Funding Health Sciences Research A Strategy to Restore Balance (1990) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-24
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Before World War II, industry and private foundations were the prima~y sponsors of U.S. health-related research.
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This "stabilization policy" explicitly made individual investigatorinitiated research project grants the highest priority for NIH and ADAMHA Starting with fiscal year 1981, a minimum number of 5,000 new and competing awards was established for NIH; after some compromises between the administration and Congress, 345 were established for ADAMHA This policy of establishing minimum numbers of new and competing awards was pursued for the following 7 years, during which time new and competing NIH research grants awarded annually grew to all time highs reaching 6,400 by 1987. Similarly, annual grant awards from ADAMHA grew to nearly 600 in the same period.
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These trends have further suppressed the proportion of approved grants that were funded from approximately 35 percent in 1988 to less than 25 percent in 1990. Even those scientists fortunate enough to receive project funding have seen downward negotiation cut deeper and deeper into their awards; scientists no longer see a direct relationship among the recommended funding levels approved by the peer review system, the grant awarded by the National Advisory Council, and the amount of funds actually received.
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The committee was not charged with reviewing the allocation of research support among specific scientific disciplines or disease areas, nor was this policy study intended to be a justification for increasing research funds. Rather, the goal of the study was to ensure that, at any given level of support, allocation policies would enable the scientific community to utilize available resources in the most efficient manner so as to create an optimal research environment and achieve society's goals for research into human disease.
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This environment should: · identify and encourage young talented individuals to pursue health research careers, · provide stable research support for talented scientists throughout their careers, ~ offer flexibility in allocating resources to foster creativity and meet changing demands, and · provide adequate modern laboratories and equipment necessary for scientific research and training. These attributes, in turn, will require effective coordination and leadership from the federal research agencies; competent, objective public and private sector administration; and responsiveness to the wishes of the American people through the political process.
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the total appropriations to all federal agencies receiving funds for health sciences research, including NIH and ADAMHA; · the allocation within each institute of NIH and ADAMHA for research and training needs; the allocations within specific research program areas; · the allocation of awarded grant funds for a specific research project contributing to the goals of the research program; and · the total allocation of funds to universities, hospitals, and research institutions that will assume fiscal responsibility for the funds, administer them, and provide the infrastructure for the research projects. Each program area within each institute or agency has specific needs to address in order to accomplish its mission at any given level of support.
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REBAIANCING HEALTH SCIENCES RESEARCH FUNDS Recommendation 2: The committee recommends that NIH reallocate its extramural health research funds over the next ten years. The committee concluded that allocation policies over the past two decades have forced an overall imbalance in the health sciences research system in which support for research project grants has been heavily favored at the expense of training and facilities.
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1. No Real Growth: Even in the event of no average real growth in the health sciences research budget during the 1990s, the committee recommends that funds for training future generations of health scientists be increased incrementally from 4.20 to 5.75 percent of the total extramural research budget by 1995 and to 6.75 percent by the year 2000.
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2. Iwo Percent Real Growth: In the event that the health sciences research budget grows, in real teens, an average of two-percent annually, the committee again recommends that funds be reallocated to training and facilities in the same proportions as in the zero growth scenario training funds increased incrementally from 4.20 to 5.75 percent of the total extramural research budget by 1995 and to 6.75 percent by 2000, and extramural construction funds increased incrementally from the present 0.25 percent of the extramural budget to 0.50 percent by 1995 and through the end of the decade.
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3. Four Percent Real Growth: In the event that the health sciences research budget grows on an average of four percent annually, the committee Commends that funds for training be incrementally increased from 4.20 percent to approximately S.4 percent of the total extramural research budget by 1995 and to 6.2 percent by 2000.
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However, even in the event of no-real growth in the federal health research budget, the committee firmly endorses that incremental increases in training funds be reallocated from the nominal increases in the overall extramural budget (funds not adjusted for inflation)
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TALENT RENI:VVAL Recommendation 3: The committee recommends an approach to restore balance in the development of talent through a broad spectrum of incentives and encouragements. The long-term success of the health research enterprise depends on the continuous development of a cadre of well-trained, creative scientists.
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Most importantly, direct fellowship awards to students would provide a strong signal that the student is an integral and valued member of the health sciences research enterprise, thus enabling more aggressive recruitment of students into postbaccalaureate health sciences education and training. Recommendation 3.4: The committee recommends that the number of physician investigators active and in training be assessed.
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The committee feels that the recently created First Independent Research Support and Transition FIRSTS Awards are moving in the right programmatic direction for providing our young scientists entry into the competitive traditional grant system (Rem. Considering the nature of the FIRST award, the committee does not feel that the progress of these awardees should or could be comparable to that required in the traditional R01 system.
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Rollover funding: This first transitional scenario would apply to research project grants awarded for periods of 5 or more years. An NIH/ADAMHA review of competing renewal applications would be convened two years before grant termination (e.g., in year 4 of a 5-year grant)
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A sliding-scale funding mechanism could reinforce and protect the best research projects and reduce the suffering from downward negotiation throughout the system. It also would increase the opportunity to sponsor high quality research proposals that are increasingly falling just below an arbitrarily established pay line.
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Between fiscal years 1989 and 1990, the BRSG program suffered a cut of $11 million, its budget declining from $55.2 to $44.4 million, and it is the target of further reductions in the proposed 1991 budget to $17.7 million. The committee feels that this small commitment
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Recommendation 5.2: To allow greater flexibility for institutions to address their own facilities needs, the committee recommends that the sponsors of health research modify indirect cost calculations in the followding ways: 1. The federal government should change federal grant accounting procedures to allow negotiation of separate line items in the IDC recovery rate for facilities renovation and construction separate from that of administrative and library costs.
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The committee links this suggested policy change to one that research institutions limit their IDC rates to current levels, and that they sequester the reimbursed facilities and equipment funds in accounts that will ensure rehabilitation or construction of research buildings and replacement of equipment. Furthermore, this policy change could allow research institutions the flexibility to set their own priorities within their budgets for IDC recovery.
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Growing federal deficits, earmarking of funds to meet specific health needs, and rigid allocation policies within the health sciences establishment have reduced flexibility within the system. These problems emphasize the need to review federal priorities and coordinate federal health sciences research efforts.
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of the National Academy of Sciences be established to review the support of health sciences research on an ongoing basis and to facilitate communication among the various sectors that support health sciences research. The vitality of the health sciences research enterprise depends not only on federal government activities but the cooperation of all parties involved in health sciences research: universities, independent research institutions, and the private sector (foundations, voluntary health organizations, and corporations)
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Traditionally, foundations and voluntary health agencies have been key supporters of interdisciplinary or innovative projects, or those that for political or other reasons are difficult to support with federal funds. These organizations can respond to new lines of inquiry faster than the government bureaucracy allows.
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Health research is a longterm investment, and scientists need to express their views to governmental representatives so that Congress and the Executive Branch can set national research priorities. Scientists also have a responsibility to serve on peer review panels; to review journal articles; and to provide advice on policy boards of the federal government, private foundations, and charitable organizations.
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Effective and longer-term corrections will be made only when those who are examining the issues have the authority to act on their conclusions as well. Therefore, the committee believes that in order to begin to resolve the problems discussed in this report and to make the best use of available research funds, ongoing communication among all research sponsors and the whole of the scientific community is vitally important.
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