The U.S. biomedical research enterprise is in serious trouble. While the National Institutes of Health (NIH)—the country’s main funding source—still boasts an impressive $30 billion annual budget, the agency’s spending power has declined more than 20% since 2004. This belt-tightening after a period of surging funding has thrown the system into disarray, with institutions and principal investigators grappling for grants and PhD candidates and post-doctoral fellows struggling to find permanent, satisfying positions.

Some observers have gone so far as to suggest that the funding shortfall is threatening America’s prowess in biomedical research. National Academy of Medicine President Victor J. Dzau, MD, and past-president of the Institute of Medicine Harvey Fineberg, MD, stated the danger bluntly in a JAMA editorial earlier this year: “The U.S. position as a global leader in biomedical research is being undermined.”

Add to these concerns an onerous regulatory environment, and all the ingredients are in place for effecting significant change. Momentum for reforming the entire system is, in fact, gaining ground. In September, the third annual Rally for Medical Research Hill Day brought together more than 300 scientists, congressional leaders, and NIH Director Francis Collins in a push for predictable and robust investment in research. A variety of other initiatives representing academic researchers, trainees, and bioscience policy experts also are mobilizing for change.

A Grand Vision

In analyzing the root causes of today’s challenges, many blame the once-admired vision of continual growth, introduced in 1945 by Vannevar Bush, the nation’s first presidential science advisor. His report, Science: The Endless Frontier, set long-term government support for science in motion. Federal budgets expanded into the late 1960s and 1970s, but dollars declined in the 1990s, up-surged from 1998 to 2003, then fell again. The “demand for research dollars grew much faster than the supply,” wrote Bruce Alberts and coauthors, in a 2014 Proceedings of the National Academy of Sciences (PNAS) paper.The authors explain how stagnant budgets led to more failed grant applications, more time spent on administration, and a growing dependence on low-paid PhD candidates and postdoctoral fellows.

“In real dollars, the NIH budget is down by 25 percent from where it was in 2003,” Alberts told CLN. A biochemist at the University of California, San Francisco, he also is the former editor-in-chief of Science and former president of the National Academy of Sciences. His coauthors on the PNAS paper, including Harold Varmus—a Nobel Prize recipient, former NIH director, and current National Cancer Institute director—carry considerable clout. They called for predictable, stable funding of biomedical research, by “adding a 5-year projected fiscal plan” to current budgets, with yearly updates, as appropriations bills are written.

Other key influencers and policy analysts support this position. A perspective piece recently published in PNAS identified predictable and stable federal funding as a very popular reform in a meta-analysis of papers on systemic change. The analysis, led by Christopher Pickett, PhD, a policy analyst at the American Society for Biochemistry and Molecular Biology (ASBMB), also revealed that most stakeholders support an increase in overall research funding and a reasonable target for U.S. research and development spending. In addition, the authors found consensus for using 3% of U.S. gross domestic product as a starting point for discussion. Finally, they urged scientists to advocate for sustainable research funding through a long-term science budget and encouraged research and development investment from nongovernmental sectors.

The Workforce Challenge

The boom-and-bust cycle of funding is having repercussions far beyond research financing. When academic institutions continued to expand their biomedical research enterprises even as federal funding stalled, this gave rise to a hypercompetitive, strained environment, with adverse consequences for trainees. “Absolutely outstanding trainees are not getting the kind of jobs that they deserve,” Alberts told CLN.

The problems originated back in 1977, explained Paula Stephan, PhD, a professor of economics at Georgia State University. That’s when the National Research Council (NRC) underscored the urgency of slower workforce growth. However, this advice was not heeded. In 1994 and 1998, the NRC again called attention to slowing workforce growth, but again, academia did not respond. Instead, the numbers of trainees swelled, Stephan explained. “We use postdocs because they are cheap and because the incentives are there to expand the research space.”

Stephan pointed to the 2013 Survey of Earned Doctorates, which boasted a better than 92% response rate. It found that 42% of new PhD recipients do not “know for sure where they will go” for their first job. “The training pipeline produces more scientists than academia, government, and the private sector [can absorb],” Alberts said.

Restructuring the Workforce

Given this labor imbalance, reform of the U.S. biomedical research system must encompass not only financial change but also workforce reorganization, Stephan suggested. “You’ve got to change the incentives,” she said. Stephan also backs increasing postdoc salaries, putting caps on what percent of a person’s salary can be charged off grants, helping students get a realistic understanding of the job market, and expanding career options. Advocates also want institutions and government to add more staff scientists, which would enhance stability and productivity in bioscience. Last spring, the National Cancer Institute announced a new program for funding staff scientists, and more awards are likely to follow.

These are thorny recommendations for sure, but multiple stakeholders are building alliances to support them. The National Postdoctoral Associationand Future of Research, representing PhD candidates and postdocs, respectively, have been building grassroots support for training reforms. In late October, Future of Research held a meeting that explored challenges trainee scientists face in today’s research climate and looked at how to equip science postdocs to be leaders in whichever career paths they follow. “We hope to raise awareness and see achievable small steps to change,” said Gary McDowell, 2015 Future of Research organizer.

Academic institutions also have the responsibility to expose PhD candidates and postdocs to the spectrum of opportunities beyond bench research, experts told CLN. “We need to celebrate many career paths and look at the scientific enterprise in a broader framework,” suggested Cynthia Fuhrmann, PhD, assistant dean of career and professional development in the Graduate School of Biomedical Sciences at the University of Massachusetts Medical School (UMMS). Fuhrmann added career development right into UMMS’ training curriculum, encouraging trainees to think about their career paths early on, build networks, and examine their skills for career opportunities in research, industry, technology transfer, or teaching.

She pointed out that NIH now requires principal investigators to report on whether individual development plans (IDPs) are completed for all NIH-supported graduate student and postdoctoral researchers, whether on training grants, fellowships, or research project grants. Further, evaluation of IDPs are now included in the review criteria of training grants. NIH through its Broadening Experiences in Scientific Training program also is aiming to expose trainees to diverse career paths outside of academia.

Movement Ahead

The push for innovation led to the release in September of a new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine, calling for a new framework for research regulation. The report acknowledges that “inefficient, duplicative, and over-scaled regulation” needlessly encumbers the nation’s research investment. It calls for “harmonizing regulations across funding agencies and reinvigorating government-university partnerships.” The document also outlined specific actions that Congress, the White House, federal agencies, and research institutions should take. A congressionally-created Research Policy Board would play an ongoing role in long-term “conception, development, and synchronization of research policies.”

ASBMB’s Pickett praised the work. “The recommendations are completely in line with previous reports and move the conversation forward,” he said. “We are eager to propose reasonable action plans for their implementation.”

Laura Newman is a freelance bioscience and medical writer based in New York City. +Email: newman@nasw.org