NIH at the Crossroads: Strategies for the Future

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NIH at the Crossroads Strategies for the
Future Elias A. Zerhouni, M.D. Director National
Institutes of Health
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Institutional Development Award (IDeA) Program

• Broadens geographic distribution of NIH-funded
  research
• Fosters health-related research in states where
  aggregate success rate for applications is
  historically low
• Increases competitiveness of investigators
  through support for faculty development and
  enhancement of institutional research
  infrastructure

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Role of IDeA Program Cited by BIO Smaller states
that have not traditionally invested in
developing their bioscience base are beginning to
do soactivities in states with smaller
bioscience RD bases have been spurred, in part,
by their participation in NIHs BRIN and IDeA
programs.
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IDeA States
23 States Puerto Rico
23 States Puerto Rico
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Increased NIH Funding to the IDeA States
1,750
1,556
1,500
1,518
1,458
1,250
1,000
1,029
Millions
881
750
699
595
500
595
555
462
463
461
424
210
214
222
160
250
100
40
5
10
1
1
1
2
2
0
'93
'94
'95
'96
'97
'98
'99
'00
'01
'02
'03
'04
'05
Fiscal Year
IDeA Program Funds
NIH Awards to IDeA states
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Scientific Highlights from the IDeA Program

• IDeA Networks of Biomedical Research Excellence
  (INBRE)
• New peptide technology as potential therapeutic
  for cancer and stroke
• Gender-specific neurological discoveries
• Centers of Biomedical Research Excellence (COBRE)
• Myelin sheath regeneration may improve nerve
  function
• Identified of new pore in vascular smooth muscle
  as a target for treating stroke
• Thyroid hormone levels linked to congestive heart
  failure

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IDeA and Beyond NIH Funding Across the U.S.
Alaska
Data Assoc of University Technology Managers
(AUTM) Survey 2004
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NIH FundingWhat is happening, why, and
strategies for management
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NIH Budget Facing a Perfect Storm in 2006

• Federal Trade Deficits
• Defense and Homeland Security needs
• Katrina
• Pandemic flu
• Post- Doubling effects
• Physical Sciences focus
• Biomedical research inflation 3 to 5

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• Competition for funds from the NIH and other
  sponsors, intensifying year by year, now stands
  at an unprecedented level, and shows no sign of
  abating. Never before have so many established
  investigators faced so much uncertainty about
  their longevity as active scientists. Never
  before have so many novices faced so many
  disincentives to entering or continuing a
  research career.

Dr. William F. Raub, NIH Associate Director for
Research and Training, strategy paper, 1982
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The budget of NIH has doubled - but -
Success rates have dropped by a thirdWhat is
happening?
The Apparent Paradox
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What Is Really Happening?

• Facilities building and faculty growth throughout
  U.S. research institutions
• 100 growth in applications and 75 growth in
  applicants per year by 2007
• Budget appropriations below inflation since 2003
• Budget cycling phenomenon

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Investment in Research Facilities at U.S. Medical
Schools
10
9.5B
8
6
Dollars (in billions)
5.4B
4
3.2B
2
0
1990-1997
1998-2002
2003-2007
Year
AAMC Survey of Research Facility Investments
(99 of 125 AAMC Member Schools)

Data Based on AAMC Faculty Roster
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New Grant Applications, Applicants and Success
Rates During and After Doubling Period
Projected
35
60,000
49,656
30
50,000
43,069
25
40,000
34,811
20
Success Rate of Grants Funded
30,000
Number of Applications/Applicants
31,791
24,154
15
20,000
10
19,663
10,000
5
-
0
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Success Rates
Applications
Applicants
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New Grant Applications, Applicants and Success
Rates During and After Doubling Period
Projected
35
60,000
49,656
30
50,000
43,069
25
40,000
34,811
20
31,791
Success Rate of Grants Funded
30,000
Number of Applications/Applicants
24,154
15
20,000
10
19,663
10,000
5
-
0
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Success Rates
Applications
Applicants
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What are My Chances of Being Funded? Success Rate
per Application Understates Funding Rate per
Applicant
40
Applicant
35
30
25
Success Rate for R01 Equivalents
Applications
20
15
10
Percentile Payline does not Equal Success Rate
5
0
1995
1997
1999
2001
2003
2005
Fiscal Year
Success Rate files as of May 3, 2006. Program
srf_indiv_060103_rfm Individuals are determined
using the pi_profile_person_id in IMPAC-II
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Inflation Eroded Gains in NIH FundingReal and
Nominal NIH Funding Levels Since 2003
30
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Nominal funding
28
27
Billions of Dollars
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Adjusted by BRDPI
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7.3 loss in purchasing power since 2003
24
23
22
FY 2003
FY 2004
FY 2005
FY2006
FY2007
Note BRDPI is the Biomedical Research and
Development Price Index
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The Budget Cycling PhenomenonWhat Funds are
Available in any One Year?
From current year to previous year
Budget Increase
Uncommitted Funds
From ending grants started 4-5 years ago
Continuing grants
Committed Funds
NIH Appropriations
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NIH Congressional Appropriations
30
28.6
28.6
28.6
28.0
27.1
25
?
23.3
20
20.5
17.8
Billions of Dollars
15
15.6
13.7
10
5
0
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
DOUBLING
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The Bottom Line Demand for Grants Took Off
Just as NIH Budget Was Landing!

• Post doubling boom in applications has led to
  a supply/demand imbalance
• Success rate drop is due to
• Near 100 increased demand
• for grants
• 40 increased costs of grants
• Decrease in inflation adjusted
• budget
• Budget cycling effect will slightly improve
  supply vs. demand of grants in 2007 and beyond

Applications
Budget
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Where Do We Go From Here?
Adaptive Strategies based on key principles
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Principle 1Protect core values and mission
Discovery and Generation of New Knowledge
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Balanced National Biomedical Research Portfolio
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Principle 2 Protect the Future

• Launched new Pathway to Independence Awards
  150 - 200 per year.
• Each Institute and Center asked to develop
  policies appropriate to the circumstances for
  each new investigator.
• New peer-review pilot allows new investigators to
  re-apply within five months instead of typical
  nine months.

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Principle 3Focus on Balancing Supply/Demand

• Actively manage supply/demand imbalance by
• adjusting programs
• Recycle budgets into larger number of competing
• grants (3 in 2007)
• Prioritize projects to maintain reasonable
• investigator-initiated success rates
• Maximize research and development activities by
• managing costs across all portfolios
• Facilitate peer-review processes to reduce need
• for multiple applications

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Principle 4Proactive Communication about
Investment in NIH

• For the first time in recorded history, annual
  cancer deaths in the United States have fallen
• 10 million cancer survivors
• Improved effectiveness of early cancer detection
  and screening
• Thanks to the doubling, new targeted, minimally
  invasive treatments for cancer multiplied
• New drugs developed for cancer prevention

Survivorship
9
6
Millions of People
3
1971
1986
1990
2003
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Principle 5 Promote NIHs vision for the future
Predictive
Preemptive
Personalized