More on Obama’s Science Policy: II

Now back to thinking about the new President’s science policy. Yesterday we visited with the legislative director of one of the big scientific societies here in Washington and both of us agreed that what happens at NIH will be of major importance. The National Institutes of Health have had a long successful history with both sides of the aisle. Democrats and Republicans are in general agreement that NIH basically “works” (in contrast to the rest of the government). Whether or not this meme is true, it’s out there and has played to the agency’s effectiveness over the years. In particular the mix of using approximately 10% of the agency’s budget to support a “high risk, high payoff” intramural campus and 90% to support a rigorously peer-reviewed extramural investigator-initiated grants program has taken on the permanence of received dogma. With the current economic challenges and the resultant chronic decrease in discretionary budget funding, there is a worry that NIH may have lost it’s groove in a more fundamental way. When only 5% of new grants are getting funded, but 30% of them are scientifically worthy of support, deciding who gets the green light begins to be similar to arguing over how many angels can dance on the head of a pin.

To be fair, NIH is engaged in a deep conversation within and among its external stakeholders about reform, but under the new administration (and particularly with a new NIH director) one might expect this process to become more urgent and potentially more consequential. One major challenge for the agency is how to reward scientific risk-taking more effectively. Currently the existing peer-review system tends to work against the “bleeding edge” which may delay important public health benefits of biomedical research. There’s also the question of how to more effectively promote scientific collaborations between the intramural scientists (on the Bethesda campus) with their colleagues in academia who may be funded by the extramural program. Currently the old “firewall” between the two branches of biomedical research funding is under siege, but the wall hasn’t come tumbling down yet. It probably should.

More fundamentally, the new Administration might consider reducing the number of NIH institutes (I forget how many of them there are, but it’s in the double digits) and figuring out a way to increase coordination among the institutes and between other federal agencies. One way to do this, is to substantially increase the power of the NIH Director at the expense of the individual Institute Directors. The new Pioneer grants undertaken by current NIH Director Zerhouni are a good first step. But more more could be done.

Finally the Bethesda, intramural NIH needs to figure out a way to balance the critical need to maintain transparency in research funding (e.g. dealing with scientific conflict of interest) with equal need to create a pleasant enough employment environment to attract the very best and the brightest. Those individuals don’t need to come to Bethesda to be well supported and to thrive–but we want them to chose to do so. Striking that balance is going to be really important for creating a intramural program that fulfills its mission.

The incoming Obama administration of course realizes, positive changes only comes about when you chose the right leadership team. His choice for NIH director, will give us a very big clue about what will happen, change-wise, with this extraordinary agency.

Jim