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Good News Bad News Howard Garrison
and Nina Barthlome |
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It has been only three years since the
doubling of the NIH budget, yet many voices are bemoaning a new funding
crisis. What has happened? Bruce Bistrian, President of the Federation of
American Societies for Experimental Biology (FASEB), borrowing from the
opening lines of Charles Dickens’s classic Tale of Two Cities,
characterized the situation as “the best of times and the worst of times.”
The NIH budget reached $28.7 billion dollars in 2005, a level unimaginable
10 years ago. But individual investigators submitting grant applications
are encountering very low paylines (often under the 15th percentile), and
there is growing concern about the future. Why does there seem to be
trouble when the future looked so bright? And what can we do to change
this situation? What Happened? The good news is that in response to the desire of the American people for longer lives and better health, Congress increased the budget of the NIH from $13.6 billion in 1998 to $27.2 billion in 2003 (Figure 1). This provided an extraordinary increase in research resources, and the funding for R01 grants rose significantly during the same period. R01 funding expanded from $5.7 billion in 1998 to $9.7 billion in 2003 (Figure 2). A large fraction of the increased funding went to boost the size of the R01 grants, which had been held down during the lean years of the early 1990s. The size of the average R01 grant rose from $243.3 thousand in 1998 to $339.1 thousand in 2003, an increase of 39.4% (Figure 3). The number of R01 grants also grew during the same period, but at a lower rate of increase. The increase in funding for biomedical research gave rise to an enthusiastic response from investigators and research institutions. New discoveries pushed back the frontiers of science and inspired scientists to think about new opportunities, as advances in one field gave rise to new possibilities in others. Both investigators and their institutions saw the promise and responded accordingly; research institutions constructed new facilities and laboratories and scientists developed new proposals. These developments, while occurring at an expedited pace, took several years to unfold. While the doubling of the NIH budget took place from 1998 through 2003, the largest increase in the number of R01 applications took place in 2004, the year after the doubling was completed (Figure 4). From a scientific perspective, the lag time between the increase in NIH funding and the flowering of new ideas for additional research was understandable and predictable. What was not foreseeable, however, was that the NIH budget would be effectively frozen after the completion of the doubling. This is the bad news; there was no “soft landing” and no return to the historic rates of growth (approximately 8% per year) that enabled NIH to keep ahead of inflation, maintain on-going research and fund new projects. The rising cost of biomedical research is not a trivial problem, and in times of limited budget growth it severely impacts the funding of new grants. According to the Biomedical Research and Development Price Index (BRDPI), the cost of medical research rose by 3.6% in 2004, by 5.5% in 2005 and is expected to increase by 4.1% in 2006. In the meantime, the NIH budget rose by 3.2%, 2.2% and -0.2% in the same years. Since the end of the budget doubling in 2003, the increase in NIH funding has been insufficient to keep pace with the rising cost of biomedical research. But researchers, spurred on by the potential unleashed by the doubling of the NIH budget, responded to the call for more biomedical research. But the larger number of grant proposals arrived at a time of flat funding. Under these circumstances, success rates (the number of total applications funded divided by the total the number of applications submitted) fell as more proposals competed for resources that were being eroded by rising costs. Success rates for R01 applications, which rose to over 30 percent in the middle of the doubling period, fell well below that level in 2004 and 2005 when applications began to rise and funding remained flat (Figure 5). What Can We Do About It? The key is to return NIH to a level of steady growth, and we must convince our elected leaders that additional funding for medical research must be a national priority. We did it once before, and we can certainly do it again. We face new challenges, however, that we did not encounter in the 1990s. For one thing, we no longer have a budget surplus, and the budget deficit has drawn many supporters of research into the camp of the fiscal conservatives. In addition, increased federal spending on homeland security, disaster relief, and defense has constrained budgets in all other areas. Biomedical research is not the only worthy cause seeking additional resources. Compounding these difficulties is the belief among some in Congress and the Administration that biomedical research has already been “taken care of.” Our success in the 1998 to 2003 period is being used as a rationale for curbing the growth of the NIH. Elected representatives, looking for some reason to say “no” to requests for additional resources, ask for evidence that the funding has benefited the American public and they are demanding proof that more funding is needed. Our case, therefore, needs to be made more effectively. We need to teach a new generation of elected officials about the achievements made possible by our prior investment in research; we must inform them of benefits yet to come. In the face of increased competition for scarce federal resources, scientists need to come out of their clinics and labs and help educate the nation about the value of scientific research. In the 1990s, the leaders of the scientific societies, in collaboration with government affairs professionals, were able to make the case for increased federal research funding. Now, with the increased competition and new obstacles before us, the tactics of the past are insufficient. We need to mobilize the energies and talents of scientists, patients, and other citizens in districts all across the nation. Members of Congress need to hear from their own constituents. As former Speaker of the House, Tip O’Neill, Jr., said, “all politics is local.” Elected officials in every state need to hear that biomedical research has produced dramatic changes in the health and quality of life; and we must let people know that this is just the beginning. Standing on the threshold of even more exciting new discoveries, we must impress upon our elected leadership that our investment in infrastructure and training must not be squandered. To do this, and to do it well, we need your help. With tools like FASEB’s E-Action Alerts and the Washington Update, you can learn about the issues and help raise funding for NIH and other biomedical research. To sign up for the E-Action Alerts go to http://capwiz.com/faseb/mlm/signup/ and for the Washington Update, go to http://lists.faseb.org/mailman/listinfo/faseb_washington_update. APS’s Legislative Action Center (http://www.the-aps.org/pa/action/index.htm) and FASEB’s Legislative Action Center (http://capwiz.com/faseb/home/) have many resources available for writing to Congress and contacting your local media. Also try APS’s Advocacy Resource Kit website (http://www.the-aps.org/pa/action/advocate/advocate.htm) for more information on how you can become involved on federal, state and local levels. For tips and talking points for contacting members of Congress, try APS’s E-Sheet: Your Guide to Meeting with Congress, http://www.the-aps.org/pa/action/congressional_meeting_e.htm, and Communicating with Congress at http://www.the-aps.org/pa/action/communicating_congress.htm. For links to other resources with advice on advocacy use FASEB’s Communicating Science webpage at http://opa.faseb.org/pages/Policy Issues/commscience.htm. To learn more about biomedical and funding issues go to http://opa.faseb.org/pages/Advocacy/ and http://www.the-aps.org/pa/action/indes.htm. Arm yourself with this information and campaign for funding in support of biomedical research. Speak to your friends and neighbors; let them know what is at stake. Together, we can make a difference. |
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| Figure 1: NIH Budget:
FY1995 – 2006.
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