NIH at the Crossroads: Myths, Realities and Strategies for the Future Presentation by Elias A' Zerho

1

NIH at the Crossroads Myths, Realities and
Strategies for the Future Elias A. Zerhouni,
M.D. Director National Institutes of Health
2

• 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
3
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

4
NIH Budget Myths and Realities
5
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?

6
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
7
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?

8
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?

9
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)
10
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

11
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
12
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
13
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
14
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
15
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

16
The Question on Everyones MindWhat are MY
chances of being funded?
17
Payline Is Not Funding Cut-off Line
-
100
Percent R01s Funded
0
0
10
20
30
40
Percentile Score
18
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
19
Where Do We Go From Here?Adaptive Strategies
A Vision for the Future
20
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 NIHs exciting vision for the future

21
Biomedical Research Has Delivered
Coronary Heart Disease
22
Biomedical Research Has Delivered
Cancer
23
Basic Discovery Today Provides the Foundation for
Tomorrows Medicine
Clinical Applications
Translational Research
Basic Research and Technology Development
24
The Future Paradigm Transform Medicine from
Curative to Preemptive
Predictive
Preemptive
Personalized
25
Transforming medicine through discovery
NIH