The need to reform the National Institutes of Health (NIH) funding process | Hacker News Reader

The need to reform the National Institutes of Health (NIH) funding process

newscience.org

63 pointsjseliger20 comments

> In 2017, 1% of NIH extramural grantees received 11% of the total funds. The top 10% of researchers received over 40% of the funds.36 37 This is a larger divide in wealth inequality than for the general U.S. population, where the top 10% of earners received 40% of (post-tax) income

What the above does not capture is much work it takes to submit and prepare a grant.

Not getting a grant also means months upon months of lost work, and years of enthusiasm out the window.

Multiply the 50K unsuccessful grants by 10x to get a magnitude of the wastage.

This captures the problem I have with this system. The wasted effort is absolutely immense. Rejected grants do come back with comments so you can try to fix the perceived problems. You can also consult with the NIH about how you can improve. But sometimes your idea is just not going to get funded.

The current pay line is about 12%. On average a researcher is going to end up failing 7/8 times. They are going to waste years of effort going back and forth to get a single R01. I don't remember the statistics but it is something like 8-10 years for a new professor to land their first R01. At my institute, you are basically required to have 2 R01 grants to keep things running. That means your job is not to do science at all, but to be a grant writing machine that gets enough funding so your lab can do whatever it is you want to do. On some level academic science is really marketing your brand of science.

I was one of the ones that didn't play the political game right (choosing mentors, proper faculty appts etc) so my grant got tossed aside (triaged). Then the choice is to either do another 5 years as essentially a post-doc while the chairman grumbles that you're costing his department money, vs. going into practice and making double what the NIH protected salary would be for a K grant, and the choice was clear.

The article lays out a major issue with the concentration of extramural funding at a few elite institutions. One additional reason that the geographical and institutional concentration of extramural funding is so harmful is the 'brain drain' effects at research institutions that face uphill climbs to access funding. A significant part of every grant application is the institutional support, which lists core facilities and other resources that are funded by the indirect cost recovery from government grants. This creates a positive feedback loop where grants fund resources that enable grants to be awarded. You can imagine how institutions without large amounts of NIH research can struggle with this.

Then you have to consider that many of these institutions are Universities with undergraduate populations. Undergraduates are engaged more and more in research exposure, which is becoming a significant prerequisite for graduate school and medical school (and especially for combined degree programs like MD/PhD programs). At universities without lots of external funding, such as NIH or NSF funding, it doesn't take a lot to imagine that there are knock on effects creating geographic and structure imbalances in the education that can be offered at a state school in say Wyoming or Nevada.

Measures, like the Grant Support Index, would have curbed the worst excesses of this imbalance, by preventing super start researchers from effectively 'renting' out their name as a co-PI for research they were tangentially involved in. Likewise, NIH could recognize the need for biomedical investigation to be a 50-state wide enterprise leveraging institutions across the country rather than something to be pursued by elite institutions, many of which concentrated in a few metro areas.

I have no evidence, but I do wonder that when we concentrate this knowledge and learning in a few metro areas, is it really a surprise that scientific literacy and health literacy can be quite low in the same areas we are failing to invest in?

What the NIH is willing to fund has very little bearing on its impact to society as well. You can have a disease that has significant impact to millions of lives and it will have $1 million in funding while another that has less impact and has 1/1000th of the sufferers receives $100s of millions. The way the funding is assigned is not in anyway based on the merit of the disease being studied and how many lives it would save or improve.

Even labs on the NIH revered institutions list struggle to get funding for the unloved diseases that really need more money. There was a assay diagnostic that showed energy deficits at a cellular level in ME/CFS and long covid and the NIH passed on funding it, for the third time in a row. That impacts millions upon millions of sufferers of a very real and growing condition. Its so bad that the bulk of funding in a lot of cases comes from private donations and organizations like the open medicine foundation which are tiny but in comparison to funding from the NIH its substantial.

The NIH has done a terrible job at assigning research funds from what I can see, a system of appropriate merit would make a lot more sense otherwise no progress will be made in extremely debilitating and painful and unknown to the public conditions.

you basically get NIH grants from socializing with the people who give NIH grants

just ask any NIH grant receiving professors

An argument (all be it, probably not a great one) for funding smaller and less impactful disease research is that major diseases are likely to see research from private medicine (because that's where the money is).

As a NIH funded researcher, everything here is spot on.

As someone who was formerly a tenured professor, and left in part because of the issues in this piece, I agree.

> The universities may have gotten “addicted” to the influx of federal funds, and adapted their operations based around absorbing more federal money.

This is an understatement. It's not "may have"; one can eliminate the "may". At many universities currently the tail wags the dog. There have been many high-profile examples of this in recent years. It used to not be this way, and the time period identified in the piece has been highlighted by many papers on the topic.

Yes, this seems like a big problem. Need to reform the NIH and crack down on the universities.

>On the other hand, there is definitely evidence that university administrators are motivated by indirect cost rates. In the most severe cases, some universities levy a “tax” on researchers for obtaining grants from non-NIH sources. In the case of Columbia University, the tax is equal to the NIH indirect cost rate minus the other institution’s indirect cost rate. That percentage is taken out of the researcher’s direct costs. This policy dramatically diminishes the value of non-NIH grants.

>For example, if a Columbia University (62.5% NIH indirect cost rate) researcher receives a grant from the Bill and Melinda Gates Foundation (10% indirect rate), with a direct cost of $1 million and a total value of $1.1 million, a whopping $525,000 intended for the researcher is redirected to the university, bringing the direct cost benefits to the researcher down from $1 million to $475,000. And frankly, that’s underselling the transfer, because non-profit grants tend to be much smaller than NIH grants; once the tax is paid, the remaining money might not even be worth applying for.

The question of whether 62.5% indirect cost rate is appropriate is a good one, but 10% is certainly not enough. Indirect costs include many things that are required in order to perform research, including real estate, power, building maintenance, administrative staff for payroll, financial management, regulatory reporting, technology, infrastructure, safety, etc. etc.

What else is a university to do if non-profits try to free-ride on the infrastructure paid for by NIH?

just for those less familiar, it may be useful to note that the shift towards federal funds is typically linked to decreases in local funding for higher education.

It isn't 'organic' there has been an outside forcing function.

That's true although in my discussions with university administration, there is a causal arrow that points a bit in the other direction too. I've had conversations with university presidents and other administration (in semi-private contexts) where it's basically stated "we don't need to advocate for state funding because we can sustain ourselves on federal funds."

I note this not to criticize the administration (although you can do that), but to point out that this dynamic has repercussions in terms of incentives. If you're a university president or provost and getting pressure from a conservative legislature to not depend on public funding (which really means "state funding" to them, but that's another discussion), and all of a sudden the federal government becomes this cash flow source, you're going to run to it, and leverage that as "being a good citizen" with the legislature. I think the causal directions go in both ways and have these kind of amplifying effects.

I have heard the same...but I honestly think that is a 'here lets not try' more so than a 'we wouldn't make use of it'.

Totally agree with you on the rest.

What is interesting is the admins now finding that those same legislators won't leave you alone even if they strip all your funding. They will mess with you for cheap points and sport.

The shift to dependency on federal funding happened during and after the second world war. The federal government discovered they could speed up research by pouring money into universities, but never accounted for how this would change incentive structures, and eventually warp the universities.

How does it get fixed though?

From the article: >What is relevant is how the public perceives these methods.

So much of the problem seems about political risk, but that seems to be a feature and not a bug of publicly funded programs. We generally want the public to have a say in how their tax dollars get spent and we want there to be transparency in the process. And yet those two factors combine to create many of the problems in the article.

Is it a misalignment of researchers and the general public in terms of priorities? Is it an issue of educating the public about the intent of fundamental research? Something else?

This is likely to persist as long as the federal government can sustain deficit spending. Until the money printer stops, there will not be political will to reduce spending.

Maybe you can explain further, but that seems to be a slightly different problem. The central issue in the article seems to be what the money is spent on, not necessarily the amount of money spent. Given the amount of waste cited, it seems like there is ample money, it's just being funneled away from fundamental research because it's politically more palatable to fund applied research.

Agreed, from another NIH-funded researcher. I was impressed with the thoroughness and balanced perspective in this whitepaper.

A while back I read The Death of Cancer by Vincent DeVita, former director of the National Cancer Institute. It's a great book, with a lot of stories about his experiences in research and with patients over a 50-year career. He argues that progress against cancer has slowed down significantly since the early days, largely because of the NIH and FDA.

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