Why didn't the National Institute of Health, the NIH properly and quickly fund coronavirus research
at the beginning of the pandemic and did what little studies they did fund have any practical
purposes for what doctors and society in general needed for protection, prevention, and treatment?
This information vacuum allowed politicians and others to step in and make whatever guidelines or
rules they desired. This was not evidence-based medicine. So what did the National Institutes
of Health do to better understand the characteristics of this coronavirus and
what evidence-based interventions could be done to minimize harm to the population as a whole?
This health policy research I'm about to talk about is published in the British Medical Journal
Open. As always there's a link in the description below to the study for those that are interested
in actually looking at the article. The National Institutes of Health is the world's largest funder
of biomedical research and they employ over 20,000 people with a budget of 45.3 billion in 2020.
The national institute of health was headed by Dr. Francis Collins with Dr. Tony Fauci
the director of the National Institute of Allergy and Infectious Diseases.
It is of course funded by the U.S. taxpayer. Now prior research has suggested that
the research funding by NIH has not been proportionately aligned with disease burden
in the population based on four other research studies meaning that more common diseases have
been getting less funding and less common diseases have been getting more funding.
In this particular study I'm talking about the authors state that the pandemic tested the
NIH's ability to fund critical research to answer important research questions about the coronavirus
that would significantly affect public health and that of course require urgent scientific
clarity. They reviewed all grants funded for Covid-19 research between January 1,
2020 and December 31st 2020. They reviewed all of the 2020 NIH budget and all grants. This figure
shows the different funding in billions of dollars from the NIH from left to right on the graph 10
billion went to neurosciences, then 7 billion to behavioral and social sciences, then 6 billion
to rare diseases, 5 billion to aging, 3 billion to social determinants of health, 3 billion to
Alzheimer's disease, and finally 2.2 billion to coronaviruses i.e. Covid-19. In summary this graph
shows in the beginning of our pandemic that the NIH spent more money on rare diseases, aging,
behavioral and social science, than Covid-19. In 2020 Covid-19 research amounted to 4.9%
which was the 2.2 billion in the preceding graph out of the entire annual budget of 45.3 billion.
One interesting thing that the researchers noted is that there were 287 grants that were
categorized as Covid but Covid was not actually mentioned in the grant abstract or was not the
focus of the grant which doesn't make a whole lot of sense. This table lists the number of grants
and dollars spent for Covid research. Each grant can have multiple areas so the percent of Covid
funding is more than 100%. I point out that the biggest areas pharmaceutical interventions at 47
followed by immunology, other research, and geriatric health. The authors do not specifically
state what the 2.2 billion in research for Covid-19 gave us in terms of something tangible
that impacted the pandemic. That would be an interesting thing to understand and discuss
in the future. In other words what knowledge did you gain from your 2.2 billion dollars?
Now spending 4.9% of the total NIH budget for covid research in the first year of this pandemic
extends previous studies that NIH funding priorities are not aligned with disease
burden in the population as stated by the authors. The significant lack of rapid clinical research
funding to understand Covid transmission of course was of concern. Physicians wanted to know other
things specifically how it spreads so we can reduce transmission. We wanted to know how long
it took from exposure to developing symptoms as well as when infected people are most contagious
to pass the disease along to others clinical mask research would have been very helpful.
Initially masks were said not to be helpful by Dr. Fauci then it was stated that masks even
cloth masks were helpful then many months later to double mask and now N95 are equivalent masks.
No randomized clinical based trials were done in the U.S. on masking as I've mentioned in many of
my other videos and we're almost halfway into 2022. This virus is going to be with us for a
while we need to know this. Now the questions about masks remain unanswered as I mentioned in
numerous other videos on the channel. In addition significant restrictions were placed on the 52
million U.S. school-aged children including closures, six-foot distancing requirements,
and outdoor masking while distancing. Only a few grants were dedicated to studying these questions
in this unique population which of course creates an enormous challenge for evidence-based
health policy making. In terms of crisis healthcare should be able to pivot its funding
towards specific grants answering those gaps in medical knowledge.
Now in the study I'm talking about there were some limitations. They only took a look at the
abstracts and not the entire funded proposal and they did not separate the share of new grants
versus continued grants. They used definitions that may not be exhaustive or mutually exclusive.
There were other barriers to clinical research including slow institutional review boards and
long journal peer review times so a rapid research protocol that protects research subjects with
standard ethical principles for research could be developed for the next health emergency and should
be. So what I'm saying is accelerating some of the barriers means the research could get done more
quickly. Now the conclusion of the authors is that NIH funding for covid grants did not align with
covid disease burden and were allocated slowly. The NIH should develop mechanisms to rapidly
pivot funding quickly to address scientific unknowns associated with sudden large-scale health
emergency. Supporting sound clinical research aimed at developing evidence-based recommendations
is important for public policy and of course it promotes public trust in the medical profession
and medical researchers during a pandemic. Public trust in the medical profession is so important.
If you're a U.S. taxpayer I'm sure you find it disheartening to hear the
results of this study where only 2% of grants were allocated to Covid research
and that only 4.9% of the total NIH budget in 2020 was actually spent on covid research. This needs
to change before any future pandemics. Please tell me your thoughts and comments below. If
you liked this video please consider subscribing to support my channel. Thanks a lot for joining
me today on Medicine with Dr. Moran. I'm Dr. Keith Moran. Get healthy if you're not and stay healthy.