The mission of the National Institutes of Health is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.”
To accomplish that mission, one would surmise that NIH’s funding for scientific research would be allocated based on the burden of disease that Americans face. Cardiovascular disease thus should receive the lion’s share of funding, followed by diabetes, cancer, and so on and so forth.
Alas, that is not the case. In fact, a 2021 analysis of NIH spending published in JAMA Network Open simply found that the single greatest predictor of an NIH institute’s current funding level was its past funding level.
“Congress does not use any systematic methodology — no disease-burden weighting, no tractability analysis, no cost-effectiveness framework — to decide how $48.7 billion in public research dollars is distributed,” researchers with the Alliance for Longevity Initiatives (A4LI) wrote in a white paper published in May. “The allocation is driven by historical inertia and the relative political strength of disease-specific advocacy organizations.”
As you might guess from the researchers’ affiliation, they contend that far more funding should be allotted to aging research.
“The hallmarks of aging — genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication — are causally upstream of the diseases that consume over 50% of the NIH budget. Yet the division tasked with understanding these mechanisms, NIA’s Division of Aging Biology, receives $346 million out of $48.7 billion: 0.71% of the total NIH budget.”
The A4LI researchers proposed a formula to more rationally allocate NIH research funding, weighted by three factors. First and foremost is disease burden, given 50 percent weight. How many disability-adjusted life years does a specific condition cost Americans? Second is upstream causality, given 30 percent weight. Some areas of research explore conditions and mechanisms that affect subsequent disease, and thus provide more ‘bang for the buck.’ Aging biology, for example, feeds into cancer, neurodegeneration, and cardiovascular disease, the researchers say. Third is scientific tractability, given 20 percent weight. How strong is the current state of science in a specific area, and how likely is it to yield meaningful advances in a decade?
“A conservative application of this formula suggests that aging biology research should receive 3–5% of the total NIH budget — approximately $1.5–$2.4 billion annually — rather than the current $346 million,” the researchers propose.
Since research funding is jealously guarded and increasingly endangered in the current political climate, the report’s authors propose a policy to allocate a small fraction of other NIH organizations’ funding to aging-focused research, managed by a joint consortium. “Every funded project would address an aging hallmark as a causal disease mechanism.”
Such a project is a sound investment, and could yield outsized benefits, they write.
“Research suggests that adding just 2.2 healthy years to the average lifespan could save $7.1 trillion in healthcare costs.”
This article was originally published by RealClearScience and made available via RealClearWire.
