0013-7227/90/1265-2233$02.00/0 Endocrinology Copyright © 1990 by The Endocrine Society
Vol. 126, No. 5 Printed in U.S.A.
Considerable concern has been raised by reports that the various institutes of the NIH will be funding new and competitive renewal grant applications at "award rates" as low as 9-11%. At the outset it is apparent that what are being quoted as "award rates" are in reality estimated "percentile pay lines," under the revised NIH ranking system. Award rates, as noted below, are defined differently. In any case, the perception in the biomedical research community is that NIH funding has been cut back, or at least compromised by expansion of funding for indirect costs and targeted areas such as AIDS research and the human genome project. Further sensitivity was imparted by the prospect of a 5.3% across-theboard reduction from the anticipated fiscal year 1990 level had Gramm-Rudman-Hollings provisions remained in force, or about a 6% increase above fiscal year 1989 if these provisions remain implemented into February 1990 (as is now occurring). Before conclusions are drawn and possible inappropriate actions are undertaken, the situation deserves careful analysis of several essential aspects.1 1. Overall funding levels for NIH have not diminished. Congress has been supportive of NIH during the past decade to the extent that the NIH budget has more than doubled in current dollars, increased by 30-40% in constant dollars, and (with the exception of 1981-1982) kept ahead of inflation in constant dollars (by about 20%). Few other discretionary areas of the Federal budget have fared as well during the Reagan and Bush Administrations. 2. Funding for NIH AIDS research rose to about 7% of the NIH budget by 1988, and is projected at slightly over 10% in the Administration's budget proposal for fiscal year 1991. Dispersed throughout several Institutes Received February 22, 1990. Address requests for reprints to: Dr. Douglas E. Kelly, Association of American Medical Colleges, 1 Dupont Circle, Northwest, Suite 200, Washington, D.C. 20036. * Dr. Kelly is the Associate Vice President for Biomedical Research of the Association of American Medical Colleges. Individuals who wish to submit editorials should contact the Editor-in-Chief. 1 Data derived from: NIH Data, 1988; NIH Extramural Trends, 1988; other recent NIH figures; Science and Technology in the Academic Enterprise: Status, Trends and Issues. The Government-University-Industry Roundtable 1989; see also detailed analysis of the effect of lengthened grant periods by Thomas J. Kennedy, Jr. [Academic Medicine (1990) 65:63-73.]
(mainly NIAID, NCI, NHLBI, as well as DRR), this research emphasizes drug development, clinical trials, and education. But a fair amount is basic (over 26% in 1988 and 1989), and hence AIDS support has enhanced, rather than detracted from overall funding to NIH for basic inquiry, facilities, and training. Indeed, AIDS has probably demonstrated convincingly, to Congress and others, the value of maintaining a broad, ongoing agenda of basic biomedical research. The NIH share of the Human Genome Project for fiscal year 1990 is less than 1% of the NIH budget. Like AIDS dollars, the Human Genome funds are considered by Congress as additions to the basic NIH budget. 3. Indirect costs have risen in slightly fluctuating fashion during the decade, but as a proportion of total cost for NIH research grants, this amounts to an increase from 27.8-30.7%; hence this factor has not detracted greatly from the increasing dollars available for direct costs. However, there is a strong possibility of further increases in indirect costs to offset financing of needed facilities. 4. The total number of NIH extramural training positions of all types has held relatively steady since 1980, but training as a percentage of total extramural research funding has continued a steady long-term decline. There were 12,091 training positions in 1980; 11,971 in 1987; 11,225 in 1989; and 11,755 estimated for 1990. A modest increase in postdoctoral MD trainees has occurred recently concurrent with a decline in the number of postdoctoral PhD traineeships. In 1989 a precipitous drop in these numbers was avoided by reprogramming $10 million from other extramural activities (center grants and contracts as well as individual projects) to cover the cost of increased stipends. 5. Individual investigator-initiated project grants (ROls and related categories) have held priority in NIH funding decisions for the past decade. Nevertheless, new and competitive renewal awards fell to less than 5400 in fiscal year 1989, the lowest level since 1982. Approximately 4630 are projected for fiscal year 1990. Training funds, contract obligations, center grants, and especially funds for biomedical construction and major equipment have been curtailed over the years in an attempt to maintain or increase the total number of ROls. Downward negotiations of 5-15% have also been used to this
2233
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
Editorial: NIH Funding for Biomedical Research, 1990: Perceptions and Realities*
2234
EDITORIAL
11. The total number of active RO1 and related grants is projected at 20,319 for 1990 (including 737 AIDS projects). This number is a decrease from the high of 20,681 reached in 1989, but it should be noted that this statistic has risen steadily from 15,970 in 1982. The pool of new and competitive renewal applications showed a
modest dip this year, a reflection of the increased number of 5-yr-plus renewals now in the noncompetitive pool. Thus, the number of RO1 and related projects remains only slightly lowered from the single peak year, but the increasing proportion of 5-yr-plus grants exerts a stiffer competition for new and competitive renewals. Without a corresponding increase in overall funding, the price for stability of the established investigator is paid by new and competitive renewal applicants. The influence of lengthened grant periods is having a particularly severe impact on award rates this year. Unless overall funding is increased to exceed inflation by a more substantial margin, or the balance of long grants reduced, new and competing renewal applications will remain at an increasing competitive disadvantage, and the research community's alarm will be correspondingly heightened. The stability of longer grants for proven investigators is highly desireable, but at some point this advantage should not overtake the importance of providing new investigators a liberal chance to enter the system and for new ideas to be tried. It is apparent that both stability and new ideas are essential to a healthy biomedical research enterprise, and an appropriate level of one should not have to be gained at the expense of the other. While these aspects are disturbing, the preoccupation with lowered award rates for individual investigatorinitiated project grants should not cloud problems surrounding two other trends in NIH research funding. This has to do with 1) whether recruitment and training of sufficient numbers of the best young minds has been compromised over the years, and 2) the lack of attention given to the maintenance and upgrading of facilities and major equipment for biomedical research. Both commodities have been systematically deemphasized by NIH and Congressional actions during the past decade in an effort to maintain an acceptable number of individual investigator-initiated projects in force. There is scant evidence to suggest that funding from patient-care proceeds or the private or industrial sector has had, or will have, a major impact in alleviating these shortfalls. In a legislative arena in which deficit-reduction looms as a continuing reality, and in a social climate characterized by declining understanding of the value of scientific leadership, it might be tempting to accept status quo or reductions in NIH resources as inevitable and appropriate. However, several compelling lines of reason argue against complacency. First, there already exists a shortage of highly qualified investigators devoted to the clinical arena. Research experience during medical school years has become a scarce commodity, and post-MD research fellowships seldom are of sufficient duration or intensity to assure commitment or independent competence for a long-term
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
end. The degree to which private and industrial funding has supplanted the lost support remains unclear. 6. The budgets of noncompeting and competing renewal project grants have increased at a steeper rate than have the budgets of new, funded projects, particularly in salary categories. NIH officials are concerned about the rising cost of these projects, particularly when measured against downward negotiations currently being employed to preserve the number of ROls. 7. The pool of competing applications is always a mixture of new, renewal, and resubmitted proposals. Applications do not equal applicants. There are currently about 1.17 applications per applicant per year. Twenty percent of principal investigators have two or more project grants. Award rates for resubmitted grant applications are substantially higher than for first-time proposals. 8. The pool of applications for NIH grant support has risen steadily during the past decade. The total number of extramural applications per year is now about 25,000, 75-80% of which are for ROls or similar awards. These levels are about 30% higher than 10 yr ago. 9. There currently exists confusion as to award rates as compared to pay lines according to percentile rank. Recent press accounts have quoted individuals erroneously citing award rates in terms of fundable percentile scores. The projected award rate overall for NIH in 1990 is approximately 24% (of all approved competing applications in a given cycle). The fundable percentile score is much lower (10-14%) and is derived from a complex formula. The award rate in 1989 was 29% and in 1988 it was 32%. 10. While multiple minor encroachments contributed (see 2, 3, and 4, above), the recent decline in award rate is due primarily to the effect of lengthened award durations. Since 1982 there has been an effort to increase the proportion of individual investigator-initiated grants in a given year which are funded for 5 yr or more, a trend which has accelerated during the past 3 yr. These awards, once initiated become noncompetitive during four or more ensuing years, rather than two. Currently, they have come to constitute more than 53% of all active ROls and related grants (an increase from 37% in 1986, and 18% in 1982). As the proportion of noncompetitive renewals increases in any given cycle of review, the number of competitive awards funded will necessarily decline even though the total number of active grants remains relatively constant.
Endo • 1990 Vol 126 • No 5
EDITORIAL
Doing so will require the courage to increase our investment in NIH at a time when short-range projections and politics call for belt tightening and deficit reduction by all parties. Proposals put forth must be researched and justified carefully. They must be crafted so as to promote the welfare of all integral components of the whole biomedical research enterprise, and not overly benefit one segment at the expense of others. Above all, we need to avoid parochial fragmentation in our approach. The investment we advocate needs to include several components in order to correct current shortfalls and warpage in the NIH system and reestablish a balanced program in the years ahead. In my personal view, these are as follows: 1. The degree of stability currently achieved by virtue of increased numbers of 5-yr-plus grants should be retained. Additional funding is essential, however, to assure that a reasonable percentage of approved competing awards can be funded. There should be an award rate above 30% in a given review-cycle, assuming an application pool of the current quality. Overall numbers of active grants should be allowed to increase somewhat to provide leeway for this adjustment. 2. Additional funding should be added to the NIH budge to provide for reasonable degrees of improvement in physical plant and major equipment. Such funds should be dispensed through appropriate peer-review mechanisms. 3. Training programs from all sources of funding should be carefully assessed and strengthened in areas found to be insufficient for future needs. Clinical research training programs should be increased in duration to assure more adequate preparation in scientific methodology and objectivity. Mentorship of trainees should be scrutinized for adequate supervision. 4. Biomedical Research Support Grants should be retained and expanded. The flexible use of these funds is especially needed to provide interim support for excellent, but unfunded competing investigators who have chanced to have their grant applications come under review during an especially difficult time. The aggregate additional cost of these proposals would probably not exceed 25% of the current (fiscal year 1990) NIH budget. Viewed from the standpoint of the current, relatively modest portion of the Federal budget which is allocated to biomedical research, this is not an unreasonable target. The extramural programs of NIH are in a crisis situation due to an accumulation of past practices in three specific areas; attention to the welfare of new grant applications, training, and capital improvement and equipment. An additional 25% investment is needed in fiscal year 1991 and justified in spite of other current constraints. There should be no illusions as to the cost
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
research-emphatic career. Additionally, the number of undergraduate US citizens attracted to academic careers in biomedical research has declined steadily during the past decade. The uncertain patterns of funding and competition noted above, coupled with increasing regulation and education-related indebtedness undoubtedly play roles in discouraging career choices in biomedical areas. This is especially true for the expanding numbers of minority students. The resultant shortage of new blood is projected to peak at a time of maximal retirement of the current generation of biomedical faculty and investigators. This period also coincides with the start of the next wave of students to be educated at college and professional school levels. An accurate projection of required biomedical research personpower is urgently needed, and appropriate steps should be taken to assure corresponding numbers of opportunities for training at various levels. Second, the facilities within which NIH intramural or university-based research is conducted have now gone too long without sufficient replacement or refurbishing. Major equipment is also becoming outdated. Private or industrial resources which might alleviate these shortfalls appear limited and localized to a few preeminent institutions. Third, the biomedical research enterprise of the United States has grown to be the best and most productive in the world. It is a hard-won resource which should not now be allowed to deteriorate, particularly since the citizenry of this and other countries have so much to be gained in terms of health-care capability that results from a broad base of effective basic and clinical research. One can generally argue that current increases in funding for biomedical research will result in savings in healthcare expenditures in the future. At the same time the biomedical research enterprise is one which provides immediate employment and intellectual vitality to this nation. It is an essential ingredient for success in a world economy, and a vital component in enhancing the scientific literacy of our citizens. In a democratic society, no other governmental responsibilities are more fundamental than the provision of education and health. The nation's biomedical research enterprise is in the unique position of serving both. Finally, the opportunity for significant basic understanding and eventual application resulting from biomedical research has never been as rich as at present. We live in the midst of an explosion of technological and theoretical opportunity to apply and expand our understanding of the intricacies of living systems. If we do not grasp this opportunity, other nations stand ready to do so, probably at our expense. It is essential both ethically and economically that we invest now to exploit more fully the opportunity at hand.
2235
2236
EDITORIAL
Congressional resistance may be quite high and must be dealt with tactfully. Congresspeople rightfully feel they have been very supportive of the biomedical research community, and other worthy domestic issues (e.g. education, drugs, environment) have taken center stage. Second, the biomedical research community must present a unified and consistent message; extravagant demands from an isolated sector will be dismissed as selfserving. And third, perhaps an even greater effort needs to be expended educating the public and youngsters about the values of a stable biomedical research enterprise. They are the future. Douglas E. Kelly
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
of this investment in future years, however. If the ratio of long-term research grants is maintained, and other needs noted above also covered, the NIH budget must be expected to swell by 1995 to a figure approaching double its 1990 level. (Kennedy, T., and D. Moore, unpublished data). Perhaps the easing of cold war tensions provides a window of opportunity to increase the nation's investment in, and assure continuation of, this valuable peaceful resource; however, this argument is not an easy one to make as long as the federal deficit remains high and employment constitutes a large share of the defense budget. Several key points should be kept in focus. First,
Endo • 1990 Vol 126 • No 5
Vol. 126, No. 5 Printed in U.S.A.
Considerable concern has been raised by reports that the various institutes of the NIH will be funding new and competitive renewal grant applications at "award rates" as low as 9-11%. At the outset it is apparent that what are being quoted as "award rates" are in reality estimated "percentile pay lines," under the revised NIH ranking system. Award rates, as noted below, are defined differently. In any case, the perception in the biomedical research community is that NIH funding has been cut back, or at least compromised by expansion of funding for indirect costs and targeted areas such as AIDS research and the human genome project. Further sensitivity was imparted by the prospect of a 5.3% across-theboard reduction from the anticipated fiscal year 1990 level had Gramm-Rudman-Hollings provisions remained in force, or about a 6% increase above fiscal year 1989 if these provisions remain implemented into February 1990 (as is now occurring). Before conclusions are drawn and possible inappropriate actions are undertaken, the situation deserves careful analysis of several essential aspects.1 1. Overall funding levels for NIH have not diminished. Congress has been supportive of NIH during the past decade to the extent that the NIH budget has more than doubled in current dollars, increased by 30-40% in constant dollars, and (with the exception of 1981-1982) kept ahead of inflation in constant dollars (by about 20%). Few other discretionary areas of the Federal budget have fared as well during the Reagan and Bush Administrations. 2. Funding for NIH AIDS research rose to about 7% of the NIH budget by 1988, and is projected at slightly over 10% in the Administration's budget proposal for fiscal year 1991. Dispersed throughout several Institutes Received February 22, 1990. Address requests for reprints to: Dr. Douglas E. Kelly, Association of American Medical Colleges, 1 Dupont Circle, Northwest, Suite 200, Washington, D.C. 20036. * Dr. Kelly is the Associate Vice President for Biomedical Research of the Association of American Medical Colleges. Individuals who wish to submit editorials should contact the Editor-in-Chief. 1 Data derived from: NIH Data, 1988; NIH Extramural Trends, 1988; other recent NIH figures; Science and Technology in the Academic Enterprise: Status, Trends and Issues. The Government-University-Industry Roundtable 1989; see also detailed analysis of the effect of lengthened grant periods by Thomas J. Kennedy, Jr. [Academic Medicine (1990) 65:63-73.]
(mainly NIAID, NCI, NHLBI, as well as DRR), this research emphasizes drug development, clinical trials, and education. But a fair amount is basic (over 26% in 1988 and 1989), and hence AIDS support has enhanced, rather than detracted from overall funding to NIH for basic inquiry, facilities, and training. Indeed, AIDS has probably demonstrated convincingly, to Congress and others, the value of maintaining a broad, ongoing agenda of basic biomedical research. The NIH share of the Human Genome Project for fiscal year 1990 is less than 1% of the NIH budget. Like AIDS dollars, the Human Genome funds are considered by Congress as additions to the basic NIH budget. 3. Indirect costs have risen in slightly fluctuating fashion during the decade, but as a proportion of total cost for NIH research grants, this amounts to an increase from 27.8-30.7%; hence this factor has not detracted greatly from the increasing dollars available for direct costs. However, there is a strong possibility of further increases in indirect costs to offset financing of needed facilities. 4. The total number of NIH extramural training positions of all types has held relatively steady since 1980, but training as a percentage of total extramural research funding has continued a steady long-term decline. There were 12,091 training positions in 1980; 11,971 in 1987; 11,225 in 1989; and 11,755 estimated for 1990. A modest increase in postdoctoral MD trainees has occurred recently concurrent with a decline in the number of postdoctoral PhD traineeships. In 1989 a precipitous drop in these numbers was avoided by reprogramming $10 million from other extramural activities (center grants and contracts as well as individual projects) to cover the cost of increased stipends. 5. Individual investigator-initiated project grants (ROls and related categories) have held priority in NIH funding decisions for the past decade. Nevertheless, new and competitive renewal awards fell to less than 5400 in fiscal year 1989, the lowest level since 1982. Approximately 4630 are projected for fiscal year 1990. Training funds, contract obligations, center grants, and especially funds for biomedical construction and major equipment have been curtailed over the years in an attempt to maintain or increase the total number of ROls. Downward negotiations of 5-15% have also been used to this
2233
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
Editorial: NIH Funding for Biomedical Research, 1990: Perceptions and Realities*
2234
EDITORIAL
11. The total number of active RO1 and related grants is projected at 20,319 for 1990 (including 737 AIDS projects). This number is a decrease from the high of 20,681 reached in 1989, but it should be noted that this statistic has risen steadily from 15,970 in 1982. The pool of new and competitive renewal applications showed a
modest dip this year, a reflection of the increased number of 5-yr-plus renewals now in the noncompetitive pool. Thus, the number of RO1 and related projects remains only slightly lowered from the single peak year, but the increasing proportion of 5-yr-plus grants exerts a stiffer competition for new and competitive renewals. Without a corresponding increase in overall funding, the price for stability of the established investigator is paid by new and competitive renewal applicants. The influence of lengthened grant periods is having a particularly severe impact on award rates this year. Unless overall funding is increased to exceed inflation by a more substantial margin, or the balance of long grants reduced, new and competing renewal applications will remain at an increasing competitive disadvantage, and the research community's alarm will be correspondingly heightened. The stability of longer grants for proven investigators is highly desireable, but at some point this advantage should not overtake the importance of providing new investigators a liberal chance to enter the system and for new ideas to be tried. It is apparent that both stability and new ideas are essential to a healthy biomedical research enterprise, and an appropriate level of one should not have to be gained at the expense of the other. While these aspects are disturbing, the preoccupation with lowered award rates for individual investigatorinitiated project grants should not cloud problems surrounding two other trends in NIH research funding. This has to do with 1) whether recruitment and training of sufficient numbers of the best young minds has been compromised over the years, and 2) the lack of attention given to the maintenance and upgrading of facilities and major equipment for biomedical research. Both commodities have been systematically deemphasized by NIH and Congressional actions during the past decade in an effort to maintain an acceptable number of individual investigator-initiated projects in force. There is scant evidence to suggest that funding from patient-care proceeds or the private or industrial sector has had, or will have, a major impact in alleviating these shortfalls. In a legislative arena in which deficit-reduction looms as a continuing reality, and in a social climate characterized by declining understanding of the value of scientific leadership, it might be tempting to accept status quo or reductions in NIH resources as inevitable and appropriate. However, several compelling lines of reason argue against complacency. First, there already exists a shortage of highly qualified investigators devoted to the clinical arena. Research experience during medical school years has become a scarce commodity, and post-MD research fellowships seldom are of sufficient duration or intensity to assure commitment or independent competence for a long-term
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
end. The degree to which private and industrial funding has supplanted the lost support remains unclear. 6. The budgets of noncompeting and competing renewal project grants have increased at a steeper rate than have the budgets of new, funded projects, particularly in salary categories. NIH officials are concerned about the rising cost of these projects, particularly when measured against downward negotiations currently being employed to preserve the number of ROls. 7. The pool of competing applications is always a mixture of new, renewal, and resubmitted proposals. Applications do not equal applicants. There are currently about 1.17 applications per applicant per year. Twenty percent of principal investigators have two or more project grants. Award rates for resubmitted grant applications are substantially higher than for first-time proposals. 8. The pool of applications for NIH grant support has risen steadily during the past decade. The total number of extramural applications per year is now about 25,000, 75-80% of which are for ROls or similar awards. These levels are about 30% higher than 10 yr ago. 9. There currently exists confusion as to award rates as compared to pay lines according to percentile rank. Recent press accounts have quoted individuals erroneously citing award rates in terms of fundable percentile scores. The projected award rate overall for NIH in 1990 is approximately 24% (of all approved competing applications in a given cycle). The fundable percentile score is much lower (10-14%) and is derived from a complex formula. The award rate in 1989 was 29% and in 1988 it was 32%. 10. While multiple minor encroachments contributed (see 2, 3, and 4, above), the recent decline in award rate is due primarily to the effect of lengthened award durations. Since 1982 there has been an effort to increase the proportion of individual investigator-initiated grants in a given year which are funded for 5 yr or more, a trend which has accelerated during the past 3 yr. These awards, once initiated become noncompetitive during four or more ensuing years, rather than two. Currently, they have come to constitute more than 53% of all active ROls and related grants (an increase from 37% in 1986, and 18% in 1982). As the proportion of noncompetitive renewals increases in any given cycle of review, the number of competitive awards funded will necessarily decline even though the total number of active grants remains relatively constant.
Endo • 1990 Vol 126 • No 5
EDITORIAL
Doing so will require the courage to increase our investment in NIH at a time when short-range projections and politics call for belt tightening and deficit reduction by all parties. Proposals put forth must be researched and justified carefully. They must be crafted so as to promote the welfare of all integral components of the whole biomedical research enterprise, and not overly benefit one segment at the expense of others. Above all, we need to avoid parochial fragmentation in our approach. The investment we advocate needs to include several components in order to correct current shortfalls and warpage in the NIH system and reestablish a balanced program in the years ahead. In my personal view, these are as follows: 1. The degree of stability currently achieved by virtue of increased numbers of 5-yr-plus grants should be retained. Additional funding is essential, however, to assure that a reasonable percentage of approved competing awards can be funded. There should be an award rate above 30% in a given review-cycle, assuming an application pool of the current quality. Overall numbers of active grants should be allowed to increase somewhat to provide leeway for this adjustment. 2. Additional funding should be added to the NIH budge to provide for reasonable degrees of improvement in physical plant and major equipment. Such funds should be dispensed through appropriate peer-review mechanisms. 3. Training programs from all sources of funding should be carefully assessed and strengthened in areas found to be insufficient for future needs. Clinical research training programs should be increased in duration to assure more adequate preparation in scientific methodology and objectivity. Mentorship of trainees should be scrutinized for adequate supervision. 4. Biomedical Research Support Grants should be retained and expanded. The flexible use of these funds is especially needed to provide interim support for excellent, but unfunded competing investigators who have chanced to have their grant applications come under review during an especially difficult time. The aggregate additional cost of these proposals would probably not exceed 25% of the current (fiscal year 1990) NIH budget. Viewed from the standpoint of the current, relatively modest portion of the Federal budget which is allocated to biomedical research, this is not an unreasonable target. The extramural programs of NIH are in a crisis situation due to an accumulation of past practices in three specific areas; attention to the welfare of new grant applications, training, and capital improvement and equipment. An additional 25% investment is needed in fiscal year 1991 and justified in spite of other current constraints. There should be no illusions as to the cost
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
research-emphatic career. Additionally, the number of undergraduate US citizens attracted to academic careers in biomedical research has declined steadily during the past decade. The uncertain patterns of funding and competition noted above, coupled with increasing regulation and education-related indebtedness undoubtedly play roles in discouraging career choices in biomedical areas. This is especially true for the expanding numbers of minority students. The resultant shortage of new blood is projected to peak at a time of maximal retirement of the current generation of biomedical faculty and investigators. This period also coincides with the start of the next wave of students to be educated at college and professional school levels. An accurate projection of required biomedical research personpower is urgently needed, and appropriate steps should be taken to assure corresponding numbers of opportunities for training at various levels. Second, the facilities within which NIH intramural or university-based research is conducted have now gone too long without sufficient replacement or refurbishing. Major equipment is also becoming outdated. Private or industrial resources which might alleviate these shortfalls appear limited and localized to a few preeminent institutions. Third, the biomedical research enterprise of the United States has grown to be the best and most productive in the world. It is a hard-won resource which should not now be allowed to deteriorate, particularly since the citizenry of this and other countries have so much to be gained in terms of health-care capability that results from a broad base of effective basic and clinical research. One can generally argue that current increases in funding for biomedical research will result in savings in healthcare expenditures in the future. At the same time the biomedical research enterprise is one which provides immediate employment and intellectual vitality to this nation. It is an essential ingredient for success in a world economy, and a vital component in enhancing the scientific literacy of our citizens. In a democratic society, no other governmental responsibilities are more fundamental than the provision of education and health. The nation's biomedical research enterprise is in the unique position of serving both. Finally, the opportunity for significant basic understanding and eventual application resulting from biomedical research has never been as rich as at present. We live in the midst of an explosion of technological and theoretical opportunity to apply and expand our understanding of the intricacies of living systems. If we do not grasp this opportunity, other nations stand ready to do so, probably at our expense. It is essential both ethically and economically that we invest now to exploit more fully the opportunity at hand.
2235
2236
EDITORIAL
Congressional resistance may be quite high and must be dealt with tactfully. Congresspeople rightfully feel they have been very supportive of the biomedical research community, and other worthy domestic issues (e.g. education, drugs, environment) have taken center stage. Second, the biomedical research community must present a unified and consistent message; extravagant demands from an isolated sector will be dismissed as selfserving. And third, perhaps an even greater effort needs to be expended educating the public and youngsters about the values of a stable biomedical research enterprise. They are the future. Douglas E. Kelly
Downloaded from https://academic.oup.com/endo/article-abstract/126/5/2233/2533004 by Tulane University user on 07 February 2019
of this investment in future years, however. If the ratio of long-term research grants is maintained, and other needs noted above also covered, the NIH budget must be expected to swell by 1995 to a figure approaching double its 1990 level. (Kennedy, T., and D. Moore, unpublished data). Perhaps the easing of cold war tensions provides a window of opportunity to increase the nation's investment in, and assure continuation of, this valuable peaceful resource; however, this argument is not an easy one to make as long as the federal deficit remains high and employment constitutes a large share of the defense budget. Several key points should be kept in focus. First,
Endo • 1990 Vol 126 • No 5
