The National Institutes of Health needs to better balance funding distributions among US institutions

Abstract

The NIH is the federal steward of biomedical research in the United States. Taxpayers fund the NIH; the NIH supports research into the underlying biology, etiology, and treatment of diseases; and benefits of that research are returned to taxpayers. This is a large and complex enterprise, but at its core are two fundamental principles. The NIH is obligated to distribute its research grants and grant dollars in a fair and impartial manner among qualified investigators nationwide and to maximize the return on taxpayers' investments. But to meet these obligations, the NIH must establish a better-balanced distribution of funding among institutions. Here, I describe why such changes are needed and propose a specific mechanism for how they could be implemented. Diversity Matters The director of the NIH, Francis Collins, has recognized that "the US biomedical research workforce does not currently mirror the nation's population demographically" and that "recruiting and retaining a The NIH should rethink how it doles out funding. Studies indicate that research output does not grow linearly with the amount of research project grant support-and that the greatest rates of return are achieved with intermediate levels of funding. Image credit: Dave Cutler (artist).

Looking back on a life of unacknowledged privilege and a call to action

“…Unconscious and conscious biases operate in two directions: biases against certain groups based on race, perception of their institution, and pedigree are important and insidious and work side by side with similar, likely equally powerful biases in favor of folks who look like us, in race, institution, and pedigree. This is the arena where the Matthew effect is most powerful, a thought supported by the data (e.g., Wahls, 2019). Each early advantage makes the next step a little easier.…”

Optimal Allocation of Research Funds under a Budget Constraint

“…51 NIH's decision process about which applications to fund considers many factors. 52,53 The NIH states that it funds research awards ''taking into consideration input from their staff, the results of the scientific peer review of the grant application, public health need, scientific opportunity, and the need to balance its scientific portfolio.'' 54 By valuing research studies across different diseases on common terms using EVSI, and accounting for the changes in EVSI as a function of research investment, our portfolio approach can support the NIH and similar entities in funding highvalue research at optimal levels of investment.…”

NIH funding trends to US medical schools from 2009 to 2018

“…This perspective also does not address the inevitable wasted intellectual capital when talented young students and faculty are unable to access adequate research training and support. In addition, scientific productivity of highly-funded institutions decreases with increased research funding as measured by the number of publications and their aggregate citation ratios per dollar of research project grant funding [4,5].…”

“…However, it is unclear if the additional funding has been distributed proportionately. Recent publications have raised concerns that NIH support has become increasingly concentrated in the hands of a select group of institutions, exacerbating funding disparities rather than bridging them [4,5].…”