Author + information
- Received February 10, 2010
- Revision received March 24, 2010
- Accepted March 29, 2010
- Published online July 13, 2010.
- Michael S. Lauer, MD* ()
- ↵*Reprint requests and correspondence:
Dr. Michael S. Lauer, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 8128, Bethesda, Maryland 20892
On February 17, 2009, the President signed into law the American Recovery and Reinvestment Act (ARRA). Designed to stimulate the ailing economy, the $787 billion legislation included a $10.4 billion allocation to the National Institutes of Health (NIH). These monies were intended to support scientific research priorities ($8.2 billion); extramural construction, repairs, and alterations ($1 billion); shared instrumentation and other capital equipment ($300 million); NIH buildings and facilities ($500 million); and comparative effectiveness research ($400 million). The ARRA presented the National Heart, Lung, and Blood Institute (NHLBI) with a number of unprecedented challenges and opportunities. Now, approximately 1 year later, we are in a position to offer some reflections about lessons learned.
Bottom-Line Facts and Figures
A total of $763 million were allocated to the NHLBI (Fig. 1);in addition, the Office of the Director of NIH allocated $68 million of comparative effectiveness research money to projects that fall within the mission of the NHLBI. The 2 largest categories of spending were for grants to investigators who responded to the NIH-wide requests for applications (RFAs), including challenge grants, grand opportunity (“GO”) grants, and small-business awards ($351 million); and grants to 358 investigators who had previously submitted investigator-initiated research proposals that were highly meritorious but missed the pay-line ($292 million). Additional monies were spent to support research employment opportunities for young investigators and summer research experiences for students and educators. Complete details about NHLBI ARRA spending can be found on our website (1). The NIH's “ARRA investment reports” (2) provide overviews of support for specific disease areas and research topics, including specific project examples. Interested readers can find specific details about all of the NIH ARRA-funded projects with the “RePORTER” query tool (3).
The NHLBI supported 136 challenge grants and 60 “GO” grants. The major challenge grants topic areas included clinical research, biomarkers, enabling technologies, comparative effectiveness research, genomics, regenerative medicine, and translational science. The major GO grant topic areas included large-scale deoxyribonucleic acid sequencing and molecular profiling, genomics beyond genome-wide association studies, comparative effectiveness research, novel methods for assessing health disparities, testing mechanistic hypotheses, and translation of fundamental research findings into clinical treatments.
The biggest initial challenge we faced was an extraordinarily tight timeline. Because the ARRA was an economic stimulus bill, it was expected that we would allocate funds within fiscal year 2009, which ended on September 30. Compared with standard NIH timelines, this left us with little time to make high-level strategic decisions, write and release RFAs, answer queries from interested investigators, subject applications to rigorous peer review, make funding decisions, obtain approvals from the NHLBI Advisory Council, and work with successful applicants to finalize budgets and specific aims.
Our second challenge stemmed from a perception that the NIH was suddenly “in a fishbowl.” The $10.4 billion allocation received a great deal of media attention (4), and many in the scientific community and in the public at large were understandably skeptical as to whether the NIH could rise to the opportunity. It was clear to us that we could not simply continue “business as usual,” but we had to take advantage of the sudden influx of money to fund innovative, scientifically valuable research that would not have been possible without the legislation.
Our third challenge was the need to generate mechanisms to support 2-year projects. The typical NIH grant funds scientists for 4 to 5 years, with some large projects (like pivotal clinical trials) lasting even longer. The ARRA provided funding for 2 years, requiring us to focus on the kinds of projects that could yield rapidly scientifically meaningful output.
We believe that 4 factors made it possible for us to meet these challenges: a well-developed strategic plan, a well-informed NHLBI program staff, a flexible administrative infrastructure, and an engaged scientific community.
In 2007, the NHLBI completed a comprehensive Strategic Plan (5), which culminated from 2 years of work that included hundreds of extramural scientists and dozens of NHLBI scientific staff. The plan provided a detailed blueprint for a comprehensive research program including basic, translational, clinical, and population sciences. On March 9, 2009, senior NHLBI leadership participated in a full-day retreat designed to develop a high-level plan for the Institute's approach to the ARRA. We were able to agree upon a general philosophy as well as write RFAs (6) mainly because we had been engaged in strategic planning for years.
Over a period of a few weeks, our staff wrote and vetted a number challenge- and GO-grant RFAs (6,7). We took advantage of our staff's expertise in a wide spectrum of biomedical science, ranging from molecular biology to population epidemiology.
Flexible administrative infrastructure
Typical NIH RFAs focus on specific topics; for example, the NHLBI recently released an RFA to support work in progenitor cell biology (8) and an RFA to support cardiovascular outcomes research (9). With the ARRA, we had to develop flexible RFAs that could simultaneously address applications dealing with wide-ranging topics. Our success in writing, posting, and processing this new type of RFA was possible because we already had well-developed administrative procedures in place and we had a cadre of administrative professionals within our division of extramural research activities (also known as “DERA”) who could adapt existing administrative procedures to the new requirements of the ARRA.
An engaged scientific community
The NIH received nearly 22,000 applications in response to the ARRA, clear evidence that the scientific community was ready and eager to put forth a high volume of research proposals. After the NHLBI initially released its challenge- and GO-grant RFAs, our staff received thousands of queries from potentially interested investigators, eager to know whether their ideas might be responsive. Because of the extraordinarily large number of applications received, we had the opportunity to assemble a cohesive and comprehensive research program that covers a wide range of cardiovascular biology and disease.
Now that the initial phase of the ARRA is over, we are acutely aware of a number of ongoing and future challenges. We are keeping particularly close tabs on high-cost, high-profile projects, including a multisite project for large-scale deoxyribonucleic acid sequencing of well-characterized NHLBI cohorts (10) and a pivotal multicenter randomized trial testing a hypothesis that computed tomography angiography is superior to standard stress testing for the evaluation of patients with suspected coronary disease (11). Irrespective of future NIH funding, major failures of large-scale ARRA projects could jeopardize NIH's standing. Across all of the ARRA projects, we will need to apply valid and objective metrics to help us understand which programs were most successful and why. We plan to capitalize on the ARRA experience by combining these metrics with our reflections on strategic planning, staff skills and expertise, administrative processes, and engagement with the scientific community.
We expect that over the next few grant cycles, we will see an unusually large number of applications, because unsuccessful ARRA applicants will reattempt to secure funding via standard NIH funding mechanisms. Perhaps the biggest challenge, one that is acutely in the minds of NHLBI staff and extramural scientists alike, is the question of what will happen after the ARRA funding concludes. The ARRA represented a 17% increase in the NIH budget for fiscal years 2009 and 2010; compared with the baseline (i.e., excluding the ARRA) 2010 budget of $31 billion, the NIH budget for 2011 is only expected to increase by 3.2% to a total of $32 billion. Some have argued that, for the NIH budget to adequately meet scientific demands, it must be increased to as much as $37 billion (12). If, as we hope, many of the our funded ARRA projects are successful, we would expect that most if not nearly all investigators will be competing for continued funding; this will present the NHLBI with the need to make progressively more difficult decisions about how best to exploit the riches and lessons of the ARRA in the years to come.
Dr. Lauer is an employee of the National Heart, Lung, and Blood Institute.
- Abbreviations and Acronyms
- American Recovery and Reinvestment Act
- grand opportunities
- National Heart, Lung, and Blood Institute
- National Institutes of Health
- request for application
- Received February 10, 2010.
- Revision received March 24, 2010.
- Accepted March 29, 2010.
- American College of Cardiology Foundation
- ↵Funding and Policies: The NHLBI and the Recovery Act. http://www.nhlbi.nih.gov/recovery/funding/index.htm. Accessed February 10, 2010.
- ↵NIH ARRA Investment Reports. http://report.nih.gov/recovery/investmentreports/. Accessed February 10, 2010.
- ↵NIH RePORTER query tool. http://projectreporter.nih.gov/reporter.cfm. Accessed February 10, 2010.
- Harris G.
- Nabel E.G.,
- Lauer M.S.
- ↵NHLBI Participation in NIH Research and Research Infrastructure “Grand Opportunities.” http://www.nhlbi.nih.gov/recovery/funding/grand-opp-grants.htm. Accessed March 21, 2010.
- NHLBI Participation in NIH Challenge Grants in Health and Science Research. http://www.nhlbi.nih.gov/recovery/funding/challenge-grants.htm. Accessed March 21, 2010.
- NHLBI Progenitor Cell Biology Consortium: RFA-HL-09-004
- NHLBI Centers for Cardiovascular Outcomes Research: RFA-HL-10-008
- ↵Economic stimulus fuels NIH search for genetic disease signatures. http://www.nhlbi.nih.gov/recovery/media/stimulus.htm. Accessed February 10, 2010.
- ↵Pamela Douglas, MD, MACC, FASE, FAHA http://www.nhlbi.nih.gov/recovery/researchers/index.php?id=226. Accessed February 10, 2010.
- Federation for American Societies for Experimental Biology