NIH investigators also conduct research through NIH’s intramural  research program. NIH Has Promoted Efforts to Support Early and Intermediate Stage Investigators, but Those Who Have Not Yet Received a Large NIH Research Grant Remain Less Competitive

		NIH Has Promoted Programs and Policies to Support Early and Intermediate Stage Extramural Investigators, but It Is Too Early to Assess Its Most Recent Initiative

Over the last 10 years, NIH has introduced programs and policies to  support extramural investigators competing for their first large NIH  research grant that leads to research independence. More recently, the Cures Act required that NIH implement the NGRI,  which the agency established in August 2017. According to NIH officials, the agency is in the process of reevaluating  which investigators should be the focus of the NGRI initiative and may  revise the program to include investigators whose careers are more  advanced. Investigators Who Had Received at Least One Large NIH Grant Had Higher Funding Rates for All Grant Types Compared to Those Who Had Not

Our analysis shows that intermediate stage investigators are more  successful at competing for grants than early stage investigators. 1.) Specifically, investigators  beginning their research careers—the early stage and intermediate stage  investigators—were more likely to receive these grants. For more  information on the trends in the number of grants awarded to early stage  and intermediate stage investigators, by award type, for fiscal years 2013  through 2017, see appendix I.

	NIH Has Taken Steps to Support a Diverse Scientific Workforce, but Disparities Persist and Its Diversity Efforts Have Not Been Fully Evaluated

		NIH Established Working Groups and Programs to Support Investigators from Underrepresented Groups

Over the last 7 years, NIH established advisory groups and other  programs to determine how best to support extramural and intramural  investigators from underrepresented groups. NIH Research Funding and Workforce Data Shows that Disparities Persist for Underrepresented Groups

Although NIH has implemented numerous diversity-related efforts, our  analysis of NIH research grant funding and intramural workforce data  from fiscal years 2013 through 2017 shows that some disparities persist  for investigators from underrepresented racial and ethnic groups, and for  female investigators. Applicants from underrepresented ethnic groups— Hispanics or Latinos— comprised 4.3 percent of the applicants for large  NIH research grants. For example, in 2017, among underrepresented racial  groups, African American or black applicants were named as  investigators on about 88 percent of applications for large NIH research  grants, about 89 percent of applications for smaller NIH grants, and about 92 percent of career development grant applications. According to data published by the National Science Foundation in 2017,  women represent slightly more than half of all doctorates in biological  sciences. However, from 2013 through 2017, women represented less  than one-quarter of all tenured NIH intramural investigators. For example, some stakeholders  suggested that for NIH’s National Research Mentoring Network, the  matching of mentees to mentors could be improved or mentioned  uncertainty about the program; questioned how often research supplements are utilized, or noted that  better mentoring and follow-up after the postdoctoral fellow’s work is  completed is warranted;  reported that while their organizations initially collaborated with the  scientific workforce diversity office, that office is not very active or  communication eventually dissipated; expressed concern about NIH’s outreach to minority serving  institutions and organizations, such as historically black colleges and  universities, when it began creating programs like the Building  Infrastructure Leading to Diversity program and the National Research  Mentoring Network and for other efforts; and  stressed that NIH should collaborate more with organizations that  represent underrepresented groups, which have already implemented  programs shown to be effective in engaging these communities in  biomedical research. NIH Has Developed a Scientific Workforce Diversity Strategic Plan, but It Does Not Include Quantitative Metrics or Time Frames to Assess the Progress of Its Strategic Goals

In 2016, NIH’s Chief Officer of Scientific Workforce Diversity established a  5-year strategic plan that describes the agency’s five workforce diversity  goals and supporting objectives. The strategic plan includes goals and  objectives that apply to both extramural and intramural investigators. For decades, concerns have been raised by the biomedical  research community about NIH’s ability to support investigators beginning  their research careers. Similar concerns have been expressed regarding  support for investigators from groups underrepresented in the sciences,  including those from racial and ethnic groups and women. While the  agency has taken many steps during this time, disparities in its research  grant funding persist. More recently, NIH  has taken positive steps such as by establishing the position of Chief Officer of Scientific Workforce Diversity, who in turn, created a strategic  workforce diversity plan and related goals and identified areas of future  evaluation. Recommendation for Executive Action

The NIH Director should develop quantitative metrics, evaluation details,  and specific time frames to assess its current efforts to support  investigators from underrepresented groups against its scientific  workforce diversity strategic goals, and use the results of its assessment  to guide any further actions.
Why GAO Did This Study

NIH's success depends on its ability to attract, retain, develop, and otherwise support biomedical investigators—including those employed in its intramural research program as well as those working in its extramural program at universities, academic health centers, and other research institutions. For decades, the agency has faced challenges in supporting early career investigators and those from underrepresented groups, including ethnic and racial minorities and women. The 21st Century Cures Act included provisions that NIH coordinate policies and programs to promote early research independence and enhance the diversity of the scientific workforce.
The act also contained a provision that GAO examine NIH's efforts. GAO reviewed the actions NIH has taken to support (1) investigators beginning their biomedical careers; and (2) investigators from underrepresented groups and women. GAO analyzed NIH data from fiscal years 2013 through 2017 on grant funding for investigators by career phase and demographic status. GAO also reviewed relevant laws and NIH policies, programs, and initiatives, and interviewed NIH officials and stakeholders from the scientific research community.

What GAO Found

The National Institutes of Health (NIH), within the Department of Health and Human Services (HHS), plays a prominent role in the nation's biomedical research. While it employs investigators in its intramural research program, over 80 percent of its budget supports its extramural program, primarily through grant funding to investigators at other research institutions. Given this, NIH has a vested interest in supporting a robust national biomedical workforce, but the agency has acknowledged that the environment is highly competitive and many investigators find that it takes years to obtain the type and amount of funding that typically spurs research independence. GAO's analysis found that extramural investigators who had received at least one large NIH research grant during fiscal years 2013 through 2017 were more likely to receive such grants in subsequent application cycles than investigators who had not yet received such grants. In response to the 21st Century Cures Act, enacted in December 2016, NIH introduced an initiative to prioritize these grants for (1) early stage investigators, who are beginning their careers and have never received a large research grant, and (2) intermediate stage investigators, who are within 10 years of receiving their first large grant as an early stage investigator. However, it is too early to assess this new initiative, which was introduced in August 2017. NIH is currently considering revising the program to include investigators whose careers are more advanced.
NIH implemented recommendations made by internal advisory bodies to support investigators from racial and ethnic groups considered by NIH to be underrepresented in biomedical research. GAO's analysis shows disparities for underrepresented racial and ethnic groups, and for female investigators, from 2013 through 2017. For example, in 2017, about 17 percent of investigators from underrepresented racial groups—African Americans, American Indians/Alaska Natives, and Native Hawaiian/Pacific Islanders combined—who applied for large grants received them. In contrast, about 24 percent of Hispanic or Latino applicants, an underrepresented ethnic group, received such grants. Asians and whites—well represented groups—were successful in receiving large grants about 24 and 27 percent of the time, respectively. Though women represent about half of all doctorates in biological science, GAO found that women investigators employed by NIH in its intramural program comprised about one-quarter of tenured investigators. NIH has taken positive steps such as establishing the position of Chief Officer of Scientific Workforce Diversity, who in turn created a strategic workforce diversity plan, which applies to both extramural and intramural investigators. The plan includes five broad goals for expanding and supporting these investigators. However, NIH has not developed quantitative metrics, evaluation details, or specific time frames by which it could measure the agency's progress against these goals.

What GAO Recommends

The Director of NIH should develop quantitative metrics, evaluation details, and time frames to assess NIH's efforts to diversify its scientific workforce against its diversity strategic plan goals, and take action as needed. HHS agreed with GAO's recommendation.