President Donald Trump is considering switching up his attack on U.S. health research budgets by capping how much the National Institutes of Health (NIH) can spend on indirect costs, The Atlantic reports. But although the plan moves the focus of cuts away from research and on to administration, it has still triggered strong reactions, including a claim it will “disembowel” a source of ingenuity.
The proposal detailed in The Atlantic, which is based on comments from two anonymous sources within the NIH, would cap the U.S. medical research center’s indirect costs at 10%. This would limit the amount the NIH can award grantees to cover the cost of the equipment, IT, administration, electricity and other overheads that are needed to run research programs. The concept of the cap and the speed at which it may be implemented have caused alarm in some quarters.
“Even if you wanted to do this, you don’t do it in one year,” Harold Varmus, a former NIH director, told The Atlantic. “It would be a tremendous blow for many of our research institutions and ignores the real cost of doing research. If you really want to disembowel a source of learning and ingenuity in America, this is what you do.”
Varmus is well placed to comment on the NIH, having served as director of the institute from 1993 to 1999 before returning to lead the National Cancer Institute from 2010 to 2015. And his concerns about the proposal are shared by others, both within NIH today and among the organizations that rely on it for funding.
Research!America’s Mary Woolley said research centers could find efficiencies in their indirect costs, but added “you’re not looking for efficiencies when you say we’ll cut off three or four of your appendages.” And one of the anonymous sources within NIH predicted “every single university president across the country” will call their representative if the proposal moves forward.
The White House has said the composition of the president’s 2018 budget proposal is still in a state of flux, adding that no final decision on NIH funding has been made. But the fact the cap is a way to both reduce the NIH budget and address perceived inefficiencies suggests it is likely to appeal to the Trump administration. Earlier comments from Health and Human Services Secretary Tom Price also suggest the NIH itself had already earmarked indirect costs for the chop.
The question is how deep the NIH can cut without damaging research. The NIH handed out $6.4 billion to cover indirect costs last year, as compared to the $16.9 billion it awarded in research funding. That meant 27% of its outlay went toward indirect costs. If the 10% cap was in place, NIH would have awarded $1.7 billion to cover indirect costs, saving the government $4.7 billion.
How well universities and other beneficiaries of NIH funding would cope without that money is a source of debate. The wide range of rates of indirect costs provided by the NIH has raised eyebrows in the past. And the fact the Bill & Melinda Gates Foundation has a 10% cap (PDF) on indirect costs has added to some people’s belief that the NIH provides too much money.
Others, as shown by Varmus and Woolley’s comments, are less sanguine about the issue.