Politicizing Science: The National Institutes for Health

A merit-based and competitive process will be politicized - or eliminated

There is widespread reporting of hundreds of grant cancellations at the National Institutes for Health (NIH)—with significantly more coming. This is in the context of ongoing funding freezes and chaotic layoffs of its expert staff, most of whom have PhDs in the fields for which they oversee review and funding processes.

These cuts, both to staff and grants, reflect a broader move to shift how the NIH allocates its $48 billion dollar research budget, from processes governed by scientific expertise, to processes governed by partisan judgements.

Media reports document a lists of words, including “at risk” and “female”, that will lead to grant cancellations. With those criteria, most rigorous health research on humans is susceptible to being cancelled.

It’s not just words that are disqualifying. Specific scientific breakthroughs, like mRNA techniques, have similarly fallen into political disfavor. NIH helped fund the recently developed mRNA-based vaccine that has put us on the cusp of a cure for the deadly and brutal pancreatic cancer.

This approach to grant cancellations and funding decisions is contrary to NIH’s mission, and the basic principle guiding funding decisions, which is that scientific expertise guides those processes.

If you’re intimate with the rigor of the NIH funding process, the politicization of funding decisions is completely disconnected from any kind of ‘efficiency’ goal. But, of course, most people are not familiar with scientific review processes. So let me tell you how the NIH review processes normally works, from the perspective of someone who does NIH funded research as a scientist, and personally benefits from NIH research as a citizen.

I want you to understand the system they’re trying to “fix”.

NIH’s Unparalleled Impact on Our Health and Economy

First, the basics. The agency funds $48 billion dollars in scientific research annually. It is the largest and most impactful scientific funding agency in the world.

While other countries might raid the US for scientific talent now or attract the immigrant scientists who have historically flocked to the US, they cannot easily emulate the decades-long infrastructure that NIH has built up in health science, which is also reflected in research production.

NIH funded research is a core contributor to declines in cardiac and cancer related mortality, and the related 6 year increase in life expectancy among Americans since 1969. Nearly all pharmaceuticals that come on the market have been fueled by science linked to NIH funded projects. NIH not only generates good science; it’s also a smart investment. In purely economic terms NIH returns about $2.56 for every dollar invested.

NIH is also the primary funder for research on rare diseases. Private research firms, such as pharmaceutical companies, don’t have an incentive to fund such diseases because it’s not profitable. Individual diseases might be rare, but in aggregate they affect nearly 30 million Americans.

As a personal example, my daughter has a rare genetic syndrome. The NIH funds nearly all of the existing research on the topic, including intramural research done at the NIH. Because NIH led the effort to map the human genome, our ability to even identify her syndrome with a diagnostic test is because of the NIH. Current medical guidelines (see here) for the syndrome are based nearly exclusively on NIH funded research.¹

A Rigorous Process for Determining Funding

That impact of the NIH is the direct result of the process by which it makes funding decisions. Those decisions are largely made by scientific experts, not through a process filtered by political ideology.

All applications are peer reviewed by advisory panels, comprised of scientific experts from around the country. Imagine a bunch of nerds that spend most of their time in labs and in front of a computer. (I am one of those nerds!) These processes are also highly formalized, rigorous, and tightly regulated to minimize bias. It is the opposite of a politicized process - it is a group of people who are world class experts on one specific domain of science who obsess about trying to get it right.

One thing I want to emphasize is that this process is remarkably efficient. The Office of Scientific Review organizes approximately 1200 review meetings every year, ultimately processing the large majority of NIH applications, but has only 0.4% administrative costs. Moreover, scientific review and program officers that oversee these processes are themselves experts, nearly always with PhDs in the fields they’re assigned to oversee.

The Figure below provides an overview of the stages in the application process.

For the First Level (Peer Review), a core group of scientists are appointed to peer review advisory panels for 4-year terms (‘standing members’), and then additional scientists (‘ad hoc members’) are added to those panels. (Here is an overview of how scientists are selected). The mixture of a stable and flexible pool of reviewers allows NIH to ensure that any given pool of applications is reviewed by members who have core scientific expertise in the submitted applications.

I have reviewed applications for the NIH for about 15 years. I have been both a ‘standing’ member of a panel and an ‘ad hoc’ member. It is a lot of work, but also one of the most rewarding parts of my job. You get to see how science evolves to take on—and hopefully answer—big questions.

What does an NIH application look like? A single application is hundreds of pages long. Here is a proposal I submitted some years back:

My most recent NIH application was 256 pages! This reflects both the need to communicate the promised scientific contributions, as well as satisfy intense administrative requirements to ensure research funds will be spent appropriately. The applications include detailed documentation of the science (e.g. the research plan), the budgets, investigators’ experience and expertise, and institutional capacity to support the science (e.g. are there labs, computing systems, and materials provided by the university required to complete the science). Complicated applications for larger projects can run up to 1000 pages. The review process is demanding, but it ensures that no-one can bluff their way through this process. It also helps ensure NIH funds are spent wisely.

Peer review panels do the first stage of deep review. As a reviewer, you write-up reviews for about 10 applications. I typically spend about a day on each application. You use a formal template to do the review, which ensures you’re assessing applications in a rigorous and consistent manner. You also receive guidance and training about this process, including conflicts of interest rules (e.g. you can’t review people at your own institution or people with whom you collaborate or have any kind of financial interest).

When I was a permanent panel member, I spent about four weeks a year devoted to panel reviews. The full panel meets, discusses the applications, with those writing the reviews leading the discussion. The full panel then “scores” the application based on their own review of the application, as well as the discussion.

That score is then translated into a percentile score, based on its ranking among other applications. In my experience, the ‘funding line’ has typically been around the 15^th percentile (i.e. 85% of applications do not get funded), though it varies across institutes, and can vary by type of investigator (such as Early Stage Investigators).

The funding line can be higher, and it can be much lower, depending on the budget, and other factors. For example, Congress allocated specific budgetary amounts for Alzheimer’s Disease research in recent years, so the funding line for that research has been higher than other areas. I’ve had years where my application squeaked under the funding line with a 7^th percentile score (with some large cuts to the budget) and years where the funding line was closer to the 15^th percentile.

What is true, however, is that only applications that ‘score’ in the very top of the distribution get funded. Mostly, experienced scientists spend months preparing applications that don’t get funded. In other words, it is an intensely competitive process, where most participants invest lots of time, and leave empty-handed. The level of competition means that merit and quality is embedded into the process.

After that first deep peer review, where applications are scored and then receive that percentile score, they are next reviewed by a second advisory panel (called “Council”). Council members are selected in a similar manner as are those who do the first level, except they tend to be, effectively, even more highly meritorious scientists. This is where you’re likely to meet some Nobel Prize winners!

Council makes the final recommendation to NIH program staff about what will be funded. In my 20 years of experience, however, your percentile score, which is determined based on that first review, nearly always determines whether you do or do not get funded. It’s a remarkably transparent process.

The Gross Inefficiency of Grant Terminations

All of this is to say that when someone receives an award, it is the result of years of preparation by the scientist, plus months of review by teams of leading researchers on the topic. It is not random. It is merit-based and transparent.

It is the opposite of what we are seeing now, which is chaos and deep dysfunction as these grants are terminated, and political criteria are imposed upon the process.

The grant terminations are also an astonishing waste of money. Projects are being cut off mid-stream, with millions of dollars already invested, which now won’t be completed. The money invested in the review processes has now also been wasted. The cuts are not saving money—they are doing away with investments that more than pay for themselves.

A Shift Towards Politicization

These cancellations are on top of the ongoing partial shutdown of NIH. Reviews of applications submitted since the Fall of 2024 are happening only at a trickle, due to Trump and DOGE’s use of a bureaucratic loophole to slow the process. Importantly, that loophole is preventing NIH from scheduling many of the expert panel reviews I described above.

Even more concerning are recent reports that NIH might gut its workforce, cutting up to 25% of its employees. Cuts at that scale, with staff that have highly specialized knowledge, would grind NIH to a halt. It also includes program officers who provide oversight throughout the process, from providing advice on applications to ensuring proper oversight once grants are actually made.

What happens next?

While we can’t be certain, a trend away from scientific expertise as the guiding framework for how NIH spends its money, and towards political ideology, makes it harder for the agency to fulfill its congressional mandate. The NIH’s mission is to "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." Politicized science that tosses aside rigor and merit in review will waste money, abandoning the science that quite literally extends the quality and length of our lives.

Pamela Herd is the Carol Kakalec Kohn Professor of Social Policy at the Ford School of Public Policy, University of Michigan.

1. If you link to the papers cited here nearly all were either studies done by NIH employed researchers (intramural) or those with grants funded by NIH (extramural).