Gabbe, Steven G. MD; Lockwood, Charles J. , MD, MCHM; Marsh, Clay B. MD
Dr. Gabbe is senior vice president for health sciences, Ohio State University, and chief executive officer, Ohio State University Wexner Medical Center, Columbus, Ohio.
Dr. Lockwood is dean, Ohio State University College of Medicine, and vice president for health sciences, Ohio State University, Columbus, Ohio.
Dr. Marsh is senior associate vice president for research and vice dean for research, Ohio State University College of Medicine, Columbus, Ohio.
Correspondence should be addressed to Dr. Gabbe, Ohio State University, 200 Meiling Hall, 370W. 9th Ave., Columbus, OH 42310; telephone: (614) 247-4477; fax: (614) 292-1301; e-mail: email@example.com.
Academic health centers are traditionally dependent on extramural agencies like the National Institutes of Health to fund medical research. The still-struggling U.S. economy has kept federal paylines stagnant in recent years even as research costs climb. Academic health center leaders need to find new funding sources to ensure that critical medical research continues. Myers and colleagues, in their report in this issue of Academic Medicine, found that scientific research funding by philanthropic nonprofit organizations rose 26% from 2006 to 2008. Even though the time frame for their study precedes the recent economic recession, their findings provide hope and guidance to academic health centers. Stable research portfolios should include a variety of sources, and Myers and colleagues suggest that partnership opportunities exist between federal and not-for-profit funding sources to focus on key disease areas. Seeking broader research funding may benefit at-risk groups like junior investigators, as the average age of a first-time NIH grant recipient in 2008 was 42 years old. To foster the new discoveries and ideas that come from young scientists, academic health centers need to diversify their research funding sources.
It is encouraging that high-visibility philanthropic organizations enhanced funding by 26% from 2006 to 2008. However, between 2008 and 2010, overall grant support from foundations declined 2.3%. Should federal and private funding continue to fall, there is an eminent threat of losing a generation of investigators. Thus, creative solutions and partnerships are needed to fund more high-priority research to cure disease and create the future of medicine.
Editor’s Note: This is a commentary on Myers ER, Alciati MH, Ahlport KN, Sung NS. Similarities and differences in philanthropic and federal support for medical research in the United States: An analysis of funding by nonprofits in 2006–2008. Acad Med. 2012;87:1574–1581.
Funding from the National Institutes of Health (NIH) has been the mainstay of support for biomedical research at academic health centers (AHCs). However, even before the onset of the recent recession, NIH funding had been stagnant. Indeed, during the past few years, while per capita spending on defense has grown to $1,600, federal spending for biomedical research has stagnated at about $100 per capita.1 Even prior to the recent economic downturn, industry support of medical school researchers had been in decline. Zinner et al2 noted that whereas 23% of faculty members using biotechnology tools reported being a principal investigator on an industry-sponsored research project in 1985, that number had dropped to 17% in 2007. Dorsey et al3 reported that biomedical research spending by industry had an inflation-adjusted compound annual growth rate of 8.1% from 1994 to 2003 but decreased to 5.8% from 2003 to 2007 (P = .05). Ever greater stress on industry funding of biomedical research at medical schools can be anticipated as a consequence of recent consolidation activity in the pharmaceutical industry. As a result, there has been an increasing focus by biomedical researchers on funding from philanthropic sources.
In this month’s Academic Medicine, Elizabeth Myers and her colleagues4 provide solid evidence that, in contrast to the grim news of relative and/or absolute declines in NIH and industry funding of AHC research, public charities and private foundations appear to have increased disease-targeted research projects and have been even more generous supporters of trainees. Myers et al describe the results of a detailed analysis of funding trends from 2006 to 2008 among members of the Health Research Alliance (HRA), a consortium of nonprofit charities and foundations that usually supports disease-specific biomedical research. Members include such well-known organizations as the American Cancer Society, American Diabetes Association, American Heart Association, the Burroughs Wellcome Fund, the Doris Duke Charitable Foundation, and the March of Dimes Foundation. Data were collected on research topics, the amount funded, and characteristics of the investigators.
The findings of that study are reassuring and enlightening. Overall funding increased 26%, or $212 million, from 2006 to 2008, while the number of grants funded increased 6%. In contrast, NIH funding increased by only 3% through this same time period. Moreover, 43% of grants and 56% of grant dollars were directed toward specific research projects. Of note, 33% of grants and 25% of dollars went to individual trainees, whereas 21% of grants and 6% of dollars went to institutions for training. This compares to only 7% of NIH funding that was directed to training awards. Only 36% of the 8,849 awards made to investigators not previously funded by philanthropic support went to women and less than 2% to African Americans. Thus, there is significant room for improvement to achieving a fuller and more diverse complement of investigators. The distribution of grants was heavily weighted toward PhD (50%) and MD–PhD (21%) investigators compared with MD-only investigators (17%).
The geographic distribution of funding through philanthropic sources mirrors that of the NIH. However, in contrast to NIH funding, which focuses more on foundational science, the philanthropic funding of HRA members primarily targets disease-oriented areas, including cancer, diabetes, and cardiovascular disease. In addition, the HRA’s philanthropic organizations target some basic and early translational scientific work in areas like genetics, biotechnology, and neurosciences. Given potential synergies with federal agencies like the NIH, there are also opportunities for joint funding between philanthropic organizations and federal agencies. As an example, the NIH Medical Research Scholars Program is a collaborative between the NIH, Pfizer, and the Howard Hughes Medical Institute (HHMI) and offers medical students an opportunity to spend a year at the NIH and interact with the most outstanding investigators in the NIH intramural program.5
Although generalizations can be made about philanthropic organizations and the targeting of research funding, it is also important to recognize that all philanthropic organizations are not the same. Whereas some foundations focus on a specific disease, the HHMI supports investigators with research support to allow them to pursue exemplary fundamental science, an agenda more resembling that of federal funding agencies. In addition, the Doris Duke Foundation and Burroughs–Welcome Trust also target early-stage science. Thus, the opportunity to look at collaborative interagency funding programs may be attractive and may allow leveraging of existing precious resources.
There are several limitations to Myers and colleagues’ study. First, the time period (2006–2008) does not allow assessment of the effects of the devastating collapse in equity valuation and bond interest rates on the endowments of these organizations. The economic downturn also affected charitable giving. Both phenomena likely adversely affected the availability of dollars for research projects and trainee funding. In addition, HRA members account for only 40% of spending by foundations, charities, and private philanthropic funds. However, these concerns notwithstanding, the trends reported by Myers et al are heartening. Their findings suggest a potential “hedge” to help begin to wean AHCs from their critical dependence on ever-decreasing NIH grant dollars to drive their research missions. As we come to grips with this “new normal,” the role of philanthropic support for research, and especially career development for young investigators, will likely become even more crucial.
In addition, the authors did not detail the age of investigators when they were initially funded by philanthropic organizations. Recent literature clarifies that despite the large increases in NIH funding from 1980 to 2008, the age of first-NIH-funded investigators rose from 36 to 42 years old. Interestingly, over the same time period, the average age of a Nobel laureate when that individual performed his or her groundbreaking research was 41.6 Philanthropic funding can make a remarkable impact as a first-funding mechanism for young investigators moving toward an academic career. Thus, knowing the age of investigators receiving philanthropic support would be important. Also, to foster the new discoveries and ideas that come from young scientists, AHCs need to diversify their research funding sources.
It is encouraging that the high-visibility philanthropic organizations discussed by Myers et al enhanced funding by 26% from 2006 to 2008. However, between 2008 and 2010, overall grant support from foundations declined 2.3%, most likely reflecting the economic climate.7 Should both federal and private funding continue to fall, there is an eminent threat of losing a generation of investigators. Thus, creative solutions and partnerships are needed to fund more high-priority research to cure disease and create the future of medicine.
Other disclosures: None.
Ethical approval: Not applicable.
1. Loscalzo J. The NIH budget and the future of biomedical research. N Engl J Med. 2006;354:1665–1667
2. Zinner DE, Bolcic-Jankovic D, Bjankovic D, Clarridge B, Blumenthal D, Campbell EG. Participation of academic scientists in relationships with industry. Health Aff (Millwood). 2009;28:1814–1825
3. Dorsey ER, de Roulet J, Thompson JP, et al. Funding of US biomedical research, 2003–2008. JAMA. 2010;303:137–143
4. Myers ER, Alciati MH, Ahlport KN, Sung NS. Similarities and differences in philanthropic and federal support for medical research in the United States: An analysis of funding by nonprofits in 2006-2008. Acad Med. 2012;87:1574–1581
6. Matthews KR, Calhoun KM, Lo N, Ho V. The aging of biomedical research in the United States. PLoS ONE. 2011;6:e29738
7. The Foundation Center. Foundation Yearbook.. 2011 ed. New York, NY The Foundation Center 2011