NIH Debates Merit Of Setting Grant Minimum

Total of new awards for individual investigators, long seen as a barometer of the agency's welfare, is object of controversy ASHINGTON--Numbers are the lifeblood of science, a way to quantify the search for truth. But a number can also make a political statement. In fact, the current bitter debate within the biomedical community over the National Institutes of Health's commitment to research proposed by individual investigators can be summed up in a single number: 6,000. As a rallying cry, the 6,000 figure has become a symbol for a vocal group of bench scientists who want Congress to insist that the National Institutes of Health guarantee to award at least that number of new and competing grants each year for investigator-initiated research. Most working scientists view this type of research, known in NIH parlance as "R01s," as vital. "We believe that R01 grants should remain the highest priority item in the NIH research budget," says Donald Brown, an embryologist at the Carnegie Institution in Washington, D.C., and president-elect of the American Society for Cell Biology. "It's the cornerstone of the success in biomedical research that our country enjoys in the international arena." Brown was one of more than a dozen speakers last month at a day-long public hearing sponsored by NIH to discuss its proposed cost-management plan. Such a plan was requested last fall by Congress in time for the round of appropriations hearings this spring on the agency's requested budget for fiscal year 1992, which begins October 1 (The Scientist, Sept. 4, 1990, page 1). Among its many suggestions to NIH, Congress proposed the minimum of 6,000 new and competing grants (those submitted by investigators who are seeking renewed support upon the expiration of their current grant) each year as part of a total portfolio of 24,000 project grants. Besides new and competing grants, the rest of NIH's portfolio consists of continuing grants in successive years following the initial award. Last year NIH funded 4,845 new and competing grants out of a total pool of 20,281 project grants, a sharp drop from a peak of 6,440 such grants in 1988 and the lowest amount in more than a decade. This year it expects to award 5,785 new grants and competing grants out of 21,186 grants; NIH officials say they hope to reach or exceed the 6,000 figure in 1992 and beyond. Few would dispute the long-term benefits that stem from allowing as many good scientists as possible to work on projects of their own choosing. But not everyone thinks that it's a good idea to set an annual goal and give it precedence over NIH-initiated projects, grants to large groups and institutional centers, and other forms of research support. Without stable funding for NIH, say such prominent science policymakers as Robert Rosenzweig, president of the Association of American Universities, and David Korn, Stanford University's dean of medicine and chairman of NIH's National Cancer Advisory Board, the 6,000 figure may be unattainable. They also worry that blind adherence to a single number will trigger another cycle of financial feast and famine for biomedical researchers. That cycle occurs when NIH adds so many new investigators in one year that it is impossible to fund them in later years without cutting back on the size and/or length of all its grants. Last year, for example, NIH was forced to trim by an average of 15 percent the budgets for investigator proposals it chose to fund. "It is the wrong goal," said Rosenzweig at the hearing, referring to the magic number. "It would reintroduce into the system the very same dynamic of fat years followed by lean years . . . by building a commitment base that could not be met by likely future appropriations." This topic also consumed most of the next day's meeting of the NIH Director's Advisory Committee, which meets quarterly to review NIH policies and practices. Korn, who testified the day before, took a second shot at the issue as a member of the advisory panel. "I don't think the NIH budget can support 6,000 grants, not now and not in the future," said Korn. "To float such a number will get us into the same sort of yogurt that we've been in for the past several years. And it will require us to perform the same sort of unpleasantness that everyone wants to avoid." Although NIH's budget has grown robustly, from $3.4 billion in 1980 to $8.3 billion in 1991, the rise was fashioned largely by having Congress augment nominal hikes requested each year by the president. Supporters of biomedical research were perennially looking for ways to persuade Congress that hefty increases were warranted. Prodded by former Connecticut Sen. Lowell Weicker and Rep. Silvio Conte (R-Mass.), the appropriations committees in both houses of Congress seized on the number 6,000 as a simple measure of the health of biomedical research. If NIH could meet or exceed that number, they reasoned, that year's appropriation must be adequate to the task. That approach was fine with NIH, too, because it usually led to more money. "In the course of making our annual budget request to Congress, the use of the number of new and competing grants that it would fund has been a powerful tool," says NIH's acting director, William Raub. "Perhaps because they do not understand the details of our enterprise, the committees [that oversee NIH's budget] have found it very useful to think in terms of the number of pieces of research that they are funding. And that information is reflected in the level of new grants." Abandoning that standard, Raub believes, might jeopardize NIH's good standing on Capitol Hill. "We are free to come up with another surrogate," Raub told his advisory committee. "But if we have nothing to put in its place, Congress may come up with something on its own." To comply with the wishes of a benevolent Congress, NIH began in 1985 to boost the number of new and competing grants. Institute directors also began to approve longer grants--from an average of 3.4 years in 1985 to the current 4.3 years. And the cost of a typical grant also climbed, from an average of $97,800 in 1980 to $193,900 nine years later. Those changes pushed up the amount of money NIH was committing each year for investigator-initiated research to the point at which, starting in fiscal 1989, the load became too heavy to bear. (That year, for example, continuing grants consumed 75 percent of all the money spent on research project grants, up from 69 percent at the start of the decade.) NIH's response was to cut sharply both the number of new and competing grants and the budgets of those grants already in the system. That process creates the feast-and-famine cycle that Rosenzweig referred to in his testimony and that he says NIH must avoid in future years. NIH's new cost management plan takes aim at these factors. It proposes to reverse the trend toward longer grants--some 51 percent of all R01 requests in 1989 were for five years, as compared with only 27 percent a decade earlier. It promises to hold annual increases in the budgets of continuing grants to a below-inflation rate of 4 percent. And it plans to cap the annual rate of growth of all grants to a biomedical price index level of 5.7 percent. At the public hearing, Korn urged NIH to model some of its recommended changes to anticipate their impact on the research community. At the advisory committee meeting, financial management chief Leamon Lee outlined a five-year budget predicated on a level of 6,000 new grants and annual increases for individual grantees that held to the rate of inflation. Under the budget, the total number of NIH grants would grow to 23,400 in 1995, consuming $6.1 billion instead of the present level of $4.5 billion. Training grants--another contentious issue after an Institute of Medicine report last fall proposed shifting NIH funds from R01s into training (The Scientist, Oct. 29, page 3)--would increase from a projected 12,100 this year to 13,500 in 1995. And NIH's total budget would stand at $10.6 billion by the middle of the decade. Those numbers have little value, however, until NIH knows how much it has to spend each year. If the money's there, then Korn and other critics of the 6,000 target say they'll gladly eat their harsh words. However, if its appropriation falls short of expectations, then NIH must tackle the nasty job of setting priorities. There is no shortage of suggestions, however. Robert Cousins, vice president of the Federation of American Societies for Experimental Biology (FASEB), spoke at the public hearing for advocates of a "6,000 or bust" strategy by attacking overhead costs and urging caution on adding training grants. "NIH must explore ways to roll back the burgeoning indirect costs that are eating away at our nation's capacity to conduct" the necessary level of research, he said; later adding that "the question of how many research trainees are needed should be reevaluated on the basis of additional information." University administrators spoke just as strongly about the critical importance of recovering institutional costs of hosting research. And Robert Petersdorf, president of the American Association of Medical Colleges, articulated the concerns of the "not necessarily 6,000" forces, testifying that "we prefer an approach . . . in which available funds, rather than a prescribed number of awards, is the determining factor." NIH will circulate the proposed management plan to the various institute councils that meet this month, and Raub says he hopes to forward the final version to Congress by the end of February. Although it seems unlikely that the document will veer too far from the congressional desire to set a floor under new and competing grants, Rosenzweig and others who share his concerns used last month's public hearing to encourage NIH to be frank with the people who control its budget. "If we're not given enough money to meet a target of 6,000 new grants, what should we do?" asked John Diggs, NIH deputy director for extramural research. "It's an unreasonable goal," Rosenzweig responded, "and they [Congress] are not unreasonable people. Given the new leadership [the expected nomination of Bernadine Healy as NIH director], there's every opportunity to revisit the issues and arrive at a more thoughtful solution."

NIH Debates Merit Of Setting Grant Minimum

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