Scientists, others hold out hope that Obama will fix the "broken pipeline"

New administration needs to raise NIH funding

America's scientific and research future has looked grim because of under-funding for the past five years, but it could turn around again under President Barack Obama's new administration.

At least that's the hope shared by research experts, including several of the authors of a report about America's "broken pipeline" in research.

Scientists have been giving testimony before Congress for more than a year about how flat-funding of the National Institutes of Health (NIH) has led to a crisis in the research community. At a March 11, 2008, meeting of the U.S. Senate Committee on Health, Education, Labor and Pensions, the nation's top research institutions released a report, titled, "A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk."

The flat funding follows on the heels of NIH's budget doubling between 1998 and 2003. This earlier financial increase had led to many biomedical improvements and new therapies, resulting in a host of medications being studied now in clinical trials, according to Senate testimony at the March meeting. (See chart on funding facts of NIH.)

Since 2003, the funding has been eroded, and the opposite impact is being felt, researchers say.

"What distinguishes the current climate at NIH relative to other periods of tight spending historically is the length of time this has been going on," says Larry S. Schlesinger, MD, a professor of medicine and director of the Ohio State University (OSU) Center for Microbial Interface Biology in Columbus.

"This spending trend has had more impact over a longer period of time, and we're seeing more consequences as a result," Schlesinger says. "Young, outstanding scientists have now been in the business of trying to get a first grant for a protracted period, and this is clearly influencing their productivity and, most importantly, their confidence in going forward in their careers."

Research institutions have employed a variety of strategies to keep young researchers on track, but they're fighting an uphill battle, Schlesinger says.

The big chill

The NIH spending crunch has had a chilling effect on bringing new physicians and scientists into the field of basic research, and it likely will have a long-term impact on clinical trial research, as well, Schlesinger and others say.

"In the current situation we're losing not only young investigators, but also established investigators," says William Lawson, MD, an assistant professor in the division of allergy, pulmonary, and critical care medicine at Vanderbilt University in Nashville, TN.

Lawson is a junior faculty member who received NIH funding through a mentor grant program, which is a grant that helps young investigators get started.

While he has made his start, Lawson says he's concerned about how many very talented young investigators are leaving the research field out of frustration over how long it is taking to receive NIH grants.

"Young investigators are getting out of research completely or are going into private practice or are pursuing industry-sponsored jobs where they are not necessarily doing investigational or discovery research," Lawson explains.

"The world's experts may weather the storm and survive the process, but it's the people who are trying to break through right now who are at real risk of being lost in the shuffle," Lawson says. "So 20 years from now when my group should be the world's experts, we may be looking at a much smaller group of people."

Potential young scientists are seeing their colleagues struggle to obtain NIH grant funding, and so many are saying "no" to research and going with the offers they receive in clinical work instead, notes Pampee Young, MD, PhD, an assistant professor in the department of pathology and medicine at Vanderbilt University.

Young also has received a grant from the NIH, but she says that time is running out for many of her colleagues.

When young researchers are hired as an assistant professor, they're given three years to establish a research program, and they're expected to bring in a lot of extramural funding in that three-year period, Young explains.

Young researchers will apply for NIH grants, but their applications are not as competitive as those submitted by senior researchers because they haven't had time to develop their research program, she adds.

"So these often do not get funded," Young says. "The funding rate at any one cycle is around 10%, so 90% of us won't get funded."

They resubmit a grant proposal after spending months working on it, and then again wait for an answer from the NIH, she says.

"You become increasingly anxious because your clock is running out," Young says.

"Many of my colleagues have passed this three-year window, and they're getting gift funds from the university," Young adds. "But they're given the message that they have a very short time to turn this situation around, or else they're out of a job."

The lost generation?

This is why NIH's flat funding has had such a devastating effect on a generation of young researchers and why its long-term impact will negatively affect clinical trial research, as well, the experts note.

"Basic science provides the pipeline for clinical science," Young says. "If you leave off basic discoveries, then clinical discoveries are based on trial and error, and clinical science won't be built on a true understanding."

The funding problems might be resolved under the Obama administration and a presumably more sympathetic congress. But experts are concerned about the timing of any requests for extra funding given the bad economy, banking and automotive company bailouts, and Obama's stated priority of focusing on investing in renewable energy.

"If you look at what Obama said, he wants to double NIH funding," Young says. "But nobody said where the money was going to come from, and the worry is there are so many pressing needs simultaneously that I don't know where we're going to be in the hierarchy of needs."

Young attended the Senate committee meeting, which was chaired by Sen. Edward Kennedy, and she believes the committee was very supportive.

"I think most people will understand that the kind of health care we get in our country, the kind of innovation we get in terms of health care progress are amazing, and we all benefit from that," Young says. "It's expensive, but it's just a matter of where our priorities are."

The new presidential administration and Congress should come up with a plan that will allow the NIH to grow in a reasonable fashion that mirrors the health care requirements of our population, Lawson suggests.

"So as this new administration looks at this they should keep in mind that we need a long-term strategy for the NIH and not a quick-fix strategy," Lawson says. "Research discoveries take time, and it takes time to develop a researcher and research career."

While Lawson and other researchers say they hope to see a change in NIH funding soon, they acknowledge the challenges in today's economic environment: "The new administration is inheriting a lot of things that require funding right now, and I hope NIH is kept on that list," Lawson says.

A matter of perspective

One argument in favor of increased NIH funding even during a difficult budget year is that NIH's budget for extramural research is quite small when put in perspective, Lawson notes.

"It costs less than $30 billion per year and comes out to $100 per person per year," Lawson says. "If health care costs several thousand per person per year, then there's a little gap there and it makes me think we need to emphasize research to develop improvements in health care."

If researchers are to make any progress in improving NIH funding, then it will happen only because they've made the case for why basic science is essential to America's biomedical agenda.

"It starts with the leadership recognizing the importance of the biomedical agenda for America," Schlesinger says. "We're in a competitive world from the biomedical research perspective, and with new research consortia springing up all over the world, there are many opportunities for trainees and scientists to join them."

The United States has enjoyed a great tradition of biomedical research that is the envy of scientists around the world, he adds.

"So it's important that our leadership recognizes that biomedical research fuels future discoveries that help improve the human condition, and that's the mission of the NIH," Schlesinger says. "We need to retain our best and brightest and allow for academic institutions to have the resources they need to continue funding outstanding and dynamic academic programs."