So far, the National Institutes of Health is hunkering down. Staggered by a looming 5-percent cut after years of flat budgets, higher education’s top provider of basic research money insists there’s no place it can reasonably scale back.
“It’s not the case that there’s fat left in the program,” declared NIH Director Francis S. Collins, just before the sequestration budget cuts took effect this month.
Provided with $31-billion a year by taxpayers, the NIH runs about as lean an operation as could be imagined, and any reductions will unavoidably harm the nation’s scientific output, Dr. Collins said.
The nation’s top provider of basic research money to universities earns considerable respect for the job it does. The NIH is “head and shoulders” better than other U.S. and foreign science agencies in the quality of its project analyses and the resulting science, said Richard H. Ebright, a professor of chemistry and chemical biology at Rutgers University who has worked with many such agencies domestically and abroad.
Yet as the reality of lost jobs and shuttered university laboratories begins to take hold, NIH advocates like Mr. Ebright are quite ready to point out to Dr. Collins the places where his agency—even if they feel deeply that it’s one of the last parts of the federal budget that deserves a cut—may in fact have some trimmable fat.
Finding efficiencies is not a new discussion for the NIH and its university partners. It’s just become a lot more urgent. Since having its budget doubled between 1998 and 2003, the agency hasn’t had an increase above inflation other than the one-year stimulus infusion of 2009. Now sequestration means an immediate 5-percent cut, at a time when many universities are trying to figure how to keep the staffing commitments they made when the doubling encouraged them to bulk up their research hiring and building construction.
“If there’s any silver lining to this crisis,” said Paula E. Stephan, a professor of economics at Georgia State University who specializes in science policy, “it’s that it’s going to make believers of a bunch of people that they’re going to have to do something.”
‘Low-Hanging Fruit’
One big target suggested by many scientists who compete for NIH grants is the agency’s own intramural program, largely involving research by government scientists at NIH’s headquarters in Bethesda, Md. It accounts for about 10 percent of the NIH budget.
Some of that program draws on centralized resources that arguably belong in a single location, like the world’s largest clinical hospital. Much of it, though, consists of small laboratories similar to those found on many university campuses.
“I’d be surprised if it’s less than half of the intramural program” that really deserves protection from cuts because it fills a unique need, said Pierre Azoulay, an associate professor of management at the Massachusetts Institute of Technology, who studies how organizational design influences the productivity of research in the health-care sector. “That’s the low-hanging fruit” for efforts to make NIH more efficient, he said.
Another target for productive budget-cutting could be the agency’s large “center grants,” in which NIH officials designate projects or fields of study and then solicit teams of outside researchers—often based at universities—who would be willing to carry them out.
Again, there may be some instances where a big-team approach and specialized facilities are justified, Mr. Ebright said. But intramural research is “very considerably weaker” than outside work, and center projects typically mean collaborations so large they have little or no competition, he said. Subjecting them to broad competition might give the NIH a 5-percent gain in scientific productivity, he said.
Others would take the hunt for efficiencies in the opposite direction. Ferric C. Fang, a professor of laboratory medicine and microbiology at the University of Washington, said researchers he knows in the intramural program are actually highly productive, in part because they can focus on the big picture rather than the nitty-gritty pursuit of grants. “Making them inefficient by making them waste all their time like we do—that would be petty, and it wouldn’t really achieve anything for science,” Dr. Fang said.
Local Model
In that regard, one compelling model may be just down the road from the NIH at the Howard Hughes Medical Institute, the nation’s largest private provider of health research money. The medical institute gives grants to highly rated researchers without requiring that specific projects be identified in advance.
Adopting that “people not projects” approach could save both the NIH and university researchers large amounts of the time and money they spend in the current grant-review process, said John P.A. Ioannidis, a professor of medicine and health research and policy at Stanford University.
Advocates of that approach include Erin K. O’Shea, a professor of molecular and cellular biology and chemistry and chemical biology at Harvard University who takes over in July as vice president and chief scientific officer at Howard Hughes.
The NIH grant process—with its emphasis on proposals, checkpoints, and follow-up reviews—is a result of government agencies’ needing to demonstrate accountability, Ms. O’Shea said. But in practice, it means researchers do their work before asking NIH to finance it, she said. “Great science doesn’t lend itself to that sort of projecting forward,” she said.
The NIH Director’s Pioneer Award, given to scientists rather than projects, is a fairly explicit attempt to mirror the HHMI approach, said Jeremy M. Berg, an associate senior vice chancellor for science strategy and planning at the University of Pittsburgh, and former director of the National Institute of General Medical Sciences.
But it’s relatively small, and in practice it has ended up looking much like a traditional grant, Mr. Berg said, as the NIH—being so much bigger than HHMI—faced an abundance of researchers in its much broader range of qualification, and often ended up choosing on the basis of project ideas.
The NIH grant-review system has clearly evolved to discourage risk, said Ms. Stephan of Georgia State, who is author of How Economics Shapes Science. A key element is the expectation of preliminary results, which can take years to compile, often leaving scientists at middle age when they get their first NIH grant, she said.
“Putting so much emphasis on preliminary results is just a killer in the system,” Ms. Stephan said.
One result is that randomness dominates the grant-review process, leading many scientists to feel the best strategy is just to flood NIH with as many applications as possible, wasting time and money for both scientists and the agency, Dr. Ioannidis said. And those who succeed aren’t necessarily brilliant scientists but people “who know how to pay their dues,” he said.
Financing Breakthroughs
Mr. Azoulay conducted a study of the HHMI system in 2010 and drew a mixed conclusion, suggesting NIH might want to more aggressively test at least some of HHMI’s methods. He backed Mr. Berg’s sense that the evaluation and monitoring processes essential to a “person not project” style of awarding grants is too resource-intensive to work at the NIH.
Also, HHMI succeeds in part because it is just one element in an overall ecosystem of scientific discovery, Mr. Azoulay said. The NIH concentrates on financing the “thousands of incremental refinements” essential to realizing the full value of a breakthrough discovery, and the overall enterprise would be weaker if NIH emphasized duplicating HHMI’s role, he said.
But, Mr. Azoulay said, the longer duration of HHMI grants—five years, commonly extended to 10, as opposed to an average of three to four years for NIH grants—seems much better for giving scientists the confidence and freedom to follow through on meaningful projects.
Dr. Collins, in particular, has been enthusiastic about big projects. Just last month, he outlined administration plans to spend $3-billion over 10 years on a major initiative to map the human brain.
Large-scale science projects do have their value. The Human Genome Project, which Dr. Collins helped lead during the 1990s, is one of the best examples. The total taxpayer investment of $3.8-billion in the project has been estimated to have returned the country nearly $800-billion in economic activity.
The Human Genome Project, though, may be an exception, Mr. Berg said. With many of the larger NIH programs, “the bang for the buck is not what it should have been,” he said.
As the sequestration budget cuts bite down on the NIH, those hoping for greater NIH efficiency include Frederick Sachs, a professor of physiology and biophysics at the University at Buffalo whose decades of work on the mechanical sensitivity of cells have helped with therapies for conditions that include muscular dystrophy and atrial fibrillation. The NIH may not have money for his latest NIH grant application, and one of his lab’s two senior staff members is already looking into selling his house and moving away.
Mr. Sachs conducted a study of the NIH’s budget doubling years ago, and found no difference in the number of research publications before, during, or after the period. Most of the added money went to faculty salaries and university bank accounts, Mr. Sachs said.
That, he said, shows that the agency should keep issuing the same number of grants, and simply reduce the value of each grant as necessary to fit the overall NIH budget. That will still leave money to pay the most important members of each lab—the younger researchers whose careers are in danger of being snuffed out by NIH budget cuts. The senior staff and the universities, he said, will manage.