National Panel Urges Shifting Funding To Biomedical Training, Better Facilities

WASHINGTON--A new report from the Institute of Medicine on how to fund health sciences research doesn't take the easy way out by asking the United States government for more money. But what it does recommend--that the government redistribute existing funds by shifting some money from research grants into training the next generation of scientists and improving research facilities--seems likely to aggravate rather than end the heated debate about how to allocate scarce federal resources. The message that the future is as important as the present was emphasized in comments from Scripps Clinic neuroscientist Floyd Bloom, who chaired the committee that issued last month's report. "While it was clear that we need more money," says Bloom, "our goal was to maximize our use of existing resources. We want to be in a position to assure our sponsors, if more money becomes available in the future, that we have a comprehensive plan for spending it most effectively." WASHINGTON--The latest battlefield in the ongoing war over priorities within the biomedical research community is the congressional Biomedical Research Caucus. The caucus, which has signed up 18 members of Congress as of the first of October, made its debut earlier this month at an afternoon symposium and reception on Capitol Hill that featured Harold Varmus, a microbiologist at the University of California, San Francisco, and a 1989 Nobel laureate in medicine, and Leon Rosenberg, dean of the Yale University School of Medicine. Varmus and Rosenberg were joined by Cori Bargman, an academic biochemist just about to start her own lab. Together the three scientists made the case for the value of biomedical research in saving lives and lowering health care costs. Their message--that basic research is an unalloyed good that should receive greater support from the federal government--is one that few people would oppose. But events in Washington aren't always as simple as they appear. The caucus owes its existence to the efforts of Peter Kyros, a former Maine congressman turned lobbyist, who has been hired by three professional biology societies to win additional funding for individual investigator grants. Kyros convinced Rep. George Gekas (R-Pa.) to sponsor the caucus as one way to increase the visibility of biomedical research within Congress. Accordingly, the organizations that have campaigned hard for that goal, including Kyros's clients--the Federation of American Societies of Experimental Biology (FASEB), the American Society for Biochemistry and Molecular Biology (ASBMB), and the American Society for Cell Biology--were well represented at the symposium. While such lobbying for more individual grants is an attractive position to many bench scientists, it is seen by others as representing too narrow an opinion of what ails the biomedical community. And the proponents of the view that the needs of institutions as well as those of individuals must be addressed--representing such organizations as the Association of American Universities and the American Association of Medical Colleges--were conspicuous in their absence from the open meeting. The organizers of the caucus, besides Gekas, are J. Roy Rowland (D-Ga.), Sonny Callahan (R-Ala.), and Bill Richardson (D-N.M.). They are members with little prior involvement, and even less power, on the congressional committees that shape health sciences research policy in the U.S. Gekas says that the caucus plans to sponsor a series of lectures next year as part of its attempt to educate those members and their staffs who are not "up to speed" on biomedical research. However, the chances that the caucus can be a force for significant change seems extremely unlikely. Like all such groups, the caucus suffers from the fact that those members with real power rarely bother to join because they already hold positions of influence. In addition, the caucus is likely to find that it is much more difficult to enlist new members once it attempts to move beyond generic support for research and begins to push for additional resources for a particular constituency. "It's easy to be for biomedical research in the abstract," notes one House staffer who attended the symposium. "But any new money has to come from somebody s program, and that's when you'll find out who your real friends are." --J.M. The report is entitled Funding Health Sciences Research--A Strategy to Restore Balance. But finding that balance hasn't been easy in a time of rising discontent among biomedical researchers about the current state of their discipline. "We've got a crisis right now," says Dan Lane, president of the American Society for Biochemistry and Molecular Biology (ASBMB), which joined with two other biological societies earlier this year to lobby Congress for an increase in the funding of individual investigator awards (The Scientist, April 28, 1990, page 2). Lane and many of his colleagues at the bench disagree with what they see as the panel's preoccupation with the supply of future scientists. "There are a lot of young scientists who aren't getting funded," he says. "And if that situation continues, it won't matter what happens down the road." Lane, who is chairman of the department of biological chemistry at the Johns Hopkins University School of Medicine, also chides the Institute of Medicine (IoM) committee for losing touch with the real world of science. "I'm disappointed that such a group wouldn't have goals similar to most of the card-carrying bench scientists in this country," he says. While scientists like Lane are clamoring for more money to fund new and competing grants from individual investigators, others are wringing their hands over a prospective shortage of newly minted Ph.D.'s who can fill the shoes of retiring faculty in the decade ahead. And university administrators say that they desperately need cash to rebuild aging facilities and purchase multimillion-dollar pieces of equipment. Given those competing pressures, the time-honored response in Washington would be to ask for more funding. But that's not what IoM President Samuel Thier wanted the committee--formed at his request more than two years ago--to do. While he asked them to look at the big picture, he also told them to think small when it comes to money. As a companion to the National Academy of Sciences, the institute does most of its work at the request of Congress and, therefore, has a ready-made audience for its findings. Since Thier knew he'd have to sell this report on its merits, he decided that the best approach was to offer a broad yet fiscally responsible analysis of the issues affecting life sciences research, while letting let the importance of the work speak for itself. "Of course there is the capacity and the opportunity to spend more money," says Thier. "But I think that the case for more should be made on the grounds that biomedical research is a positive good, not because it's tough to run the current system." Forced to choose, committee members decided that the most important goal was to keep the pipeline filled with talented scientists. "The general conclusion we reached was that we will [always] be losing investigators now in the system, and that it is essential to replenish the pool," said Bloom, speaking at a September 27 symposium at the National Academy of Sciences to mark the release of the 243-page report. "We would have liked to ask for more money, but we decided that a balanced approach was the best way to reinvigorate the system over the long haul. We also believe that it will relieve some of the stress now in the system." The report offers two recommendations aimed at doing that. One asks NIH to increase the proportion of its budget now devoted to training from 4.2 percent to 5.75 percent over the next five years--with the necessary $12 million each year to come from extramural research grants. A second recommendation would increase the amount spent on facilities, over a similar period, from 0.25 percent to 0.50 percent of the extramural budget, with the funds again coming from research. If the total budget doesn't grow, then the only way to achieve those increases is through cuts in research funding. That approach doesn't please scientists who feel that the number of competitively awarded grants to individual investigators is the single best indicator of the field's health. That number has dipped from a high of 6,400 in 1987 to 4,600 in 1990 (nearly two-thirds of the 20,000 annual NIH grants are continuations of grants awarded in earlier years). And they are worried that the number, which is on the rebound, won't rise fast enough if resources are diverted. "We know that support for new research investigators has been drastically curtailed this year," says Michael Jackson, executive director of the Federation of American Societies in Experimental Biology (FASEB), of which ASBMB is a member. "But we don't know if a similar crisis exists in training, and therefore we don't know how urgent it is to reallocate funds for that purpose." The IoM committee was unable to determine how many biomedical scientists are being trained with federal funds, notes committee member Dennis Smith, chairman of the biology department at Wayne State University. While NIH has figures on specific programs so designated, it does not keep track of how many graduate students and postdocs are being supported on investigator grants, nor what type of training is being provided under such grants. Still, Smith and others say that current levels of training are insufficient to provide replacements for those leaving the field because of retirement, a failure to obtain funding, or for better opportunities here. "A lot of us came through the system when NIH was investing a large percentage of its money--up to 17 percent in the 1960s--on training," Smith said. "But that share has shrunk dramatically, and I am very worried about where the researchers of tomorrow will come from." Putting more money into training to produce more scientists seems counterintuitive at a time when only one in four applications to NIH is being funded. But Bloom and other committee members say that it's the best course in the long run. "It would have been easy enough for us to agree on a number [of new and competing grants] and then go out and campaign for it," says Bloom. "But if we really want to assure the quality of the research enterprise for decades to come, then any single number is artificial. By itself, it's not going to solve the problem." The IoM report is thick with ideas on how to tackle the so-called crisis in biomedical research. It recommends new undergraduate programs to attract students into science, new predoctoral training programs, an outreach program for women and underrepresented minorities, and a more stringent evaluation of fledgling scientists funded for the first time by NIH. The report is silent on the details, however, including how such new efforts should be funded. More controversial are its suggestions for ways to make more money available to a larger pool of scientists. One is novel--a sliding scale for grants, in which the more highly rated applications receive full funding and those with lower ranking get proportionately less than the full amount requested. Another is opportunistic--a new facilities program funded with the $300 million that Congress now spends annually on pork-barrel projects. A third involves technical fixes--new accounting methods to provide for more rapid depreciation of buildings and equipment. Yet another is arcane--keeping the money paid by the government for so-called indirect costs in a separate fund for maintenance and renovation. Thier acknowledges that each proposed change is certain to please some within the scientific community and offend others. For example, the issue of how much universities should charge the government for the indirect costs of doing science divides bench scientists, who want to hold costs down and make more money available to grantees, and academic administrators, who say their institutions cannot support research unless they are reimbursed for its true cost. But, says Thier, with so many misconceptions about the real causes of such problems as low award rates, shrunken grant requests, deteriorating facilities, and uncertainty about the future supply of scientists, the report's greatest value is its bluntness. Thier predicts that its effects will begin to show up in the NIH budget over the next three to five years. That depends on whether it can grab and hold the attention of the politicians who ultimately set the course of U.S. biomedical research. But Terry Lierman, a former top aide to the Senate appropriations subcommittee that controls the NIH budget, warns scientists not to hold their breaths in waiting for a response. "I think it's a very positive report," says Lierman, now a health lobbyist. "But it couldn't have come at a worse time. Congress is just finishing the '91 budget, and the next budget cycle doesn't start for six months. Still, Congress has indicated that it's willing to listen to new ideas, and this report certainly gives [legislators] the pieces they need to put together the whole puzzle."

National Panel Urges Shifting Funding To Biomedical Training, Better Facilities

Interested in reading more?

Become a Member of