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NIH Budget Increase on One Hand, Fewer Outputs on Another

I love reading the news posts in Nature and Science that I
receive in the journal’s eAlerts. This past month was most interesting because
there were two news posts that I thought were actually a bit contradicting. The
first one titled “Spending bills put NIH on track for the biggest raise in 12
years” was published in July of this year and explains how both houses of
congress want to increase the National Institutes of Health’s (NIH) annual
budget (Kaiser, 2015a). The Presidential branch wants to give the NIH a 1
billion dollar increase while just recently, a Senate panel approved a 2
billion increase. The article also goes onto say that certain programs have
been given priority such as the Alzheimer’s research and others like the Agency
for Healthcare Research and Quality will receive cuts. Needless to say, I am
sure that biomedical and behavioral scientists throughout the country are
probably ecstatic. But is this really a good thing?

The other news blurb I read was titled an “A for effort,
C for impact from U.S. biomedical research, study concludes” also written by
the same author (Kaiser, 2015b). In this article, Jocelyn Kaiser reports the
results of a study by two research scientists Dr. Arturo Casadevall and Anthony
Bowen who examined publications in the PubMed database and the number of
authors, along with the approval of new drugs and their work was published in
the journal
Proceedings of the National
Academy of Sciences (USA)
. The researchers compared publication outputs
with the number of new molecules approved by the U.S. government. What they
found was not too surprising. They showed that while the annual publications
have grown 6 fold and the number of authors 9 fold in the past 10 years, the
number of new drugs approved only doubled (Kaiser, 2015b). The researchers also
measured gains in U.S. life expectancy which have been modest. Now we need to
take this information with a grain of salt. First, the NIH, while it has made
efforts to increase the translation of research into products and services,
still remains a basic science funder. Second, one cannot expect a 1:1 increase
in knowledge output and translation into a drug. There is a “loss in
translation” due to many reasons which are that not all new molecules end up
translated into drug products and translation is a process that involves many
other variables and taking a drug to the market is a much longer and difficult
process than discovering a new molecule. So the fact that there is not a
similar 6 fold increase in articles and only a 2 fold increase in drugs to the
market is not surprising.

Despite there not being a direct translation of basic
discovery, the question remains whether increasing the NIH budget is a good
idea. The doubling of the NIH budget which was completed in 2003 and has
resulted in an increase in the number of PhD, more and longer post-docs,
insufficient research-based positions at the faculty level, increase in mean age
of first-time NIH R01 winners, decrease success rates in obtaining NIH research
funds among a host of other issues. Many have touted this as being a major
problem creating a hypercompetitive environment which is unsustainable (Alberts
et al., 2014). And I believe much of these problems have started because the
NIH budget doubled. Bruce Alberts and colleagues wrote a provocative paper,
also published in
Proceedings of the
National Academy of Sciences (USA)
last year, which explains strategies to
help sustain the current biomedical workforce in the U.S. Their recommendations
along with some of mine with my colleague Dr. Brian Martinson include how to
increase early career scientists beginning to develop research programs while
simultaneously sustaining research programs of mid-career scientists. Ensuring
universities and colleges have more permanent, scientific positions. Perhaps
also placing caps on the number of soft-money (based on grant support) doctoral
students and post-doctoral fellows are being produced so the number of entry
scientists balances exiting scientists such that they have promising job
prospects. Now this doesn’t mean we shouldn’t increase the NIH budget. I am a
proponent of basic research and encourage research output. But we need to be
mindful that the same slipup we had before with the doubling of the NIH budget
over a decade ago will not happen again. So NIH, universities and colleges, and
individual scientists need to devise strategies on how best to handle the
increase in NIH budget so we can sustain the current biomedical workforce.


Alberts, B., Kirschner, M.W., Tilghman, S. and Varmus, H.
2014. Rescuing US biomedical research from its systemic flaws.
Proceedings of the National Academy of
Sciences (USA)

Bowen, A. and Casadevall, A. 2015. Increasing disparities
between resource inputs and outcomes, as measured by certain health
deliverables, in biomedical research.
of the National Academy of Sciences (USA)
. Advanced online publication doi:

Kaiser, J. 2015a. Spending bills put NIH on track for the
biggest raise in 12 years.
Science 349:12-13.

Kaiser, J. 2015b. A for effort, C for impact from U.S.
biomedical research, study concludes.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.

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