Top Things to Know: Principles for the Future of Biomedical Research in the United States and Optimizing the National Institutes of Health
Published: February 19, 2025
Prepared by Stephanie Scarmo, PhD, MPH
- Groundbreaking achievements in science and medicine have contributed to reductions in cardiovascular disease and stroke mortality over the past seven decades. Many of these advances were supported through investments by the National Institutes of Health (NIH), the global leader in funding biomedical research.
- NIH spends roughly 80% of its nearly $48 billion annual budget on extramural research, supporting approximately 300,000 scientists and research staff affiliated with more than 2,500 universities, academic health centers, hospitals, and independent research institutes in the U.S. and globally. Additionally, the NIH spends roughly 11% of its overall budget on intramural research, which includes thousands of principal investigators, staff clinicians and scientists, and trainees.
- This public investment has produced important economic returns, including supporting more than 4000,000 jobs and roughly $93 billion in economic activity in the U.S.
- Unfortunately, public funding has not kept pace with the burden of disease or rates of inflation. This presidential advisory presents five principles to optimize the future of the U.S. biomedical research enterprise in general, and the NIH in particular.
- Specifically, the U.S. should continue to prioritize high-quality biomedical research that is innovative and impactful through a coordinated strategy for prioritizing research questions and streamlining funding. This should include patients and communities most affected by disease; researchers, clinicians, and public health professionals who will conduct the research; and health and disease-specific organizations like the AHA to provide expertise when setting priorities and determining resource allocation.
- NIH should continue to improve efficiency and transparency in its peer review process. This includes multidisciplinary review panels, training and mentoring support for reviewers, and reducing the administrative burden for the grant application itself.
- NIH, in coordination with other agencies, should play a larger role in the translation of evidence into practice, including more funding for implementation research. This includes strengthening partnerships between NIH and other federal agencies, engaging relevant stakeholders and impacted communities throughout the research process, and expanding its current translation and research communication initiatives.
- NIH should continue to build and support the biomedical research workforce with funding and training opportunities to foster innovation and improve retention, including for mid-career professionals.
- Predictable, robust, and sustained public investments in biomedical and population-based research initiatives should be a national priority to maintain the U.S.’s position as a global leader, improve health for all, and reduce the burden of disease.
- We encourage efforts to evaluate the processes and science funded by NIH to ensure that they best align with contemporary population health needs. The NIH and federal agencies that fund and implement biomedical and population-based research initiatives are vital to support today’s current and future health challenges, drive foundational science, improve patient health, reduce the global disease burden, address upstream and preventive strategies, and improve the value of our public health and health care investments.
Citation
Wu JC, Arnett DK, Benjamin IJ, Creager MA, Harrington RA, Hill JA, Ho PM, Houser SR, Scarmo S, Shah SH, Tomaselli GF; on behalf of the American Heart Association. Principles for the future of biomedical research in the United States and optimizing the National Institutes of Health: a presidential advisory from the American Heart Association. Circulation. Published online February 19, 2025. doi: 10.1161/CIR.0000000000001319