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Funding health sciences research. A strategy to restore balance
83 research ana which should be high on our priority list, since most (if not all) economic analysis is baaed on the assumption of rational individuals. Laxear deals with the impact of demographic changes (i.e. the aging population) on future labour force policies within firma Rust finally focussea on the retirement behavior of men. This paper is the second in a series of three papers dealing with the subject, but dcea not yet report final conclusions. This volume is ncommcndcd for anybody (not only economists) interested in the problems of the elderly, especially because of the rich variety in methodology (model specifications and estimation techniques) and in available data sets that are used to come to grips with two issues specific for the elderly population. The papers contained in this volume obtain a number of interesting conclusions, which should be studied further and taken into account in designing government policies towards the elderly. Professor K. Kesteloot, Ph.D. School of Public Health University of Leuven Leuven, Belgium
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Funding Health Sciences Research. A Strategy to Restore Balance By the Committee on Policies for Allocating Health Sciences Research Funds of the Institute of Medicine Washington D.C., National Academy Press, 262 pp., 1990, ISBN O-309-04343-3, $27.95 In the last few yearn funding for health tience.s research in the United States has faced the paradox that despite the greatest Fedeml and private investment the probability that any new grant application will be funded has never been lower. Further, there is a recognition that important parts of the health research enterprise have beam neglected in order to keep thin gap from growing wider: health sciences as a career is now unattractive and in consequence the necessary cadre of well-trained scientists is threatened for the fuhue.; outmoded facilities and equipment are beginning to constrain creativity of current medical scientists; and those grants that are funded have nearly all suffad severe attrition adversely tiecting their e&tivenes.g and rimelincse. Apart from current funding difficulties, because of the perceived eerious impact of this situation in later years, in May 1988 the Institute of Medicine appointed a Committee of Policies for Allocating Health Sciencu~ Research Fun& to study theee problema and trends. The committee were asked to review the current policies of all sponsonr of health sciences restarch and to recommend appropriate revisions in th= in order to restore the balance of the essential componenta of health reaearch, namely rcseamh, training, equipment and facilities - and to ensure that the funds committed would be used in the most effect& manner to sustain the vitality of U.S. biomedical reaearch. Initially, the history of support for health sciences and the change to the predominance of federal funding over that of industry and private foundations is reviewed. The rapid growth in grants and their funding up to 1988 and the various policies pursued by governmen t and NIH to stab&e a system outgrowing its fimding are described. The Committee (not surprisingly) reach the conclusion that the moat crucial long-term investment is the development of career scientists. It make3 a number of recommendations, including a priority setting framework for the effective allocation of funds for short and longer term needs; and for the maintenance of owzall balance amongst research, people and facilities. An enlightened approach ia adopted by making these recommendationa within scenarios of varied percentage growth in health science research budgets. Fur&r, det&d recommendations - and justification for these - are concerne d with identification and training of scientists, ways of assessing progress, research management and in particular communication
84 among federal agencies. Finally, the Committee emphasises the place and responsibility of scientists in this exercise. Although thia volume is specifically concerned with U.S. problems, there are few if any western countrite who will not recogniet a number of comparable problems and learn from the Committee’s deliberations. For example the 84 co-ordination of research policies between public and private agencies was achieved in the United Kingdom in the field of cancer. It is therefore of real value and intereat to all those concerned with the financing and management of research and the problems in trying to balance insuBicient funda for current demands and yet ensuring a secure future for health sciencea research. The book is admirably presnted aa is to be expected from the Institute of Medicine. M. Ashley-Miller, MD Secretary The Nuffield Provincial Hospital Trust London, United Kingdom
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Funding Health Sciences Research. A Strategy to Restore Balance By the Committee on Policies for Allocating Health Sciences Research Funds of the Institute of Medicine Washington D.C., National Academy Press, 262 pp., 1990, ISBN O-309-04343-3, $27.95 In the last few yearn funding for health tience.s research in the United States has faced the paradox that despite the greatest Fedeml and private investment the probability that any new grant application will be funded has never been lower. Further, there is a recognition that important parts of the health research enterprise have beam neglected in order to keep thin gap from growing wider: health sciences as a career is now unattractive and in consequence the necessary cadre of well-trained scientists is threatened for the fuhue.; outmoded facilities and equipment are beginning to constrain creativity of current medical scientists; and those grants that are funded have nearly all suffad severe attrition adversely tiecting their e&tivenes.g and rimelincse. Apart from current funding difficulties, because of the perceived eerious impact of this situation in later years, in May 1988 the Institute of Medicine appointed a Committee of Policies for Allocating Health Sciencu~ Research Fun& to study theee problema and trends. The committee were asked to review the current policies of all sponsonr of health sciences restarch and to recommend appropriate revisions in th= in order to restore the balance of the essential componenta of health reaearch, namely rcseamh, training, equipment and facilities - and to ensure that the funds committed would be used in the most effect& manner to sustain the vitality of U.S. biomedical reaearch. Initially, the history of support for health sciences and the change to the predominance of federal funding over that of industry and private foundations is reviewed. The rapid growth in grants and their funding up to 1988 and the various policies pursued by governmen t and NIH to stab&e a system outgrowing its fimding are described. The Committee (not surprisingly) reach the conclusion that the moat crucial long-term investment is the development of career scientists. It make3 a number of recommendations, including a priority setting framework for the effective allocation of funds for short and longer term needs; and for the maintenance of owzall balance amongst research, people and facilities. An enlightened approach ia adopted by making these recommendationa within scenarios of varied percentage growth in health science research budgets. Fur&r, det&d recommendations - and justification for these - are concerne d with identification and training of scientists, ways of assessing progress, research management and in particular communication
84 among federal agencies. Finally, the Committee emphasises the place and responsibility of scientists in this exercise. Although thia volume is specifically concerned with U.S. problems, there are few if any western countrite who will not recogniet a number of comparable problems and learn from the Committee’s deliberations. For example the 84 co-ordination of research policies between public and private agencies was achieved in the United Kingdom in the field of cancer. It is therefore of real value and intereat to all those concerned with the financing and management of research and the problems in trying to balance insuBicient funda for current demands and yet ensuring a secure future for health sciencea research. The book is admirably presnted aa is to be expected from the Institute of Medicine. M. Ashley-Miller, MD Secretary The Nuffield Provincial Hospital Trust London, United Kingdom