NIH budget woes: Spin versus reality

As I mentioned before, I was at the American Association for Cancer Research Meeting in Los Angeles last week. During the meeting, I happened to attend a plenary session talk by the Director of the National Cancer Institute (NCI), Dr. John Niederhuber, whose topic was the rather dire NCI funding situation. I’ve written about this topic before, both in general, in terms of my personal experience “sweating to the NIH paylines,” to lamenting at how we as biomedical researchers are in essence treated as freelance money sources for medical schools. Coupling Dr. Niederhuber’s talk at the meeting with a detailed discussion of NIH budget woes that was published in the most recent Science, it seemed like an opportune time to revisit the topic, mainly because there is a definite disconnect between the seriousness of the picture painted by Dr. Niederhuber and that painted by the Science article. The problem is, the disconnect is between bad and horrible.

As much as I’ve admired his work as an academic surgeon since his days at the University of Michigan, I’ll start out by pointing out that I got the definite impression from some of Dr. Niederhuber’s remarks that he is a bit out of touch. One remark in particular disturbed me: “I remember from my own career those downturns in the NIH funding meant perhaps that I didn’t have as many technicians in the lab, that maybe we were down a postdoc or two during those hard times. I know that you are experiencing that this time.”

Uh, no, Dr. Niederhuber. Big-time investigators like you, who happen to have multiple R01 grants and thus could afford to hire multiple postdocs and multiple technicians, might feel such a mild pinch. Most investigators do not run labs that are machines with multiple employees, as Dr. Niederhuber’s was before he became NCI Director. Personally, I have only one postdoc in my lab at the moment. When my technician left a few months ago, I was forced to make a tactical decision not to replace him for at least a few months because salaries had been growing the 4% a year mandated by the university as each year my grant was cut between 2%-3%. Indeed, prior to that I had projected that, if trends had continued, by year four of my grant salaries would take up 100% of my budget, leaving me zero money to buy supplies. By the end of this year, I would have either had to dip into my dwindling startup funds or let someone go.

I dodged a bullet there–for now. I could also mention that my original budget had been cut 23% when the original grant was awarded, but investigators who are fortunate enough now to obtain funding even in this tight environment are finding their budgets cut across the board over 30%. This has the perverse effect of charging the investigators obtaining the funding to do all the work proposed in the grant proposal but not providing sufficient funding for them to accomplish the work. This was the lament that I heard from new investigators at the NIH New Investigator Orientation that I attended when I first got my grant. The situation can only be worse now than it was two years ago. Dr. Niederhuber may think that he understands the pain of young researchers now, but in reality his suffering during prior NIH downturns does not impress this young investigator.

Be that as it may, Dr. Niederhuber did start out discussing the impact of what is essentially a flat NIH budget and a slightly declining NCI budget. As some of you may know, there was a near doubling of the NIH budget between fiscal years 1998 and 2003, ending in 2004. From 2004 to 2008, however, the budget has been, in essence, flat. A flat budget means in essence that the NCI has lost approximately 12% in real purchasing power from 2004 to 2007. He also appropriately pointed out, as I mentioned before, that the doubling of the NIH budget produced a frenzy of building of new laboratory space in universities and medical schools, some $15-16 billion worth. In the meantime, the number of NIH applications per year increased from 3,000 to nearly 7,000 per year. Thus, even as the NIH budget was doubling, the seeds of our current “hard landing” were planted. As the Science article points out:

Still, with a budget totaling $29.2 billion in 2007, NIH is hardly a pauper. What brought biomedical research to this place of financial anxiety? The doubling flooded NIH with billions more dollars over a relatively brief time. Whereas a private corporation might conserve some of this windfall, by law NIH must spend nearly all the money it receives the year it receives it. That provoked a massive expansion in biomedical research, and expectations of federal support surged to a level that could not be sustained when the budget stopped growing. The crash is hitting labs, careers, and the psyches of scientists with a vengeance.

[…]

Nine years ago, Congress set out to double the NIH budget and within 5 years sent it soaring from $13.7 billion to $27.1 billion. But everyone knew the golden days would not last. In October 2000, eight senior scientists and policymakers began meeting informally to discuss how to maintain the momentum. In 2002, the group published a commentary in Science presenting different budget models and their impacts on research priorities (Science, 24 May 2002, p. 1401). Its most pessimistic prediction modeled annual increases of 4%. Says David Korn, a former Stanford University dean now at the Association of American Medical Colleges (AAMC) in Washington, D.C., who helped bring the group together: “We didn’t model increases below 4% a year because the tradeoffs and the sacrifices that would have been caused … were too difficult for us to deal with in the model.”

The result, as chronicled in both Dr. Niederhuber’s talk is plunging success rates for NIH grants, particularly for first time grants, from 33% to 19% (according to the Niederhuber talk). But in reality, that overall number is deceiving, because it counts all applications. Any given grant application can be resubmitted twice after rejection, for a total of three submittions (called the -01, A1, and A2 submissions). The problem is that more and more investigators have to submit and resubmit for an ever declining chance at funding, because in general the chances of success on the first submission are well below 10%. These days, paylines for many institutes are running around the range of the 10th to 13th percentile:

Nowhere does the funding gap seem wider than when looked at through the lens of age. “It’s just about inconceivable for a brand-new investigator to get an NIH grant funded on their first submission these days,” says David Sweatt, chair of the neurobiology department at the University of Alabama, Birmingham. Sweatt has hired three young scientists in the past year and worries about their future. “I see it as this dark shadow hanging over people who are just starting out their labs,” he says. “They’re having to spend so much time being anxious over funding, to the detriment of having time to think creatively about their research.”

At Vanderbilt University in Nashville, Tennessee, pediatric infectious disease specialist John Williams recently learned that his first R01 application failed to make the cut on its second try. Although NIH institutes generally give new investigators a bonus by increasing the pay line–from 12% to 14% at NIAID, for example, or from 12% to 18% at NCI–that only helps if the grant isn’t among the 40% or so that are set aside when they’re “triaged” and left unscored by evaluators.

What all this means is that right now is a very bad time to be a new investigator indeed. The odds of obtaining funding are worse than they’ve been since the bad old days of the early 1990’s (which, ironically enough, was when I was in graduate school), and more and more time and effort are required writing grants, rather than concentrating on science. However, it’s not so great a time to be approaching mid-career, as I am. A critical point in an investigator’s career is when the first R01 grant nears its end, and that investigator must renew it for the first time. Keep the grant, and you’ve passed a major hurdle in your career; lose the grant, and you may find yourself scrambling for scraps, begging for so-called “bridge” funding that universities try to provide to help investigators in this situation, or end up leaving academia.

That time is a mere three years away for me; two, actually, because I will have to apply to renew my grant around9-12 months before it expires. And, believe me, I’m sweating it already.

However, there’s an even worse effect of this fiscal uncertainty, and that is on the willingness of investigators to take on graduate students, whose stipends are usually funded through their thesis advisors’ grants:

Yet the numbers fail to convey the gnawing unease and foreboding expressed by scientists across disciplines and at every stage of their careers. “The ripple effect here is amazing and paralyzing,” says Steven Dowdy, a cancer biologist at the University of California, San Diego. At Brown University, molecular cell biologist Susan Gerbi, who helps oversee graduate training, canvassed 49 faculty members in eight departments recently, as she does every year, to see how many would take on a graduate student from next year’s pack. “In the past, it was a majority,” around 90% of those who responded, she says. “This year, only about 25% of the trainers said they would be interested … because they did not have a guarantee of funding for next fall.”

I know, I know. To some here, I’m whining because the government is no longer funding my area of interest to the level it once was, and it’s getting harder and harder to obtain the sine qua non of our present system of funding biomedical research: the R01 grant. Fair enough. The root cause of my whine is that the consequences of our present NIH funding morass would not nearly be as dire were not our entire system of biomedical research so utterly dependent upon the largess of the federal government and had not our universities become so addicted to NIH funding to the point that investigators are expected, in essence, to pay their own salary and rent with external funding, mostly from the government. But that’s the system we have, and until there is the will or support for radical change it is the system we will have for the foreseeable future. Worse, the doubling of the NIH budget, which seemed like such a good idea at the time, has produced unintended consequences galore. As was described in the Science article, some of these consequences were foreseen as early as two years into the doubling. Ironically enough, a stable, slower increase in the NIH budget over a decade, even if the budget took a decade to double rather than five years, would almost certainly have provided far more benefit than the boom and bust cycle that good intentions produced. If our current dysfunctional system is the way we as a nation are going to choose to fund critical biomedical research, there really needs to be found a way to mitigate or avoid these boom and bust cycles, lesser versions of which have been bedeviling researchers ever since the NIH was formed.

With that in mind, I consider the worst thing about the present prolonged downturn to be that the “rich” (i.e., well-funded labs) will continue to do just fine. They may have to shed a “technician or two” or a “postdoc or two,” to paraphrase Dr. Niederhuber, in order to ride out the downturn, but they will not be closing. They may have their grants cut, as Dr. Harold Varmus, the head of Memorial Sloan-Kettering Cancer Center did, but unlike many other more junior investigators they won’t be afraid that they will have to shut their labs any time soon. The problem and big question is, though: Who will be replacing these esteemed and senior scientists when it comes time for them to retire, if younger scientists can’t keep their labs funded long enough to become senior scientists themselves?