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www.sciencemag.org SCIENCE VOL 296 24 MAY 2002
1401
F
ive years ago, the U.S. Congress
agreed to double the budget of the
National Institutes of Health, setting a
goal to increase the agency’s budget to
$27.3 billion by 2003. This was an extraor-
dinary commitment to accelerate NIH
funding, which over the past four decades
had doubled roughly every 10 years (1).
In October 2000, the authors began to
meet unofficially to consider how the
biomedical research enterprise, and the re-
markable momentum generated in the dou-
bling period, might best be sustained. We
were driven by our conviction that crucial to
maintaining America’s remarkably successful
biomedical research partnership between the
federal government and academia was trust
that the commitments would be sustained.
Balancing the Commitment Base
A central challenge for NIH has always
been balancing current commitments, initi-
ating new projects, and funding new inves-
tigators. More than 50% of NIH funding is
expended in investigator-initiated research
project grants (RPGs). The award of a new
RPG carries a funding commitment that
averages just over 4 years. The recent surge
in appropriations has permitted NIH to
fund record levels of new and total re-
search projects, and thereby to accumulate
a substantial commitment base. Manage-
ment of that base makes the NIH exquisite-
ly vulnerable to static funding levels. This
was vividly illustrated in November 2000,
when Congress considered freezing the
NIH budget. NIH developed contingency
plans that would have resulted in a 40%
decline from the previous year in the num-
ber of competing RPGs (2, 3). Fortunately,
the freeze was not implemented.
Previous disruptions in funding have had
unfortunate consequences. In the late 1980s
and early 1990s, the federal budget deficit, a
recession, and administrative changes within
the NIH caused oscillations in funding. Under
pressure from Congress and others, NIH at-
tempted to maintain the numbers of new
awards artificially by spreading insufficient
funds more widely; the agency routinely cut
requested research budgets by more than
20%. These reductions were arbitrary and
much deeper than those recommended by
peer reviewers and institute councils (4). The
Congress and Administration also increased
disallowances on indirect cost recovery and
placed caps on the recovery of salaries, direct
administrative support, and tuition payments
on training awards. The net effect was to
destabilize established research teams, to cre-
ate uncertainty in young people contemplat-
ing research careers, to stimulate investigators
to slice research projects into smaller grant
proposals, and to shift a larger share of funded
research costs onto awardee institutions.
The current rapid expansion of NIH
programs has stimulated similar concerns
about the years to follow (5), causing one
legislator to ask the acting NIH Director,
“if we come to a ledge and we drop off—
what’s going to happen?” (6).
A Funding Model
The “doubling” budget increases of 14 to
16% annually will not recur in the near
term. We began by negotiating a common
set of principles for prioritizing and allocat-
ing resources. These principles were applied
to a funding model that estimated various
scenarios for budget growth in the 3 years
after doubling. These scenarios included an-
nual growth rates of 4, 6, 8, and 10%, and
assumed an appropriation of $27.3 billion
for NIH in FY 2003. The model tested how
priorities conflicted under each budget sce-
nario. It was not designed to identify a sin-
gle solution, but to determine whether the
principles could be applied to future
funding scenarios in a manner that
permitted the NIH flexibility in meet-
ing its goals.
Principles for Prioritizing
Resources
Preserve the integrity of the merit
and peer-review processes. This re-
quires that an appropriate success
rate for funding relative to approval
be maintained. “Appropriate” is
widely accepted to lie between 30
and 40%. Lower success rates force
reviewers to try to make overly fine
discriminations among proposals, to
divert the energy of applicants to
repetitive proposal writing in an at-
mosphere of growing hopelessness,
and to create a climate of disinclination to
fund innovative proposals (7).
An adequate flow of funds into new
and competing RPGs is needed for peer
review to function, for attracting young
people into research careers, and for NIH
to be responsive to new research ideas.
Accordingly, the model incorporated these
concepts within its parameters: (i) The
RPG success rate should not fall below
30%; (ii) funding should be maintained for
competing RPGs at not less than 14% of
the NIH budget; (iii) fluctuations in grant
levels should be avoided.
Preservation of peer review also re-
quires maintenance of adequate support
for NIH research management and support
(RMS) functions that have substantially
increased in recent years.
Maintain new investigators. Because an
influx of new investigators is essential, the
number of NIH-supported training opportu-
nities should be maintained and supported
at realistic funding levels for stipends, tu-
ition, and benefits. Stipends of first-year
postdoctorate students should be increased
to $45,000 annually, and for predoctoral
trainees to $25,000, in agreement with the
new policy objectives for NIH training
grants (8). Transitional mechanisms like
new career development (“K”) awards for
clinical researchers should be maintained,
and loan repayment programs should be ful-
ly funded. New programs of start-up funding
for senior postdoctoral fellows [like the NCI’s
Temin awards (9)] should be expanded.
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Fiscal year
Budget authority
($ millions)
NIH approp. (Actual)*
30-year historical rate (9%)
Low rate (2.2%)
2.2% rate proposed by OMB
30-year trend line
10,000
15,000
20,000
25,000
30,000
35,000
40,000
NIH appropriations compared with average rate from
1971 to 1998 (9%) and OMB-proposed low rate (2.2%)
postdoubling. At the point of intersection of the curves
in FY 2007, the net effect of the 5-year doubling in-
vestment on the magnitude of the biomedical research
enterprise would be extinguished.
S CIENCE’ S C OMPASS
POLICY FORUM
POLICY FORUM: SCIENCE POLICY
The NIH Budget
in the “Postdoubling” Era
David Korn,* Robert R. Rich, Howard H. Garrison, Sidney H. Golub,
Mary J. C. Hendrix, Stephen J. Heinig, Bettie Sue Masters, Richard J. Turman
D. Korn is senior vice president for Biomedical and
Health Sciences Research, and both he and S. J.
Heinig are at the Association of American Medical
Colleges, Washington, DC 20037, USA. R. R. Rich is
president and H. H. Garrison is director of the Office
of Public Affairs, S. H. Golub is executive director,
M. J. C. Hendrix is past president, and B. S. Masters is
chair of the Science Policy Committee, Federation of
American Societies for Experimental Biology, Bethes-
da, MD 20814, USA. R. J. Turman is director of Federal
Relations, Association of American Universities,
Washington, DC 20005, USA.
*To whom correspondence should be addressed. E-
mail: dkorn@aamc.org
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24 MAY 2002 VOL 296 SCIENCE www.sciencemag.org
1402
Sustain commitments to continuing
awards. Funding stability is essential for
success of multiyear research projects, for
stabilization of research teams, and for
training and career development of new
scientists. Average duration of the RPG
award should not fall below 4 years. Fund-
ing for continuing awards should recognize
that measures of inflation in biomedical re-
search tend to exceed the Consumer Price
Index by approximately 1.5% per year.
The average cost of awards has increased
markedly during the doubling period (up
more than 44% from 1998) (10), largely be-
cause of scientific advances and the intro-
duction of new technologies. Arbitrary re-
ductions in recommended funding of awards
could have even more adverse effects on
NIH research than in earlier years. If reduc-
tions from peer-recommended levels of
funding are necessary, the cuts should not
exceed 3 to 6%.
Preserve the capacity of awardee insti-
tutions. There is already significant cost-
sharing, direct and indirect, on federally
sponsored biomedical research, and the fi-
nancial stresses on academic medical cen-
ters provide little capacity for further cost-
sharing. Congress and NIH must recognize
that reductions in approved budgets will re-
duce the scope of research accomplished.
Recognize new needs of contemporary
biomedical science. Scientific progress is
invariably accompanied by growing com-
plexity and expense. New areas of research
underscore modern biology’s reliance on
sophisticated instrumentation, information
systems, animal models, specialized sup-
port facilities, and large teams of individu-
als with highly specialized skills. Transla-
tion of new basic research advancements to
clinical research and improved patient care
will require that a sophisticated research in-
frastructure, still embryonic, be integrated
into health-care delivery systems. NIH bud-
gets should continue to respond to scientific
opportunity by providing adequate funding
for the National
Center for Re-
search Resources
and other NIH
components that
support major re-
search resources.
Maintain a ro-
bust intramural
NIH research pro-
gram. The NIH in-
tramural program
is the organizing
center of our na-
tion’s biomedical
research enterprise.
The last compre-
hensive review of
this program occurred in 1994 in a different
climate of science and funding policy (11).
The scope and needs of the program would
benefit from reexamination.
Lessons from the Model
Resource allocations can conform to these
principles if overall funding is maintained at
8 to 9% annually, near the historical rate (12).
Annual appropriations increases of less than
6% squeeze competing funding priorities and
force retrogressive choices on NIH leader-
ship. At risk would be new research support,
maintenance of previous commitments, ade-
quacy of support for equipment and shared
resources, shrinkage of training opportuni-
ties, and other deleterious consequences.
To ease the transition to the postdoubling
environment, NIH should continue to in-
crease infrastructure and training support
and should attempt to reduce existing cost-
sharing. Once doubling is finished, the pres-
sure to share costs will increase. Thus, the
level of annual growth for NIH, between 2.1
and 2.3% (13), included in the President’s
Budget for FY 2004–07 is alarming and
worse than any scenario we modeled (see
figure, previous page, and table, this page);
it would create wrenching choices for NIH
and the research community.
New Realities
The Administration has proposed a FY 2003
budget of $27.3 billion for NIH, a 15.8% in-
crease over the current year; if funded, this
will complete the doubling goal. The budget
allocates 53% of the increase to NIAID, pri-
marily to counter bioterrorism, and to NCI.
Most other NIH institutes and centers would
receive budget raises between 8 and 9%,
which means that they would be managing a
postdoubling research portfolio next year.
This is due to dramatic changes in the econo-
my and national priorities.
The first change is the disappearance of
the projected federal budget surplus and the
return to deficit spending. The second, far
more momentous, change occurred with the
terrorist attacks on America. Forthcoming
budgets must properly reflect expanded pri-
orities for military readiness and national se-
curity. The president requested that $1.75
billion of the $27.3 billion requested for
NIH be directed to biological defense, of
which $1.08 billion is dedicated to basic and
applied research. This may well generate
new, broadly applicable innovations, as well
as focus attention on such areas as emerging
infectious diseases, vaccine development,
and restoration of the nation’s public health
infrastructure. It also may inadvertently
“crowd out” spending for research activities
not directly related to biodefense.
Many policy-makers may feel that the fed-
eral government has done its part for NIH-
funded research and that the agency can be
allowed to coast, aside from its bioterrorism
research, at static levels of funding. To the
contrary, we emphasize that levels of growth
below 6 to 8% will negate many of the ad-
vantages achieved by the doubling and will
undo the benefits of this extraordinary and
bold policy decision. They will also severely
strain the relationship of trust between NIH
and its awardees on which our nation’s suc-
cesses in biomedical research rest.
References and Notes
1. NIH Almanac—Appropriations; available at
www.nih.gov/about/almanac/appropriations/index.htm.
2.
NIH Grants News
(Office of Extramural Research,
National Institutes of Health, Bethesda, MD, Novem-
ber 2000); available at http://grants2.nih.gov/
grants/newsarchive_2000.htm#20001120; accessed
8 March 2002.
3. S. Haley,
Washington Fax
, 30 November 2000.
4. Division of Research Grants, NIH,
Extramural Trends:
Fiscal Years 1985–94
(NIH publ. no. 96-3506, Na-
tional Institutes of Health, Bethesda, MD, October
1995).
5. D. Malakoff,
Science
292, 1992 (2001).
6. Hearing transcript, Senate Committee on Appropria-
tions, Subcommitee on Labor, Health and Human
Services, Education, and Related Agencies, 23 May
2001, p. 17
7. Association of American Medical Colleges,
Maximiz-
ing the Investment
(Association of American Medical
Colleges, Washington, DC, 1998).
8. “NIH statement in response to addressing the na-
tion’s changing needs for biomedical and behavioral
scientists,” March 2001; available at http://grants.nih.gov/
training/nas_report/NIHResponse.htm; accessed, 22
March 2002.
9. “The Howard Temin Award,” Program Announcement
PAR-00-66, National Cancer Institute, Bethesda, MD,
22 February 2002; available at http://grants2.nih.gov/
grants/guide/pa-files/PAR-00-066.html.
10.
The FY 2003 President’s Budget for HHS: The Budget
in Brief
(Government Printing Office, Washington,
DC, 2002), p. 44; available at www.hhs.gov/budget/
docbudget.htm.
11. P. A. Marks, G. H. Cassell,
NIH Intramural Research
Program, Report of the External Advisory Committee
of the Director’s Advisory Committee and Imple-
mentation Plan and Progress Report
(National Insti-
tutes of Health, Bethesda, MD, 1994).
12. Annualized rate of growth in NIH appropriations
from 1971 to 1998, not adjusted for inflation.
13.
The President’s Budget, FY 2003
[Office of Manage-
ment and Budget, FY 2003 Analytical Perspectives
(database), February 2002].
14. Supporting Online Material is available at www.
sciencemag.org/cgi/content/full/296/5572/1401/DC1.
NIH FUNDING INDICATORS UNDER TWO MODELED SCENARIOS
NIH growth scenario 8% Model 4% Model
Fiscal year 2004 ’06 2004 ’06
Number of new and competing 10,600 11,100 9,950 9,450
grants
Total number of grants 39,860 44,555 38,775 41,249
Average cost increase for +4.2 +4.2 +2.5 +3.0
noncompeting grants (%)
Research centers, other research (%) +8 +7 +3 +3
Training (%) +5 +5 +3 +3
Increase in total nos. of RPGs (%) +5.7 +5.0 +4.2 +2.1
Success rate (%) 32 32 30 27
NIH funding indicators under two scenarios. A more detailed table is
available (
14
).
S CIENCE’ S C OMPASS
