Can the big ship NIH turn at all?

The National Institutes of Health is the major funding agency for biomedical research in the United States. Nevertheless, there are shocking disparities in grant awards for investigators according to race, gender, age, institution, and state. Such unbalanced allocations must be corrected as they do not encourage the varied perspectives, creative ideas and experimental approaches that are needed for a strong research enterprise.

Here are some of the shocking funding disparities:

  1. 11%, 40%, and 50% of NIH research grant dollars go to 1%, 10%, and 19% of NIH funded investigators.
  2. Half of research grant money goes to 2% of funded organizations and 10% of states.
  3. Funding inequality has been rising since 1985, leading to hyper-competition for limited grant money.
  4. From 2003 to 2015 the number of NIH research project grant applicants rose from 60,000 to 90,000. At the same time the number of awardees remained at 27,500.
  5. From 2003 to 2015 the NIH budget lost 22% of its purchasing power as a consequence of budget cuts, sequestration, and inflation.

One way to address the disparities in NIH grant funding would be to cap funding per investigator. It has long been suspected that large, highly funded laboratories are less productive than modestly funded groups. Two recent studies confirm this hypothesis. An examination of the scientific output of investigators (measured by number of publications and citation rates) funded by the National Institute of General Medical Sciences concluded that productivity declines above $300,000 of annual direct costs (see illustration below). The first R01 grant (a popular investigator initiated grant mechanism) yields on average 5 scientific papers, while a third R01 produces about one paper.

A second study examined all NIH funded investigators, and concluded that optimal productivity comes at about $400,000 total costs per investigator per year. The results also show that productivity drops below this number.

Productivity peaks

Marginal return (Y axis) as a function of annual NIH research project grant funding (total costs) per investigator (X axis) based on the maximum RCR (A), median RCR (B) and annual weighted RCR (C). RCR, relative citation ratio. Image credit.

On average, larger groups are less productive, and less effective training environments for new scientists, than smaller groups. For this reason NIH director Francis Collins in 2017 proposed a funding cap per investigator that would have provided money for 1,600 new awards to help early and mid-career investigators. Unfortunately the NIH decided to cancel this plan, in response to an outcry from a few very powerful and well-funded scientists who were threatened by the proposed change.

Wayne Wahls calls upon the NIH to establish a lower limit – $200,000 – and an upper limit – $800,000 – for the amount of research project grant funding per awardee each year. Such a policy would free up sufficient funds to award $400,000 per year to 10,452 investigators who are currently not funded. This change could go some distance towards relieving funding disparities in the US.

There are plenty of qualified applicants for the 10,452 new grant opportunities. Only a quarter of grant applicants are funded each year, and 60,000 grant applicants did not get any NIH research money from 2010-2015. Competition for funding would still be high and only very good investigators would receive these new awards.

Unfortunately, establishing an upper and lower limit for NIH funding per investigator would not solve the problem of having too many people competing for limited research dollars. But it’s not likely that the NIH budget will increase to levels that would fix this problem.

Although I agree that a lower and upper limit of NIH funding per investigator is a good idea, I have little confidence that it will be implemented. I’ve watched the NIH in action for over 35 years and no substantive changes – save for Harold Varmus’ doubling of the budget from 1998 to 2003 – have ever transpired. Big ships turn slowly, but the big ship NIH can’t turn at all.

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