1797 POLICYFORUM F ederal funding for biomedical R&D through the National Institutes of Health has grown from $8.3 billion in FY1984 to $28.7 billion in FY2008 (1, 2). The NIH supports half of all federal nondefense R&D and more than 60% of federally funded research in American universities (3). The agency awards funds to research performers based on " peer review " but the decisions are not in...

For almost 50 yr the federal government has been committed to building and maintaining the capacity of the university-based biomedical research system. The system of peer-reviewed research grant funding to universities has produced the most successful health research enterprise in the world. The philosophy and vision of this enterprise was articulated by Vanevar Bush in his classic prescription...