NIH at the Crossroads: Myths, Realities and Strategies for the Future
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NIH at the Crossroads: Myths, Realities and Strategies for the Future Elias A. Zerhouni, M.D. Director National Institutes of Health.

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NIH at the Crossroads: Myths, Realities and Strategies for the Future Elias A. Zerhouni, M.D.

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Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

NIH at the Crossroads: Myths, Realities and Strategies for the Future

Elias A. Zerhouni, M.D.

Director

National Institutes of Health


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

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


Nih budget facing a perfect storm in 2006

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%


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

NIH Budget:

Myths and Realities…


What is driving success rates

What is Driving Success Rates?

  • Is NIH placing more emphasis on applied as opposed to basic science

  • Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research?

  • Is it due to the Roadmap?


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

Basic and Applied Research

60.0%

56.4%

55.8%

55.2%

55.2%

55.2%

53.9%

56.6%

52.1%

56.1%

53.0%

50.0%

43.5%

41.0%

40.8%

40.5%

41.0%

39.8%

39.2%

40.0%

40.8%

38.5%

38.4%

30.0%

20.0%

10.0%

7.0%

5.7%

5.0%

5.5%

5.2%

4.8%

3.7%

3.1%

3.1%

3.6%

0.0%

FY 1998

FY 1999

FY 2000

FY 2001

FY 2002

FY 2003

FY 2004

FY 2005

FY 2006

FY 2007

Basic Research

Applied Research

Other


What is driving success rates1

What is Driving Success Rates?

  • Is NIH placing too much emphasis on translational science at the expense of basic research?

  • Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research?

  • Is it due to the Roadmap?


What is driving success rates2

What is Driving Success Rates?

  • Is NIH placing too much emphasis on translational science at the expense of basic research?

  • Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research?

  • Is it due to the Roadmap?


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

NIH Roadmap for Medical Research

FY2005 Request = $28,757M

  • Developed to increase synergy across NIH

  • Not a single initiative but over 345 individual awards in FY 2005:

    • 40% basic

    • 40% translational

    • 20% high risk

Non-Roadmap

99.2%

($28,520 Million)

Roadmap

0.8%

($237 Million)


What is really happening 3 fundamental drivers

What Is Really Happening?3 Fundamental Drivers

  • Large capacity building throughout U.S. research institutions and increase in number of tenure-track faculty

  • Appropriations below inflation after 2003

    • Increases of +3 % in ‘04, 2.2% in ‘05 and 0% in 06

    • Biomedical Inflation in 2004 was ~ 5%

  • Budget cycling phenomenon


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

+8,359

+8,303

New Grant Applications and Success Rates During and After Doubling Period

35%

60,000

49,656

30%

31%

50,000

43,069

25%

40,000

Projected

22%

20%

Number of Applications

% Success Rate of Grants Funded

30,000

19%

24,154

15%

20,000

10%

10,000

5%

0%

0

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Success Rates

Applications


As many applicants in past 2 years as during previous 5 years

As Many Applicants in Past 2 Years as During Previous 5 Years!

5334

5208

26583 - 21249

31791 - 26583

(2003) – (1999)

(2005) – (2003)

Period of doubling


The budget cycling phenomenon what funds are available in any one year

The Budget Cycling Phenomenon:What 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


Nih congressional appropriations

NIH Congressional Appropriations

$30

$28.6

$28.6

$28.6

$28.0

$27.1

$25

?

$23.3

$20

$20.5

$17.8

$15

Billions of Dollars

$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


The bottom line demand for grants took off just as nih budget was landing

The Bottom Line: Demand for Grants “Took Off” Just as NIH Budget Was “Landing!”

  • NIH managed well despite small increases in 2004 (2.9%) and 2005 (2%) by shifting “one time” funds from 2003 to 2004

  • Budget cycling effect will improve demand vs supply of grants in 2007 but we need to educate public about need for sustainability in research


The question on everyone s mind what are my chances of being funded

The Question on Everyone’s Mind:What are MY chances of being funded?


Payline is not funding cut off line

>99% of grants under the

payline are funded

Payline

Success Rate

per application

-

75

50

-

25

-

Payline Is Not Funding Cut-off Line

-

100

Percent R01s Funded

0

0

10

20

30

40

Percentile Score


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

27.6%

22.3%

Success Rate per Application Understates Funding Rate per Applicant

40%

Applicant

35%

30%

25%

Applications

Success Rate for R01 Equivalents

20%

15%

10%

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


Where do we go from here adaptive strategies a vision for the future

Where Do We Go From Here?Adaptive Strategies A Vision for the Future


Strategies

Strategies

  • First: Know the facts

  • Second: Develop adaptive strategies

    • Protect the essential:Knowledge and Discovery

    • Increase number of competing grants (supply/demand management)

    • Support new investigators

      • New Pathway to Independence Program

      • Institutes and Centers efforts to assist new investigators

  • Third: Convey a unified message

    • Increase communications about positive impact of NIH at local, regional and national levels

  • Fourth: NIH’s exciting vision for the future


Biomedical research has delivered

500

  • 63% decrease in Mortality

  • ~ 1 million early deaths averted per year

  • $2.6 trillion in economic return

  • New, effective treatments and prevention strategies

Average investment

per American

~$3.70

per year

~ 1,329,000 Projected

Deaths in 2000

400

300

Deaths per 100,000

200

~ 514,000 Actual

Deaths in 2000

100

50

55

60

65

70

75

80

85

90

95

00

Year

30-year investment

per American:

~$110

Total

Biomedical Research Has Delivered

Coronary Heart Disease


Biomedical research has delivered1

30-year investment

per American:

~$260

Total

  • For the first time in recorded history, annual cancer deaths in the United States have fallen

  • 10 million survivors

  • Advent of early detection and screening

Average investment

per American

~$8.60

per year

9

6

Millions of People

3

1971

1986

1990

2003

Biomedical Research Has Delivered

Cancer


Basic discovery today provides the foundation for tomorrow s medicine

Basic Discovery Today Provides the Foundation for Tomorrow’s Medicine

Clinical

Applications

Translational

Research

Basic Research

and

Technology Development


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

Participatory

The Future Paradigm:

Transform Medicine from Curative to Preemptive

Predictive

Personalized

Preemptive


Nih at the crossroads myths realities and strategies for the future elias a zerhouni m d

Transforming medicine through discovery

NIH


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