NIH at the Crossroads: Myths, Realities and Strategies for the Future
Elias A. Zerhouni, M.D.
Director National Institutes of Health
Competition for funds from the NIH and other sponsors, intensifying year by year, now stands at an unprecedented level, and shows no sign of abating. Never before have so many established investigators faced so much uncertainty about their longevity as active scientists. Never before have so many novices faced so many disincentives to entering or continuing a research career.
Dr. William F. Raub, NIH Associate Director for Research and Training, strategy paper, 1982
NIH Budget Facing a “Perfect Storm” in 2006
Federal & Trade Deficits Defense and Homeland Security needs
Katrina
Pandemic flu Post- Doubling effects Physical Sciences focus Biomedical research inflation- 3 to 5%
NIH Budget: Myths and Realities…
What is Driving Success Rates?
Is NIH placing more emphasis on applied as opposed to basic science
Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?
Basic and Applied Research
60.0%
53.9%
55.2%
56.4% 56.6%
55.2%
55.2%
55.8% 56.1%
52.1%
53.0% 43.5%
50.0%
40.5%
40.0%
39.2% 38.4% 38.5%
39.8% 40.8%
41.0%
41.0%
40.8%
30.0%
20.0%
10.0%
5.7%
5.5%
5.2%
4.8%
5.0%
7.0% 3.7% 3.6% 3.1%
3.1%
0.0% FY 1998 FY 1999 FY 2000 FY 2001 FY 2002 FY 2003
FY 2004
FY 2005
FY 2006
FY 2007
Basic Research
Applied Research
Other
What is Driving Success Rates?
Is NIH placing too much emphasis on translational science at the expense of basic research?
Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?
What is Driving Success Rates?
Is NIH placing too much emphasis on translational science at the expense of basic research?
Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?
NIH Roadmap for Medical Research
FY2005 Request = $28,757M Non-Roadmap 99.2%
($28,520 Million)
Developed to increase synergy across NIH Not a single initiative but over 345 individual awards in FY 2005: ― 40% basic ― 40% translational ― 20% high risk
($237 Million)
Roadmap 0.8%
What Is Really Happening? 3 Fundamental Drivers
Large capacity building throughout U.S. research institutions and increase in number of tenure-track faculty Appropriations below inflation after 2003
Increases of +3 % in „04, 2.2% in „05 and 0% in 06
Biomedical Inflation in 2004 was ~ 5%
Budget cycling phenomenon
New Grant Applications and Success Rates
During and After Doubling Period
35% 60,000
49,656
% Success Rate of Grants Funded
30% 25% 20%
31%
43,069
50,000
Number of Applications
40,000 22%
24,154
Projected
19% 30,000 20,000 10,000 0
15%
10% 5% 0%
+8,359 +8,303
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Success Rates
Applications
As Many Applicants in Past 2 Years as During Previous 5 Years!
5334 5208
≈
26583 - 21249
31791 - 26583
(2003) – (1999) Period of doubling
(2005) – (2003)
The Budget Cycling Phenomenon:
What Funds are Available in any One Year?
Budget Increase Uncommitted Funds
From current year to previous year From ending grants started 4-5 years ago
Committed Funds
Continuing grants
NIH Appropriations
NIH Congressional Appropriations
$30 $25
$27.1 $23.3 $28.0 $28.6 $28.6 $28.6
Billions of Dollars
$20
$17.8
$20.5 $15.6 $13.7
?
$15
$10 $5 $0
FY FY FY FY FY FY FY FY FY FY 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
DOUBLING
The Bottom Line:
Demand for Grants “Took Off” Just as NIH Budget Was “Landing!”
NIH managed well despite small increases in 2004 (2.9%) and 2005 (2%) by shifting “one time” funds from 2003 to 2004 Budget cycling effect will improve demand vs supply of grants in 2007 but we need to educate public about need for sustainability in research
The Question on Everyone’s Mind:
What are MY chances of being funded?
Payline Is Not Funding Cut-off Line
>99% of grants under the payline are funded
100 Percent R01s Funded
75 50 25 0 0 10 20 Percentile Score 30 40
Payline
Success Rate per application
Success Rate per Application Understates Funding Rate per Applicant
Success Rate for R01 Equivalents 40% 35% 30% 25% 20%
Applicant
27.6%
Applications 22.3%
15% 10%
5% 0% Fiscal Year
Success Rate files as of May 3, 2006. Program srf_indiv_060103_rfm Individuals are determined using the pi_profile_person_id in IMPAC-II
Where Do We Go From Here?
Adaptive Strategies
A Vision for the Future
Strategies
First: Know the facts
Second: Develop adaptive strategies
Protect the essential: Knowledge and Discovery Increase number of competing grants (supply/demand management) Support new investigators
New Pathway to Independence Program Institutes and Centers efforts to assist new investigators
Third: Convey a unified message
Increase communications about positive impact of NIH at local, regional and national levels
Fourth: NIH‟s exciting vision for the future
Biomedical Research Has Delivered
Coronary Heart Disease
Average investment per American
~$3.70
per year
63% decrease in Mortality ~ 1 million early deaths averted per year
Deaths per 100,000
500 400 300 200 100
Actual Total Deaths 95 2000 in 00 50 55 60 65 70 75 80 85 90 Year
$2.6 trillion in ~$110 economic return ~ 514,000
per American:
~ 1,329,000 Projected Deaths in 2000 30-year investment
New, effective treatments and prevention strategies
Biomedical Research Has Delivered
Cancer
For the first time in recorded history, Average investment annual cancer deaths per American in ~$8.60the United States per year have fallen
10 million survivors
Millions of People 9 6 3
1971 1986 1990 2003
30-year investment per American:
Advent of early ~$260 detection and Total screening
Basic Discovery Today Provides the Foundation for Tomorrow’s Medicine
Clinical Applications
Translational Research
Basic Research and Technology Development
The Future Paradigm:
Transform Medicine from Curative to Preemptive
Predictive
Personalized
Preemptive
Participatory
NIH
Transforming medicine through discovery
Elias A. Zerhouni, MD, Director, NIH
May 4, 2006