What do NIH cuts mean to you? A conversation with Elizabeth Shane, MD

Cuts to NIH funding are affecting labs across the country, resulting in fewer grant opportunities, smaller grants, and general uncertainty about the future of federal funding for research.  Elizabeth Shane, MD, professor of medicine and vice chair for clinical and epidemiological research, discusses how a limited funding future affects her research and what it may mean for generations to come.

1.  Please briefly describe your research.  How much do you depend on NIH support?

My research focuses on bone diseases such as osteoporosis. In particular, I study bone diseases that develop in conjunction with other medical conditions, such as kidney failure, organ transplantation, cystic fibrosis, and HIV infection. I also use high-resolution imaging to understand the effects of various diseases and drugs on bone quality and strength, as well as to learn more about why bones break. About 90 percent of my work depends on NIH funding.

2.  What are the current and possible future effects of NIH budget cuts on your lab and work?  For example, on staffing? Facilities? The pace or scale of your work? The projects you choose to pursue?

The NIH budget cuts mean that I will not be able to conduct all the research I had originally planned and that I may have to reduce my staff. The cuts will slow the pace of my work. In addition, the current low success rates for NIH grant proposals are discouraging as I apply for new grants.

I am adjusting to the changing funding climate by carefully considering which aims I will pursue and which will have to wait; I am looking at how I can reapportion staff to my various grants. I am also trying to generate philanthropic support for my work to make up for limited grant funding.

3.  What effect will cuts have on the research itself, as well as on the broader field?  Will they slow down advances?  Discourage new talent?   

They will definitely slow advances. NIH funding rates seem to be very low for my area of research right now, so I am considering ways to adjust my work. I am looking to see whether I can apply my research skills to other questions that are tangentially related to bone disease, my primary focus. I am trying to figure out what type of research is getting funded and whether I can shift my emphasis to that type of work. This means that many clinical questions, problems, and gaps in our knowledge are likely to remain unresolved.

But the worst problem is what a reduced NIH budget does to "new talent." I think young physician-investigators see the writing on the wall and will be discouraged from pursuing careers in investigation. Even more disturbing is what is happening to people with career development awards who have spent the past five or six years training to become investigators—they are having a very difficult time getting R01 funding, the most common types of research grants. Many of these young investigators will leave research, which means that the considerable time and money devoted to their training (K awards, NIH Loan repayment plan, etc.) will not result in new advances in medical research and knowledge.

4. What do you wish the public to know about the importance of NIH funding? 

That it is a driving force for economic prosperity, that it employs many people in all walks of life, that it keeps our country at the cutting edge of science in the world, and that it directly and positively influences their health.