Booting Earth Optimization System
Thank you for your patience. Your civilization is very important to us.
Thank you for your patience. Your civilization is very important to us.
Agency Report Card
Seek fundamental knowledge and apply it to enhance health
Seek fundamental knowledge and apply it to enhance health
2003 Doubling complete ($27.2B) — then budget flatlines for a decade ↗
2013 Sequestration cuts $1.7B from NIH — 640 fewer grants funded ↗
2020 $4.9B emergency COVID supplemental — suddenly money is available when Congress is scared ↗
Budget increased 165% (FY2000 $17.8B → FY2024 $47.3B) while novel drug approvals rose from 27 (2000) to 50 (2024) — volatile, but about 75% higher comparing 2000–04 with 2020–24. Only 3.3% of the budget reaches actual clinical trials.
| Year | NIH program level (nominal USD, fiscal year; excludes ARPA-H and emergency supplementals) | CDER novel drug approvals (new molecular entities; plus new therapeutic BLAs from 2004), calendar year |
|---|---|---|
| 2000 | $17.8B | 27 |
| 2002 | $23.3B | 17 |
| 2004 | $28B | 36 |
| 2006 | $28.6B | 22 |
| 2008 | $29.6B | 24 |
| 2010 | $31.2B | 21 |
| 2012 | $30.9B | 39 |
| 2014 | $30.1B | 41 |
| 2016 | $32.3B | 22 |
| 2018 | $37.3B | 59 |
| 2020 | $41.7B | 53 |
| 2022 | $45.2B | 37 |
| 2024 | $47.3B | 50 |
“97% clinical trials, 3% overhead — the exact mirror of your NIH”
Total annual funding for the National Institutes of Health
Share of NIH budget that actually funds clinical trials — ~$1.55B of $47B
Average cost per patient in a traditional randomized controlled trial
Share of researchers' time spent writing grant proposals instead of doing science
“Forty-seven billion dollars. Three point three percent touches a patient. The rest funds the world's most expensive grant-writing competition.”
On a well-run planet, this agency would have been deprecated centuries ago. Here is what replaces it.
Decentralized Institutes of Health — National Institutes of Health + FDA