Drinking from the fire hose of the NIH Stimulus Package

Dr. David Guzick, M.D., Ph.D.

May 06, 2009

In response to this past Autumn’s financial tsunami, the United States has borrowed and printed money to fund an economic stimulus package and both bank and corporate bailouts. Other countries have followed suit. The capital markets appear to be settling down and stimulus dollars are just beginning to enter the economy. The final chapters, however, are yet to be written as the unprecedented spike in money supply to thwart a deflationary spiral is being titrated against the prospect of future inflation.

Back in November, I argued that NIH was a logical target for a portion of the financial stimulus. I commented that, in 2007, the NIH awarded almost $23 billion in research grants and contracts which, according to Families USA, created more than 350,000 new jobs nationwide. Moreover, these grants generated more than $18 billion in wages from those new jobs, and spurred more than $50 billion in business activity in the states.

I also posited that there are other benefits to increasing NIH funding as part of an overall federal stimulus package: first, the funds are distributed to a variety of localities throughout the country, without the inefficiencies of political earmarks; second, a merit system for awarding funds to the best applications is already in place; third, through the Bayh-Dole amendment, incentives exist for the development of commercializable discoveries; and fourth, there are beneficial downstream effects on the population's health, longevity and productivity.

In early February, 2009, Congress approved legislation to spend $787 billion on fiscal stimulus (the “American Recovery and Reinvestment Act of 2009” or ARRA for short). ARRA was quickly signed into law by President Obama. The bill contains something for everyone, including scientists—$10 billion for National Institutes of Health (NIH), $700 million for the Agency for Healthcare Research and Quality (AHRQ) to conduct comparative effectiveness research, $2.5 billion for the National Science Foundation (NSF) and $650 million for the Centers for Disease Control for chronic disease control. All of these funds—about 1/3 of the current NIH budget--must be spent in this federal fiscal year and next, i.e., in the next 18 months.
Faculty in the School of Medicine and Dentistry are well out of the starting gate in the race to the ARRA finish line. As Tom Pearson, MD, PhD, MPH, Senior Associate Dean for Clinical Research, puts it--given the very tight deadlines for a wide variety of grant applications vying for unprecedented amounts of money to be spent quickly over the next two years--this amounts to “drinking from the ARRA fire hose.”

The availability of these funds comes at an important time when research enterprises such as ours at SMD, which had grown in response to the doubling of the NIH budget, are now teetering under the weight of their own infrastructure and overhead. It is wonderful that stimulus funds will be available for facilities construction and renovation, for small and large instrument grants, for the start-up of new faculty recruitment, for supplements to several aspects of the CTSA, for supplements (i.e., “revised applications”) to existing grants, and for new, innovative research under the heading of “Challenge” and “Grand Opportunity” grants. We are applying for funding under all of these categories, as summarized below. We should also step back from this, however, and ask: “OK, I know that the reason this research funding must be spent quickly is to create jobs as part of the economic stimulus package. But then it goes away. What happens then? What should happen? I will close with an attempt to answer this question and comment on some promising statements coming out of the White House.

Steve Dewhurst

Tom Pearson Pearson

We have been in continual communication with our faculty to apprise them of opportunities under ARRA and to facilitate timely preparation of grant applications to NIH. The herculean day-to-day efforts of Steve Dewhurst, PhD, and Tom Pearson, MD, PhD, MPH deserve special note and praise, as does the extraordinary job that ORPA has done in accommodating the spike in research applications, under the leadership of Gunta Liders. In a February 24th communication to faculty, followed by a more detailed memo on March 11th, we set out organizational and procedural actions to optimize SMD’s response to ARRA. The specific aims of this effort were: (1) To collect and disseminate information from a broad range of federal (and possibly state) sources that solicit applications for funding; (2) To identify URMC faculty and programs that might respond to such opportunities; and (3) To support the preparation and submission of competitive applications.

To achieve these aims, Drs. Pearson and Dewhurst crafted a process that emphasizes inclusiveness of Schools, Departments, and Programs; transparency of the process for deciding who would submit applications in cases where a limited number could be submitted; comprehensiveness and efficiency in the identification of funding opportunities; and adequacy of support for grant preparation, review, and institutional sign-off in the setting of a heavy administrative burden. Indeed, the process not only encourages faculty to participate in these stimulus programs, but to do it smartly by picking and choosing the opportunities with reasonable chances of success. For example, a very modest number (compared to many institutions) of Challenge grants were submitted to NIH on April 28. This was appropriate, as only a limited number of these grants will be funded out of 12,200 Challenge grant submissions nationally! On the other hand, scores of applications for supplemental and competitive grants, and for specific program solicitations with much better chances of funding, have been submitted by SMD faculty across the spectrum of NIH offerings, totaling more than $100 million in requested ARRA funds.

In a manner similar to that of our internal CTSA applications, a temporary intranet website was also established in the Clinical and Translational Science Institute (CTSI) through the work of Dr. Pearson, the CTSI administrators (Tom Fogg and Kathleen Jensen) and staff with assistance from the Bioinformatics Key Function (Mike Hazard). This site provides general information on ARRA, a listing of institute-specific links, a warehousing of ideas for fundable, short-term projects, and a warehousing of RFAs and RFPs organized by sponsoring agency. (To access, go to the CTSI website, http://www.urmc.rochester.edu/ctsi, for linkage to the ARRA intranet site. You will need a URMC id and password.).

Establishing an administrative process that facilitates grant submissions is one thing, but in the end it is our faculty who think through aspects of their science that might be most competitive for funding, and who do the work of actually writing the grant applications. It is extremely satisfying as a medical school dean that our faculty have responded to ARRA with an extraordinary outpouring of grant submissions that are as strong in quality as they are in volume. According to data collected by Brian VanWuyckhuyse, Financial Director of Core Scientific Support Services at SMD, for the period March 1 through May 4, comparing 2009 with 2008, we have submitted $100 million more in grant requests this year than last! What is even more remarkable is that our level of activity for regular (i.e., not Stimulus) grant applications has not slackened off one bit. Thus, despite the fact that our faculty were applying for $100 million worth of Stimulus grants over an intense period of two months, they were simultaneously submitting their regular grant applications at the same rate as last year.

Viewed strictly from the perspective of external support for SMD’s research mission, the huge bolus of NIH funding outlined above is indeed reason to celebrate, and we would all be wearing a big smile were it not for the fact that the overall economy is in deep recession (albeit getting worse at a slower rate). These additional research funds are in fact long overdue given that the expansion in NIH funding nationally came to a screeching halt after 2003 and has been essentially flat since then. Theoretically, these stimulus dollars will generate research programs that will continue when the funding ends in 18 months. Some of the capital expenditures under ARRA that will create new facilities and upgrade scientific cores may indeed accomplish the objectives of immediate job creation plus future enhancement of productivity. However, the research itself is a continual process of inter-digitated scientific stories. These stories involve hypotheses, experiments and data analysis, advancing knowledge in small steps, punctuated importantly by some “eureka” moments. This process doesn’t end when the bolus funds are spent; if the research has any merit, it will generate additional scientific questions. Thus, a good “shovel ready” project in biomedical science will yield not an endpoint in 18 months but a new beginning. No doubt, additional NIH (or similar) funding will be needed to sustain the stimulated scientific enterprise, so that it can produce even more knowledge, more jobs, and hopefully more improvements in health.

Clearly, a durable commitment to science is needed that will be shielded from the political process of annual congressional budget negotiations. Such a commitment must include the education of the next generation of investigators who can have some reasonable expectation that funding opportunities will be available to them at the end of their training. Unfortunately, our history of boom-and-bust NIH cycles, and the continual increase in the age at first R01 (now 43 years old) do little to instill the confidence needed among our best and brightest young people to enter biomedical research as a career.

We now have a proponent of science in the White House who might indeed foster a radical change in the benchmarks we use to fund scientific research. In recent years, as GDP has increased while the budgets for NIH, NSF and other federally funded research agencies have remained flat, the proportion of GDP spent on research and development has been declining. Last year, this figure for the U.S. was estimated to be 2.6%. By contrast, for example, Israel spends 6% of its GDP on research and development. Strikingly, in a speech before the National Academy of Sciences on April 27, 2009, President Obama advocated that the nation spend 3% of its GDP on science. Given that the U.S. GDP is currently $13.84 trillion, this implies a goal of spending $415 billion on science, an increase of about $55 billion from the current level of 2.6%.

If indeed the U.S. makes a commitment to spend a fixed percent of its GDP on science (biomedical, physical, behavioral, environmental, etc.), a virtuous circle may result, with an increase in GDP spurred by an investment in science in turn generating more dollars for scientific investment. Such a commitment will attract new talent to the field of scientific research, allow Universities and research institutes to plan in a more rational manner, and lead in general to a brighter future for future generations as a result of the discoveries and advances that will ensue. We all look forward to replacing our current drink from the ARRA fire hose with an adequate, balanced, and stable diet of research support that will most effectively nurture research and development of biomedical discoveries over the long term.

Meliora,

David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry
University of Rochester

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