Pediatric Research. National Institutes of Health support in the 'steady-state' decade, 1983-1993
E. R. Stiehm
Department of Pediatrics, University of California Los Angeles, School of Medicine, USA.
OBJECTIVE: To examine the trend in the US Public Health Service's National
Institutes of Health (NIH) funding for pediatric research over the last 10
years in terms of dollars expended, grants awarded to pediatrics
departments vs other medical school departments, NIH Clinical Research
Center support, and the distribution of NIH grants to all medical schools
and children's hospitals in the United States. METHODS: Statistical
information from the Division of Research Resources of the NIH, the NIH
Clinical Research Center office, and the Society for Pediatric Research for
the fiscal year 1982-1983 was compared with fiscal year 1992-1993.
Inflation-adjusted dollar calculations were used. All numbers reflect total
costs (direct plus indirect costs). RESULTS: Research grant support to
medical school departments has been stable, increasing only 1% per year in
inflation-adjusted dollars to a total of $3.051 billion; while the total
number of grants has decreased 12% to 12785 awards. Support for pediatric
research increased 91% in inflation-adjusted dollars (to $164 million)
during this period, and the number of pediatric research grants increased
from 390 to 608 (up 56%). However, the nation's 76 clinical research
centers (CRCs) show pediatric clinical research is diminishing. Support for
such research has fallen a dramatic 55% in 10 years, despite $5.4 million
for pediatric acquired immunodeficiency syndrome (AIDS) clinical trials.
There are more pediatric researchers since 1983 (1327-1857), increasing
dramatically the number of unfunded pediatric scientists. Disparity of
research funding continues between the top research-oriented medical
schools (15 of the 126 departments receive 51% of the awards), compared
with 72 medical school departments that have 0, 1, or 2 pediatric research
grants. Most medical students in the United States will never encounter an
NIH-funded pediatric researcher during their medical school training.
CONCLUSIONS: Pediatric research has increased its absolute and relative NIH
grant support in the last 10 years to a greater degree than all other
clinical departments except for psychiatry, neurology, and anesthesiology.
The distribution of grants favors a small number of departments and
children's hospitals. Clinical pediatric research supported by the NIH has
fallen dramatically. In the era of stable NIH funding, pediatric
investigators must develop other sources (private funding and industry) for
expanding their research activities.
