n engl j med 355;11 www.nejm.org september 14, 2006 1088 that in some cases, 5 years of funding for projects was not long enough to deliver results. Although the foundation is known for its “lean” structure, some grantees said that current staff levels are barely adequate to handle the existing workload, and Yamada said that it will have to grow in order to double its spending. Choosing worthy ...