How the Recession Has Affected Medical Research

Question: How has the recession affected the NIH's funding priorities?

Francis Collins: Having the economy struggling at the level that it is and having rising concerns, understandably so, about the federal deficit has certainly had an impact on funding for biomedical research through the National Institutes of Health.  When you look at the support we’ve had, we are grateful that even in tough economic times there has been a willingness to try to keep up at least with what we were doing before.  But we haven’t gained much in terms of buying power over the last 10 years, we’ve been pretty much flat—even though the dollars being put in medical research have gone up a big, inflation has eroded that.  The one exception was a $10 billion dollar increment as part of the Recovery Act, which needed to be spent in two years and which was invested in ways that I think are truly exciting. But science doesn’t operate on two-year cycles, so now that the Recovery Act money is running out, we are facing what could be very lean times indeed for medical research.  

That forces us to be even more specific about how we set priorities. It forces us to say, we can’t do everything.  It forces us in some instances to close down programs that have been reasonably productive, but compared to what we’d like to do now in terms of new an innovative projects aren’t quite as compelling as if we had unlimited resources.  It makes the job of a science manager a lot tougher, but is the reality of what we are currently living with.

Question:
Does the tight budget make it less likely that unorthodox or creative studies will get funding?

Francis Collins:
I think there’s been a lot of concern that when budgets get tight, the peer review process can tend to be a little more conservative.  And budgets are tight right now.  If you send a grant to the NIH that’s got your best ideas in it, the chances that you’ll get funded is less than 20%.  In some of our institutes, it’s down around 10%. That’s a terrible stress on the system. That means that investigators are having to write and rewrite grants over and over again in order to just keep their labs going.  That means that reviewers who come to look at those grants spend time going into the details of a big pile of exciting applications knowing that probably they’re only going to be able to fund a small number.  

And if you were a reviewer, and you’re looking at a pile of grants and amongst them are some very solid applications from very well-established investigators who have a really amazing track record.  And then there’s another pile of new investigators you haven’t heard of who are just getting into the scientific arena, and don’t have as much preliminary data and haven’t published as much.  There is a tendency, I think, to go with the proven entities and that may mean you are missing out on the innovative stuff from the new investigators.  

To try to counter that, NIH has established a number of programs which can only be applied to if you have a slightly wacky idea.  So those include things like the Pioneer Awards, and the New Innovator Awards, and the Transformative R01 Awards.  All of those have a pretty high bar for innovation and a pretty limited requirement for preliminary data.  And they are some of the most exciting science that we are currently supporting, but it’s a small fraction of the total.  But it is an effort to try to avoid the conservatism that might otherwise become more prominent in times of difficult budget support.

Recorded September 13, 2010
Interviewed by David Hirschman

Having a smaller budget is forcing the NIH to be even more specific about how it sets priorities, and, in some instances, to close down productive programs.

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