Sustaining the Engine of U.S. Biomedical Discovery

Academic medical centers are where most of the research sponsored by the National Institutes of Health (NIH) is performed. In the past decade, the centers have scaled up their research operations as the NIH budget doubled but now face shortfalls as fewer proposals are funded. In this Sounding Board article, an argument is made for more robust long-term NIH support. In the past decade, academic medical centers have scaled up their research operations as the NIH budget doubled but now face shortfalls as fewer proposals are funded. In this article, an argument is made for more robust long-term NIH support. The U.S. biomedical research community, redolent of opportunity and brimming with optimism during the years from 1998 to 2003 when the budget of the National Institutes of Health (NIH) doubled, is now facing the prospect of an unprecedented fifth straight year of no real growth in NIH appropriations. 1 If so, the agency's purchasing power will have fallen more than 13% since fiscal year 2003. Fueled by NIH budgets that had increased annually since 1971 at an average nominal rate of nearly 9% 2 (or 3.34% adjusted for inflation 3 ), the nation's biomedical research enterprise has never experienced a recession of this . . .