My two cents about the NIH "pause"

With some insider background

First a preface: I actually started drafting a few posts in November, but then life happened. A couple of family members had major medical episodes, which derailed my schedule. Then I had to take on a bonus teaching assignment, which has taken much more of my time than I expected. So, I apologize for my absence.

You may have seen in the news that the NIH (and some other agencies that fall under DHS) are in varying levels of shut down. I’d love to cite some actual articles, but I’m finding the articles online to be spotty in their accuracy and clarity. There is a communication block from the NIH, so nothing authortitative is out there to read. The articles I’ve read don’t clearly distinguish between NIH-funded intramural and extramural (NIH staff and scientists vs people outside the NIH that obtain NIH reserach dollars). Here’s the short of it, as best as I can tell: NIH is somewhat shut down at this point. Grant review panels are not running and are in fact being shut down - grant reviewers are actually being sent home from in-person meetings. Some NIH-sponsored conferences are being cancelled. You only know for sure if you happen to have non-NIH sponsored contact info (email addresses and cell phones) for those NIH contacts. There is some talk about NIH travel being stopped, but it isn’t clear if this is NIH-funded travel for outside researchers, or travel for NIH personnel. Grants that were likely going to be awarded are on pause for the time being. All of what I just said is based on what little I’ve gathered from internet articles and my own NIH-funded colleagues.

Side note - some aspects of this happen from time to time. When there is a transition of power at the NIH, sometimes these pauses happen, according to one of my more experienced colleagues. Not just D vs R - any transitions may result in these sort of disruptions. And sometimes NIH does retrict the travel of their personnel, or how they can spend their funds. I’ve seen it myself - some meetings they might not be allowed to attend, or maybe they can attend but not go to certain dinners, etc. So, some of this is not new. Any shock and awe you read in the media about this “pause” should be viewed through that lens.

Dr. Vinay Prasad put out a video on twitter/X on his thoughts on this pause. He made some excellent points, and he made some inaccurate points. I’d like to address both.

Accurate: The NIH may need to reconsider how funding decisions are made. Anyone that has been paying attention has seen really weird stuff get funded. Some stuff is extremely incremental, some stuff has no impact on human health or potentially helping human health (growing human scalps on mice anyone?), and honestly some really good work is not funded due to the personal biases of reviewers and the lack of “champions” in the review panel. Should there be more weight put on importance of scientific areas? The NIH presumes that their tight funding paylines (only the top 10-15th scoring percentile of submitted grants get funded) makes the best work get funded, but how does that actually work out? Vinay made the very good point that we should take a look at the output of those funded grants to see if they have really moved the needle in medicine and human health. Excellent point.

Not quite true: Vinay made the point that the process NIH uses to evaluate their funding decisions has never been scientifically studied. They have studied the impact of bias on the perception of the investigator/applicant. I know because I took part in that study. They explored whether perceptions of gender and/or race affected how the proposal was scored. I’m not sure what they did with this information other than maybe a training video reminding reviewers that they should be unbiased… not sure that worked honestly given what I’ve seen in study section. But honestly… you’d have to hault the funding process to do a study to evaluate the funding process. I’m not entirely sure how efficient that is.

Not entirely accurate: Vinay said that we shouldn’t be so upset about travel being affected by this NIH pause, because of the slush funds of indirects being charged of grants. First let me explain indirects: Universities tack on an additional percentage on top of the reserach budget that are “indirect costs”, that supposedly pay for infractructure (building maintanance, electricity, admin staff, etc). That percentage is different for every university/research institution, is negotiated with the NIH, and varies dramatically.

Perhaps Vinay’s institution(s) use their indirects differently than other institutions. Here’s the truth - very little of that makes its way back to the investigator. Sometimes none of it makes its way back, so it can’t be used for fancy conferences in Hawaii as Vinay said. Honestly, most of it goes to higher admininistration - not the hard working people that manage grants and work with investigators directly, but the people who create bureaucracy. DEI offices are built off these funds. Offices that implement and enforce “compliance training” for all kinds of things, also supported by indirects. Departments are often cash-strapped and not allowed to hire enough computational support, admin support, etc. Want to buy a computer? With the various rules both NIH and universities put in place, that’s easier said than done. IRBs are understaffed even though they should be supported by indirects.

With that background… Do I think we need a better look at how NIH dollars are spent? Yes. Can people survive without an extra trip or two? Sure. (I will say that I have personally benefitted from the networking I did at a national conference - one of my best collaborations grew from that networking.) But this is honestly the tip of a much bigger iceberg regarding how NIH dollars are spent.