Structural Disequilibria in Biomedical Research

Many are calling for large increases in the budget for the National Institutes of Health (NIH) to address the damaging effects on biomedical research resulting from recent flat funding levels. Yet politicians respond with skepticism, as the NIH budget is already very large and was doubled over the 5-year period 1998 to 2003 (1). What is often left unsaid is that the fundamental problems are structural in nature—biomedical research funding is both erratic and subject to positive-feedback loops (2, 3) that together drive the system ineluctably toward damaging instability. It may be possible to create broad political support for large annual NIH funding increases into the indefinite future. But if not, objective analyses of systemic instabilities, followed by incremental adjustments, would be strongly in the interest of maintaining the quality of U.S. biomedical research.