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BMJ Study: Insufficient Clinical Research by NIH Led to Politicization of COVID

Reuters: Lindsey Wasson

According to a new study in the British Medical Journal (BMJ), in 2020, the National Institutes of Health (NIH)—the federal government agency dedicated to studying public health threats—committed just 2 percent of the 56,169 grants it issued that year towards the study of COVID-19. Alarmingly, as the devastating pandemic destroyed the global economy and killed thousands of Americans, the agency devoted significantly more funding towards behavioral and social science research than coronaviruses during the first year. 

In the preprint study, investigators from Penn State and Johns Hopkins Universities found that “Rare Diseases research received 2.5-fold more funding than coronavirus research and aging research received 2.2-fold more research funding than coronavirus research.” Immunization, Infectious Diseases, Human Genome, Genetics, HIV/AIDS, Lung, and Cardiovascular research also received more funding than Coronaviruses in 2020 and continued to do so in 2021 and 2022. 

NIH
NIH Funding by Research Area (2020)

The analysis reveals the NIH had a $42 billion budget in 2020, appropriated by Congress, with $2.2 billion allocated to COVID-19 research. In studying COVID-19, the most common clinical/scientific areas examined were social determinants of health (8.5% of COVID-19 funding), immunology (25.8%), and pharmaceutical interventions research (47.6%). 

The agency issued 104 grants to study COVID-19 non-pharmaceutical interventions, of which two grants explored the efficacy of face masks, and six studied the effectiveness of social distancing. Meanwhile, of the 83 COVID-19-funded grants on transmission, five were awarded to study airborne transmission of COVID-19, and two were grants on the transmission of COVID-19 in schools. 

The researchers remarked, “In the first year of the pandemic, the NIH diverted a small fraction of its budget to COVID-19 research.” And approval for the COVID-19 research that received funding took an average of 151 days from the time the funding opportunity was announced to the award notification date, with the majority of funding not delivered until the last few months of the year.  

NIH
Number of COVID-19 Grants Approved by NIH in 2020

NIH Funding Patterns Under Scrutiny Since the 1990s

The world’s largest funder of biomedical research, the NIH employs over 20,000 people. Research sponsored by the agency “aims to tackle the toughest problems in healthcare while financially supporting research at every stage.” Earlier examination showed that NIH research funding had been disproportionately aligned to disease burden in the population. 

The BMJ analysis reveals that throughout the 1990s, NIH funding patterns were under significant scrutiny from Congress and the scientific community “due to concerns that funding allocations by the NIH failed to adequately reflect the burden of disease on society.” 

In 1998, the Institute of Medicine (IOM) released a groundbreaking report guiding the NIH “to improve and develop disease-specific funding processes.” This guidance, combined with a landmark study published in the New England Journal of Medicine and a follow-up study by Gillum et al. in 2011, disclosed that “the NIH disease-specific funding levels were not correlated with several measures of disease burden.”

The same view has been echoed for years by lawmakers like President Trump and Sen. Rand Paul (R-KY), who have regularly criticized the NIH for irresponsible funding. In May 2021, Sen. Paul tweeted“Ever wonder why a lizard waddles when he walks? Well, for one and a half million taxpayer dollars, NSF had lizards walk on a treadmill while taking x-rays of their joints—what did they discover? That they need more taxpayer money before they could conclude any answer.” 

Prior to Sen. Paul’s skepticism surrounding NIH funding, in 2017, President Trump recommended that Congress slash $7 billion from the NIH over two years, primarily reducing unnecessary research grants. In stark opposition, lawmakers instead increased spending on biomedical research at the NIH, securing a $2 billion increase for the agency. 

Study: Delayed Agency Response Led to the Politicization of COVID-19

Yet, researchers in The BMJ preprint document that despite all the years of substantial funding channeled towards protecting Americans from emerging diseases and the decades-long advice to improve its funding processes, the NIH’s inability to respond quickly to the COVID-19 pandemic is troubling. The study points out “the lack of rapid clinical research funding to understand COVID-19 transmission may have contributed to the politicization of the virus.”

Indeed, some of the most fundamental questions asked by medical professionals in early 2020, such as how it spreads, when infected individuals are most contagious, and whether masks protect individuals from spreading or getting the virus, went unanswered. Likewise, doctors offering effective treatments like Ivermectin were quickly censored. Study authors maintain that “In the absence of evidence-based answers to the common questions, the public was asking, political opinions filled that vacuum.”

Expanding further on the failed responsibility of the federal agency tasked with keeping us safe, the researchers explain that NIH funding patterns for COVID-19 grants did not align with COVID-19 disease burden and were allocated slowly. Stating the importance of sound  clinical research aimed at developing evidence-based recommendations—especially relevant to addressing a public health emergency—the authors conclude:

“The social and political climate of the COVID-19 pandemic has been plagued with misinformation hindering important mitigation efforts. The NIH, as the largest research funding arm of the federal government, has a responsibility to fund research that can address misinformation with evidence. A resilient health care system in times of crisis should be able to pivot funding toward specific grants answering critical gaps in knowledge.”

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