[HN Gopher] The need to reform the National Institutes of Health...
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       The need to reform the National Institutes of Health (NIH) funding
       process
        
       Author : jseliger
       Score  : 55 points
       Date   : 2022-05-04 15:12 UTC (7 hours ago)
        
 (HTM) web link (newscience.org)
 (TXT) w3m dump (newscience.org)
        
       | DennisP wrote:
       | 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.
        
       | jhart99 wrote:
       | As a NIH funded researcher, everything here is spot on.
        
         | stevenbedrick wrote:
         | Agreed, from another NIH-funded researcher. I was impressed
         | with the thoroughness and balanced perspective in this
         | whitepaper.
        
         | bumby wrote:
         | 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?
        
         | derbOac wrote:
         | 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.
        
           | avs733 wrote:
           | 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.
        
             | nickff wrote:
             | 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.
        
             | derbOac wrote:
             | 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.
        
               | avs733 wrote:
               | 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.
        
           | eli_gottlieb wrote:
           | 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._
        
             | secabeen wrote:
             | 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?
        
       | acjo wrote:
       | 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?
        
       | adlfkjlkjalwe wrote:
        
       | glofish wrote:
       | > _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.
        
         | jhart99 wrote:
         | 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.
        
           | caycep wrote:
           | 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.
        
       | PaulKeeble wrote:
       | 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.
        
         | stainablesteel wrote:
         | you basically get NIH grants from socializing with the people
         | who give NIH grants
         | 
         | just ask any NIH grant receiving professors
        
         | cogman10 wrote:
         | 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).
        
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       (page generated 2022-05-04 23:01 UTC)