What’s Wrong with NIH Grants?

Mike Lauer is the former Deputy Director for Extramural Research at the National Institutes of Health. A cardiologist and researcher, he joined the NIH’s National Heart, Lung, and Blood Institute in 2007 as the Director of the Division of Prevention and Population Science. From 2015, he oversaw the NIH’s $32 billion funding program for external research. Since leaving NIH in 2025, he has become an outspoken advocate for fundamental reform in how the federal government supports biomedical research.

We discuss:

* Why the NIH used to fund 60% of grant applications — and now funds just 10%

* How “soft money” forces researchers to fund their own salaries

* How distributing lots of small grants wastes everyone’s time

* How block grants could fund more breakthrough science

* Why researchers don’t get their first independent award until their mid-40s

The full transcript for this conversation is at www.statecraft.pub