THE CRISIS IN BIOMEDICAL RESEARCH FUNDING ROBERT G. PETERSDORF***t WASHINGTON, D.C.
Many in the biomedical research community are deeply concerned about what some have described as a crisis in grant funding. The "crisis," if it can be characterized as such, relates directly to the inability of some of the nation's best talent-often those with a long track record of funding-to obtain support from the NIH for new or continuing competitive projects. These applications have often been judged as being both important and well-conceived by scientific review panels. There are several phenomena that, in concert, are responsible for limiting the funds available for even the most meritorious proposals. The first relates to the growth in the NIH budget in the aggregate. Figure 1 shows the size of the NIH budget over the past 15 years in actual and inflation-adjusted dollars. As the top line indicates, there have been steady increases in the budget of the Institutes during this period and indeed in almost every year since their founding. Offsetting these gains in the budget, however, have been the pernicious effects of inflation. The lower line represents inflation-adjusted growth and illustrates the extent to which much of the budgetary increase has been necessary to keep the system on an even keel. In fact, after inflation, budgetary increases during the last three years-the period in which the access to new and competitive renewal funding has become most restricted-have been extremely modest-on the order of 1-3%-and the growth curve is relatively flat (1). Another relevant budgetary consideration during the last decade has been the need to address an important health concern that emerged during that period-AIDS. Beginning in 1982, Congress began designating a portion of the overall NIH appropriation for projects dedicated to a better understanding of this deadly disease. The AIDS budget has expanded dramatically since 1982, though it is a smaller share of the budget than some might guess-9.7% in FY 1991-and it is stabilizing (Fig. 2). When constant dollar growth is examined in isolation of AIDS funding, we see a slight decline in the budget between 1987 and 1990. However, it is likely that the need to confront AIDS had expanded rather * President, Association of American Medical Colleges, Washington, D.C. ** I am indebted to Mr. Allan Shipp, Division of Biomedical Research, Association of
American Medical Colleges, for valuable assistance in the preparation of this manuscript. t Send reprint requests to the author at the Association of American Medical Colleges, 2450 N Street, N.W., Washington, D.C. 20037. 182
183
CRISIS IN BIOMEDICAL RESEARCH FUNDING
NIH Funding in current and constant dollars
C
0
In
ft0
75
77
79
81 83 85 Fiscal Year
87
89
91
Source: NIH FIG 1. The NIH budget over the past 15 years in actual and inflation-adjusted dollars. Steady increases have occurred almost yearly since the Institutes' founding.
than detracted from funding opportunities. Given the pressing fiscal constraints precipitated by the budget deficit, it is unlikely that the NIH budget would have grown to current levels if it were not for the compelling nature of the AIDS enigma. Other targeted programs, such as the human genome initiative, are perceived by some to contribute to the declining availability of research funds. The human genome initiative is not a very significant factor, however, and consists of slightly less than 1.0% of the overall NIH budget in FY 1991. A second factor contributing to the difficulty in obtaining new and competitive research funding relates to the demand for new funds, presumably driven by the plethora of new scientific opportunities. In recent years, while growth in the NIH budget has moderated significantly, scientific opportunities have been expanding at an unprecedented rate. Molecular biology and its offshoots are opening a whole new realm of
184
ROBERT G. PETERSDORF
NIH Funding non-AIDS,
non-genome
AIDS
human genome
0
5 = a
4
o 0
4.o 3 m
c =
e = C
0
0
2
1
0 -
Fiscal Year Source: NIH
FIG 2. Annual NIH appropriations, including AIDS and human genome research, from 1982-1991. AIDS funding in FY '91 comprised a 9.7% share of the NIH budget.
research possibilities. Perhaps as a consequence of these developments, the demand for funding, measured by applications submitted to the NIH, has been increasing dramatically. In FY 1980, the NIH reviewed a total of 14,142 applications for research project grants. By FY 1990, the Institutes reviewed 20,154, an increase of 42%. During the same time frame the NIH budget expanded by 23% after inflation. A third factor contributing to the decreasing availability of NIH funds for competing grant applications is the increasing cost per grant. As suggested in the discussion of inflation, science is an expensive proposition, and is getting more expensive all the time. The Biomedical Research and Development Price Index (BRDPI), a special measure of inflation developed by the department of commerce that applies to the components of biomedical research, has risen in recent years faster than the consumer price index, by several percentage points. Inflationary factors, and related rising personnel and overhead costs,
185
CRISIS IN BIOMEDICAL RESEARCH FUNDING
contributed to an increase in the average award size for investigatorinitiated grants during the last decade from $84,200 in FY 1980 to $173,600 in FY 1990, a 106% increase. As a consequence, even without programmatic expansion, it would take considerable increases in the overall NIH budget to keep a constant number of NIH grants afloat. When measured in comparable 1980 dollars, that average grant in 1990 is only worth $96,500. A fourth factor, and perhaps the most significant in explaining the difficulty in obtaining new and competitive renewal funding, is the increasing average length of grant awards (Fig. 3). The average length of a research project grant has increased from 3.3 years in FY 1983 to 4.2 years in FY 1990. This is a direct consequence of complaints by the research community over the burden that frequent reapplication for grants placed on productive scientists who were spending an increasingly large amount of time drafting grant proposals and less time conducting actual research. Scientists, it was decided, should be entrusted with funding for a longer period, and beginning in FY 1985, NIH embarked on an explicit policy of increasing the average length of research project grants. In addition, other special extended-length awards were developed, such as the five-year merit and first awards, and the seven-year Javits and outstanding investigator awards. In 1983, 17.6% of awarded research
Average Length of Award for RPGs
a 0 0
0 0
1983
1984
1985
1986
1987
1988
1989
Source: NIH FIG 3. Average length of research project grant awards from 1983-1990. The length grew from 3.3 years in FY '83 to 4.2 years in FY '90.
1990
average
186
ROBERT G. PETERSDORF
project grants were for five years or longer. By 1990, this figure had risen to 59.1%. Three-year awards, which in 1983 represented 69.6% of the grant pool, made up only 30.9% by 1990. Exacerbating the effect of increasing the length of awards was a coincident surge, peaking in 1987, of the number of new and competing renewal grants funded (Fig. 4). What we saw then was a synergistic effect in which out-year funding demands created by simply lengthening awards were enhanced by the sheer number of additional awards being injected into the system. Consequently, a progressively larger portion of the NIH extramural program was being devoted to out-year commitments (Fig. 5), represented in the figure by the "noncompeting" grants. In FY 1990, the year in which this trend was most pronounced, 77% of the grants funded were noncompeting continuations. As a result an ever-larger share of each year's NIH appropriation must be set aside for ongoing commitments to extramural projects. Of all the funds available for extramural research in FY 1990, over three-fourths were already obligated to out-years as noncompetitive renewals, restricting funds available for new entrants to the system or
NIH Research Project Grants: 1980-1991 New and Competing Renewal Awards 7-
6
5
_
I
V 7- 7
i&_ 'a°4
7X
I,
X,
7 7
1:: 2
I'
_
.2
z
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 191H
Fiscal Year Source: NIH FIG 4. New and competing renewal grants funded from 1980-1991. A surge in the number of new and competing renewal grants funded accompanied the increase in average award length, peaking in 1987.
CRISIS IN BIOMEDICAL RESEARCH FUNDING
187
NIH Research Project Grants New & Comp. Renewal
g Noncomp.
-,X.-
r77A
20 0
X C
15
a 6
711
71
7/1
7/
7-
t10 5
n
1982
1983 1984 1985 1986 1987 1988 1989 1990 1991
Fiscal Year
Source: NIH FIG 5. A comparison of the number of NIH new and competing renewal project awards with NIH funding for "noncompeting" grants. In FY '90 77% of the grants funded were noncompeting continuations.
for those coming back at the end of their grant period to compete for renewal. As a consequence, the number of new and competing renewals has dropped precipitously in recent years from approximately 6,200 in 1988 to 5,300 in 1989 and 4,600 in 1990. Theoretically, as the longerterm awards begin cycling out again, and their representation in the grant portfolio stabilizes, a new equilibrium should be established, which would relieve some of the current stresses. However, it seems unlikely that the equilibrium will be attained in the short term because both NIH and the Congress are implementing a policy objective of funding as close to 6,000 new and competing renewal grants as possible. This can only be done at an enormous price, with cutbacks in individual grant budgets as high as 20 to 25%. These four elements-modest post-inflationary growth in the NIH budget, the rising cost per grant, the escalating competition for awards,
188
ROBERT G. PETERSDORF
and, perhaps most importantly, the extension of award duration-have all contributed to a situation in which successful access to the NIH grant system has become greatly restricted. Times of trouble often unify people against a common problem, but in this case, there has occurred a disturbing fractionation within the biomedical research community. Internecine battles are being fought over issues such as indirect costs, facilities, training, and other elements of infrastructure which are perceived to compete with investigator-initiated projects. This is illustrative of how current funding exigencies have precipitated a tendency within our community to focus on the short term, on issues of immediate concern, without sufficient reflection as to what would be of most benefit to the national research effort in the long haul. This splintering is a serious matter and, in my view, represents as great a threat to the future of biomedical research as any of the funding problems. To achieve reconciliation within the community, there must be better analysis of the factors responsible for the problem, accompanied by the development of rational strategies to solve them. Some say the current situation could have been avoided had the NIH thought out more carefully the implications of its grant-making tactics. Others argue that the problem rests at a higher level, i.e., the current and prior administrations-by not assigning research, particularly biomedical research, a sufficiently high priority. Wherever ultimate responsibility lies, it is indisputable that NIH does not have an integrated, long-term strategy for research funding. Both the House Appropriations Committee and its Senate counterpart recognized this vacuum and proposed a plan for NIH. Table 1 shows the 10-point strategy developed for the NIH by the House Appropriations Committee in its FY 1991 appropriations report language. The Senate version had fewer elements, but reiterates concerns over the length of grants, total grant costs, and program balance. I will focus on the more explicit House plan (2). The primary concern expressed in the House plan was to promote stability and predictability within the NIH program. To achieve that objective, the House asked NIH to move over the next four years to awarding approximately 6,000 competing grants and to establish a stable total grant pool of 24,000. The House also asked NIH to develop mechanisms to ensure that the average length of a grant not exceed approximately four years and that increases in the average cost of a grant not exceed the BRDPI. A significant departure from current practice with important implications for peer review was a recommendation that review groups consider the total costs of a grant, including indirect costs, at all stages of review. Congress also asked NIH to eliminate downward negotiations, while
CRISIS IN BIOMEDICAL RESEARCH FUNDING
1. 2. 3.
4.
5. 6. 7. 8. 9.
10.
189
TABLE 1 House Funding Plan for the NIH Move over the next four years to a stable research grant pool of approximately 6,000 new (and competing renewal) grants and a total grant pool of 24,000; Provide necessary cost controls on the system by ensuring that the average length of a grant not exceed approximately four years and that the average cost of a grant not exceed the BRDPI; Consider the total costs of a grant, including indirect costs, at all stages of the grants review process; Eliminate downward negotiations (with review groups being more aggressive in stripping proposals down to the bare minimum); "Approve" grants on more stringent standards of scientific merit (rather than approving any grant with even technical merit); Fund research trainees at NAS-recommended levels; Limit center grants to 640, with inflation-based budgetary increases; Increase funding for other mechanisms according to inflation; Provide a contingency reserve fund to the NIH director for emergencies or unanticipated opportunities (to be split in future years between the NIH director and individual institute directors); Provide adequately for maintenance and repair of NIH facilities.
requesting that review groups be more aggressive in stripping proposals of unnecessary costs. The AAMC has traditionally opposed arbitrary cuts to study-section approved budgets and would be pleased to see elimination of downward negotiations. However, we hope that these and other more recent proposals do not lead study sections to consider cuts beyond what is scientifically appropriate. Out of concern that an excessive portion of submitted grant applications are being "approved" by NIH, Congress also has asked study sections to "approve" grants on more stringent standards of scientific merit (rather than just approving any grant with any degree of technical merit, as now occurs). Other recommendations made in the House report included: * funding research trainees at NAS recommended levels; * limiting center grants to 640, with inflation-based budgetary increases; * increasing funding for other mechanisms according to inflation; * providing a contingency reserve fund to the NIH director for emergencies or unanticipated opportunities (to be split in future years between the NIH director and individual Institute directors); and * providing adequately for maintenance and repair of NIH facilities. The NIH was not mandated to follow this plan to the letter and, in fact, has made minor modifications. However, for all practical purposes, the plan remains intact. The Institute of Medicine, the AAMC, the
190
ROBERT G. PETERSDORF
Federated Societies for Biology, and others have commented on the resultant NIH Management Plan and other issues, including, in the case of the IOM, emphasis on training and facility construction. All of this was placed on the back burner by the OMB and legislative proposals to cap indirect costs. This is a troublesome topic, full of arcane facts, that is beyond the scope of this discussion. The current funding problems are serious, and their impact on both individual scientists and the nation's biomedical research effort are significant. Quick fixes will not ensure a vigorous research climate in the years to come. We need to look long and hard at the future and ask tough questions about what it will take to stabilize all elements of our national research effort. I believe the greatest immediate threat to the future of biomedical research is academe's own lack of unity. All concerned scientists, whether as individuals, as part of societies, or as coalitions should make efforts that will lead to an informed understanding of the problems we face so that we may devise a unified approach to dealing with them. REFERENCES 1. National Institutes of Health, Office of Science Policy and Legislation, NIH Data Book 1989, December 1989. 2. National Institutes of Health, A Plan for Managing the Costs of Biomedical Research, June 1991.
Many in the biomedical research community are deeply concerned about what some have described as a crisis in grant funding. The "crisis," if it can be characterized as such, relates directly to the inability of some of the nation's best talent-often those with a long track record of funding-to obtain support from the NIH for new or continuing competitive projects. These applications have often been judged as being both important and well-conceived by scientific review panels. There are several phenomena that, in concert, are responsible for limiting the funds available for even the most meritorious proposals. The first relates to the growth in the NIH budget in the aggregate. Figure 1 shows the size of the NIH budget over the past 15 years in actual and inflation-adjusted dollars. As the top line indicates, there have been steady increases in the budget of the Institutes during this period and indeed in almost every year since their founding. Offsetting these gains in the budget, however, have been the pernicious effects of inflation. The lower line represents inflation-adjusted growth and illustrates the extent to which much of the budgetary increase has been necessary to keep the system on an even keel. In fact, after inflation, budgetary increases during the last three years-the period in which the access to new and competitive renewal funding has become most restricted-have been extremely modest-on the order of 1-3%-and the growth curve is relatively flat (1). Another relevant budgetary consideration during the last decade has been the need to address an important health concern that emerged during that period-AIDS. Beginning in 1982, Congress began designating a portion of the overall NIH appropriation for projects dedicated to a better understanding of this deadly disease. The AIDS budget has expanded dramatically since 1982, though it is a smaller share of the budget than some might guess-9.7% in FY 1991-and it is stabilizing (Fig. 2). When constant dollar growth is examined in isolation of AIDS funding, we see a slight decline in the budget between 1987 and 1990. However, it is likely that the need to confront AIDS had expanded rather * President, Association of American Medical Colleges, Washington, D.C. ** I am indebted to Mr. Allan Shipp, Division of Biomedical Research, Association of
American Medical Colleges, for valuable assistance in the preparation of this manuscript. t Send reprint requests to the author at the Association of American Medical Colleges, 2450 N Street, N.W., Washington, D.C. 20037. 182
183
CRISIS IN BIOMEDICAL RESEARCH FUNDING
NIH Funding in current and constant dollars
C
0
In
ft0
75
77
79
81 83 85 Fiscal Year
87
89
91
Source: NIH FIG 1. The NIH budget over the past 15 years in actual and inflation-adjusted dollars. Steady increases have occurred almost yearly since the Institutes' founding.
than detracted from funding opportunities. Given the pressing fiscal constraints precipitated by the budget deficit, it is unlikely that the NIH budget would have grown to current levels if it were not for the compelling nature of the AIDS enigma. Other targeted programs, such as the human genome initiative, are perceived by some to contribute to the declining availability of research funds. The human genome initiative is not a very significant factor, however, and consists of slightly less than 1.0% of the overall NIH budget in FY 1991. A second factor contributing to the difficulty in obtaining new and competitive research funding relates to the demand for new funds, presumably driven by the plethora of new scientific opportunities. In recent years, while growth in the NIH budget has moderated significantly, scientific opportunities have been expanding at an unprecedented rate. Molecular biology and its offshoots are opening a whole new realm of
184
ROBERT G. PETERSDORF
NIH Funding non-AIDS,
non-genome
AIDS
human genome
0
5 = a
4
o 0
4.o 3 m
c =
e = C
0
0
2
1
0 -
Fiscal Year Source: NIH
FIG 2. Annual NIH appropriations, including AIDS and human genome research, from 1982-1991. AIDS funding in FY '91 comprised a 9.7% share of the NIH budget.
research possibilities. Perhaps as a consequence of these developments, the demand for funding, measured by applications submitted to the NIH, has been increasing dramatically. In FY 1980, the NIH reviewed a total of 14,142 applications for research project grants. By FY 1990, the Institutes reviewed 20,154, an increase of 42%. During the same time frame the NIH budget expanded by 23% after inflation. A third factor contributing to the decreasing availability of NIH funds for competing grant applications is the increasing cost per grant. As suggested in the discussion of inflation, science is an expensive proposition, and is getting more expensive all the time. The Biomedical Research and Development Price Index (BRDPI), a special measure of inflation developed by the department of commerce that applies to the components of biomedical research, has risen in recent years faster than the consumer price index, by several percentage points. Inflationary factors, and related rising personnel and overhead costs,
185
CRISIS IN BIOMEDICAL RESEARCH FUNDING
contributed to an increase in the average award size for investigatorinitiated grants during the last decade from $84,200 in FY 1980 to $173,600 in FY 1990, a 106% increase. As a consequence, even without programmatic expansion, it would take considerable increases in the overall NIH budget to keep a constant number of NIH grants afloat. When measured in comparable 1980 dollars, that average grant in 1990 is only worth $96,500. A fourth factor, and perhaps the most significant in explaining the difficulty in obtaining new and competitive renewal funding, is the increasing average length of grant awards (Fig. 3). The average length of a research project grant has increased from 3.3 years in FY 1983 to 4.2 years in FY 1990. This is a direct consequence of complaints by the research community over the burden that frequent reapplication for grants placed on productive scientists who were spending an increasingly large amount of time drafting grant proposals and less time conducting actual research. Scientists, it was decided, should be entrusted with funding for a longer period, and beginning in FY 1985, NIH embarked on an explicit policy of increasing the average length of research project grants. In addition, other special extended-length awards were developed, such as the five-year merit and first awards, and the seven-year Javits and outstanding investigator awards. In 1983, 17.6% of awarded research
Average Length of Award for RPGs
a 0 0
0 0
1983
1984
1985
1986
1987
1988
1989
Source: NIH FIG 3. Average length of research project grant awards from 1983-1990. The length grew from 3.3 years in FY '83 to 4.2 years in FY '90.
1990
average
186
ROBERT G. PETERSDORF
project grants were for five years or longer. By 1990, this figure had risen to 59.1%. Three-year awards, which in 1983 represented 69.6% of the grant pool, made up only 30.9% by 1990. Exacerbating the effect of increasing the length of awards was a coincident surge, peaking in 1987, of the number of new and competing renewal grants funded (Fig. 4). What we saw then was a synergistic effect in which out-year funding demands created by simply lengthening awards were enhanced by the sheer number of additional awards being injected into the system. Consequently, a progressively larger portion of the NIH extramural program was being devoted to out-year commitments (Fig. 5), represented in the figure by the "noncompeting" grants. In FY 1990, the year in which this trend was most pronounced, 77% of the grants funded were noncompeting continuations. As a result an ever-larger share of each year's NIH appropriation must be set aside for ongoing commitments to extramural projects. Of all the funds available for extramural research in FY 1990, over three-fourths were already obligated to out-years as noncompetitive renewals, restricting funds available for new entrants to the system or
NIH Research Project Grants: 1980-1991 New and Competing Renewal Awards 7-
6
5
_
I
V 7- 7
i&_ 'a°4
7X
I,
X,
7 7
1:: 2
I'
_
.2
z
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 191H
Fiscal Year Source: NIH FIG 4. New and competing renewal grants funded from 1980-1991. A surge in the number of new and competing renewal grants funded accompanied the increase in average award length, peaking in 1987.
CRISIS IN BIOMEDICAL RESEARCH FUNDING
187
NIH Research Project Grants New & Comp. Renewal
g Noncomp.
-,X.-
r77A
20 0
X C
15
a 6
711
71
7/1
7/
7-
t10 5
n
1982
1983 1984 1985 1986 1987 1988 1989 1990 1991
Fiscal Year
Source: NIH FIG 5. A comparison of the number of NIH new and competing renewal project awards with NIH funding for "noncompeting" grants. In FY '90 77% of the grants funded were noncompeting continuations.
for those coming back at the end of their grant period to compete for renewal. As a consequence, the number of new and competing renewals has dropped precipitously in recent years from approximately 6,200 in 1988 to 5,300 in 1989 and 4,600 in 1990. Theoretically, as the longerterm awards begin cycling out again, and their representation in the grant portfolio stabilizes, a new equilibrium should be established, which would relieve some of the current stresses. However, it seems unlikely that the equilibrium will be attained in the short term because both NIH and the Congress are implementing a policy objective of funding as close to 6,000 new and competing renewal grants as possible. This can only be done at an enormous price, with cutbacks in individual grant budgets as high as 20 to 25%. These four elements-modest post-inflationary growth in the NIH budget, the rising cost per grant, the escalating competition for awards,
188
ROBERT G. PETERSDORF
and, perhaps most importantly, the extension of award duration-have all contributed to a situation in which successful access to the NIH grant system has become greatly restricted. Times of trouble often unify people against a common problem, but in this case, there has occurred a disturbing fractionation within the biomedical research community. Internecine battles are being fought over issues such as indirect costs, facilities, training, and other elements of infrastructure which are perceived to compete with investigator-initiated projects. This is illustrative of how current funding exigencies have precipitated a tendency within our community to focus on the short term, on issues of immediate concern, without sufficient reflection as to what would be of most benefit to the national research effort in the long haul. This splintering is a serious matter and, in my view, represents as great a threat to the future of biomedical research as any of the funding problems. To achieve reconciliation within the community, there must be better analysis of the factors responsible for the problem, accompanied by the development of rational strategies to solve them. Some say the current situation could have been avoided had the NIH thought out more carefully the implications of its grant-making tactics. Others argue that the problem rests at a higher level, i.e., the current and prior administrations-by not assigning research, particularly biomedical research, a sufficiently high priority. Wherever ultimate responsibility lies, it is indisputable that NIH does not have an integrated, long-term strategy for research funding. Both the House Appropriations Committee and its Senate counterpart recognized this vacuum and proposed a plan for NIH. Table 1 shows the 10-point strategy developed for the NIH by the House Appropriations Committee in its FY 1991 appropriations report language. The Senate version had fewer elements, but reiterates concerns over the length of grants, total grant costs, and program balance. I will focus on the more explicit House plan (2). The primary concern expressed in the House plan was to promote stability and predictability within the NIH program. To achieve that objective, the House asked NIH to move over the next four years to awarding approximately 6,000 competing grants and to establish a stable total grant pool of 24,000. The House also asked NIH to develop mechanisms to ensure that the average length of a grant not exceed approximately four years and that increases in the average cost of a grant not exceed the BRDPI. A significant departure from current practice with important implications for peer review was a recommendation that review groups consider the total costs of a grant, including indirect costs, at all stages of review. Congress also asked NIH to eliminate downward negotiations, while
CRISIS IN BIOMEDICAL RESEARCH FUNDING
1. 2. 3.
4.
5. 6. 7. 8. 9.
10.
189
TABLE 1 House Funding Plan for the NIH Move over the next four years to a stable research grant pool of approximately 6,000 new (and competing renewal) grants and a total grant pool of 24,000; Provide necessary cost controls on the system by ensuring that the average length of a grant not exceed approximately four years and that the average cost of a grant not exceed the BRDPI; Consider the total costs of a grant, including indirect costs, at all stages of the grants review process; Eliminate downward negotiations (with review groups being more aggressive in stripping proposals down to the bare minimum); "Approve" grants on more stringent standards of scientific merit (rather than approving any grant with even technical merit); Fund research trainees at NAS-recommended levels; Limit center grants to 640, with inflation-based budgetary increases; Increase funding for other mechanisms according to inflation; Provide a contingency reserve fund to the NIH director for emergencies or unanticipated opportunities (to be split in future years between the NIH director and individual institute directors); Provide adequately for maintenance and repair of NIH facilities.
requesting that review groups be more aggressive in stripping proposals of unnecessary costs. The AAMC has traditionally opposed arbitrary cuts to study-section approved budgets and would be pleased to see elimination of downward negotiations. However, we hope that these and other more recent proposals do not lead study sections to consider cuts beyond what is scientifically appropriate. Out of concern that an excessive portion of submitted grant applications are being "approved" by NIH, Congress also has asked study sections to "approve" grants on more stringent standards of scientific merit (rather than just approving any grant with any degree of technical merit, as now occurs). Other recommendations made in the House report included: * funding research trainees at NAS recommended levels; * limiting center grants to 640, with inflation-based budgetary increases; * increasing funding for other mechanisms according to inflation; * providing a contingency reserve fund to the NIH director for emergencies or unanticipated opportunities (to be split in future years between the NIH director and individual Institute directors); and * providing adequately for maintenance and repair of NIH facilities. The NIH was not mandated to follow this plan to the letter and, in fact, has made minor modifications. However, for all practical purposes, the plan remains intact. The Institute of Medicine, the AAMC, the
190
ROBERT G. PETERSDORF
Federated Societies for Biology, and others have commented on the resultant NIH Management Plan and other issues, including, in the case of the IOM, emphasis on training and facility construction. All of this was placed on the back burner by the OMB and legislative proposals to cap indirect costs. This is a troublesome topic, full of arcane facts, that is beyond the scope of this discussion. The current funding problems are serious, and their impact on both individual scientists and the nation's biomedical research effort are significant. Quick fixes will not ensure a vigorous research climate in the years to come. We need to look long and hard at the future and ask tough questions about what it will take to stabilize all elements of our national research effort. I believe the greatest immediate threat to the future of biomedical research is academe's own lack of unity. All concerned scientists, whether as individuals, as part of societies, or as coalitions should make efforts that will lead to an informed understanding of the problems we face so that we may devise a unified approach to dealing with them. REFERENCES 1. National Institutes of Health, Office of Science Policy and Legislation, NIH Data Book 1989, December 1989. 2. National Institutes of Health, A Plan for Managing the Costs of Biomedical Research, June 1991.
