Op-Ed: In Defense of the NIH

March 20, 2017

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Last week, President Trump released his budget proposal. There were winners and losers:

This budget, whether or not it actually passes, represents the values of the current administration, an administration that promised to put “America First” and to “Make America Great Again.”
This budget hurts a lot of agencies, but I want to talk about one agency getting hit hard, the National Institutes of Health, which, in my opinion, is a wonder of the modern world. An American wonder.
Full disclosure here. Part of my salary comes from an NIH grant. The other part comes from taking care of veterans at the VA medical center in West Haven, Conn., so technically I’m on both the winning and losing side of this budget.
But it struck me, in reading about the response to the NIH cuts, that many people are unaware of just how important this agency is.
First of all, let’s focus on 20%. Is that a big deal? These are government agencies, right? You can always find 20% fat to trim.

The dark blue line is the NIH budget over the past 60 years or so, adjusted for inflation.

Since 2003, we’ve seen steady decreases.
And of that budget, more than 80% goes to grants. Another 10% goes to research in the NIH’s own labs.

In other words – cutting 20% means cutting grants. There are no two ways about it.
And grant funding at NIH is crazy competitive. Take a look at funding levels over the past 15 years:

The blue line shows the success rate, steadily declining since 2003, as the budget was reduced.
Cut the budget? Fund less grants. The current success rate is around 18%.

And please realize that the 82% that aren’t funded are not bad science. In fact, I’ve reviewed many proposals for the NIH that were very impressive, had a high public health impact, and would have saved lives but there simply wasn’t enough money to pay for them.
I want to make an argument for why the NIH represents the very best of American values, something we should hold aloft and treasure and encourage others to emulate.

First, the NIH is a true meritocracy. Grants get funded based on the strength and feasibility of the idea, and the importance to the public. Bad grants by high-profile researchers get rejected routinely. Compelling grants from relative unknowns get funded.
Second, the NIH is a powerful economic engine. NIH drives innovation, and innovation is the past, present, and future of the American economy. It’s what makes us great. This study from the Journal of Law and Economics found that every dollar spent by the NIH in basic science research stimulates $8.40 of industry investment.

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