foundation for advances in medical care as well as our biotechnology and pharmaceutical industries. Viewed in this light, cutting support for NIH-funded research would cost far more than the dollars saved. Whether this message survives the current debate on deficit reduction will have lasting implications for the economy and public health in the United States.
- Ehrlich, E. An economic engine. NIH research, employment, and the future of the medical innovation sector. United for Medical Research, 2011.
- Stevens AJ, Jensen JJ, Wyller K, et al. The role of public-sector research in the discovery of drugs and vaccines. N Engl J Med. 2011;364:535-541.
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