Kurt Williamson, Ph.D., is an associate professor of biology. His research focuses on viruses in the environment and he teaches courses in virology and molecular biology. Email him at kewilliamson@wm.edu.
The views expressed in this article are the author’s own.
In the last month, many hasty decisions have been made in the name of supposedly increasing efficiency. While these decisions are having systemic effects across a growing number of federal agencies, I want to draw your attention to the impact on just one federal agency: the National Institutes of Health. Since it’s a big, bloated federal bureaucracy, it must be teeming with waste, middle managers and redundancy, right? And just look at these overhead rates. The NIH has had its day in the sun as a so-called ATM for scientists and it is time to freeze all funding and tighten the belt with across-the-board cuts NOW.
No doubt, inefficiencies could be identified and remedied with careful analysis and rational implementation. But the approach being employed is neither thoughtful nor careful, and it is downright dangerous. Before mindlessly hacking away at the NIH in the name of cost saving, we are obliged, first, to understand what the NIH is, what it does and what we get from our financial investment in its mission.
NIH stands for National Institutes of Health, whose stated mission is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.” The agency started as the Marine Hospital Service in the late 1800s, later being formed into the National Institute (singular) of Health in 1930.
Today, it is known as the National Institutes, plural, because the umbrella of NIH covers 27 different institutes and centers that focus on different aspects of human health and disease, including cancer, heart conditions, genetic disorders, aging, stroke and mental health. Which area(s) of human health should we stop investigating in an effort to save money and improve government efficiency?
Speaking of efficiency, let’s look at what we have received from our investment in the NIH: innovations in the form of drugs for treating cancer, pain, neurodegenerative diseases like Alzheimer’s and ALS and viral infections; interventions for managing pain, addiction and physical disabilities and advanced surgical procedures. These advances allow us to live longer, healthier lives than we otherwise would have without such investment. Which of these important benefits would you rather not have in order to save a little money?
Another critical benefit we receive from our investment in the NIH is innovation and job creation in the biotechnology sector. “Biotechnology” just means the interface between living systems and new developments in other fields like chemistry, electronics, computer science and physics. Some key examples of biotechnology that are fundamental to our quality of life today include the process by which we can safely make synthetic human insulin for treating diabetes (a biotechnology known as “expression vectors”), and DNA sequencing, which can reveal the genetic basis of a cancer cell or identify a new infectious disease agent. Without the research, testing and clinical trials sponsored by the NIH, we would not have the pace of innovation the US enjoys, nor the economic benefits that arise from the development, marketing and application of these innovations. It is conservatively estimated that every $1 invested in NIH endeavors returns over $2.50 to the US economy on that investment. How much future growth are we willing to sacrifice for today’s cost-cutting?
One more important benefit that we receive from our investment in NIH is the training it provides to future researchers and physicians who will practice in the US, to the benefit of US citizens. The NIH administers dozens of programs (and invests millions of taxpayer dollars) to train and support scientists at all levels of their careers so that they can deliver the highest quality, highest impact results that lead to those previously mentioned improvements in our health and the length of our lifespans. Without a pipeline to train and support our best and brightest, where will our next-generation cancer treatments come from? Who will devise novel approaches to organ transplantation? How will we develop even safer and more effective interventions for opioid addiction? And how much are these new developments and improvements worth to you?
From where I sit, working with undergraduate students at the very beginning of their professional careers, the training and support of new and early-career scientists is a particularly hard blow that will affect all of us for years to come. Students who had been accepted for early-career experience through NIH summer research internships are receiving notices that these programs have been terminated. Students who had been accepted to competitive 2-year training fellowships at NIH, to prime them for biomedical research immediately after completing their baccalaureate degrees, are likewise receiving cancellation notices. The internships, postbaccalaureate training programs and other foundational experiences offered by the NIH that would have set these students on paths to practicing medicine and conducting innovative medical research have all evaporated overnight. The Trump administration has decided that these students are not worth the investment, and the impact will be devastating.
The immediate impact will be a brain-drain because our best and brightest will not find training or employment opportunities in the domestic biomedical sector and will either seek opportunities abroad or abandon medicine altogether, depriving our country of this important pipeline. As a result, our pace of innovation and development will decrease, and economic opportunities and biomedical advances will happen elsewhere — but not here. The ultimate consequence of today’s shortsightedness will be a decline in the overall quality of health and lifespan in the US.
So, I end where I began: it’s not that large federal agencies like NIH cannot or should not be audited for sound financial practices, evaluated for program effectiveness and improved. I am sure they can, but that is not what’s happening now. The current administration is hurting you, and future generations of Americans, with this thoughtless and destructive approach, and it needs to stop.
