NIH releases a plan to confront structural racism. Critics say it’s not enough

Saying structural racism is a chronic problem throughout biomedical research and within their own walls, leaders of the National Institutes of Health Thursday unveiled a plan intended to eliminate a big gap in grants awarded to white and minority scientists and boost funding for research on health disparities.

The agency, the largest funder of biomedical research in the United States, said it would also expand a program to recruit, mentor, and retain researchers from underrepresented racial and ethnic groups, and appoint diversity and inclusion officers at each of its 27 institutes and centers.

The report says NIH leaders failed to acknowledge numerous firsthand accounts of racism in the workplace and the organization has failed to attract, retain, and promote scientists from underrepresented racial and ethnic groups. Less than 2% of NIH senior investigators are Black.

Published in the journal Cell, the plan acknowledges that structural racism is a problem throughout society and says “biomedical science is far from free of its stain.” Not only have people of color experienced health inequities for centuries, the report notes, but scientists of color have been stymied in their careers by not getting adequate funding and other support from NIH.

Their plan to dismantle racism, NIH Director Francis Collins and his colleagues wrote, was just the beginning of what they recognize is a “monumental task.”

Advocates working to address inequities in science said they were encouraged by the NIH plan but said it is unlikely to bring about major changes, and they called on the agency to put much more money into the initiative. “There is no doubt there is a sincere desire on the part of NIH leadership to address this question, but is this enough to really move the needle?” asked Freeman Hrabowski, a Black mathematician and president of the University of Maryland, Baltimore County.

Like many Americans, leaders of the NIH started grappling with the issue of racism in earnest after the murder of George Floyd last summer, at a time when those at the NIH — whose mission is to seek and apply knowledge to enhance the health of all people — were already reeling from the racial health inequities the coronavirus pandemic had laid bare.

“I talk about this being a tipping point. There really has been a significant change in viewpoint nationwide and in the scientific community,” said Marie Bernard, the chief officer for scientific workforce diversity at the NIH and one of the leaders of the new effort, called UNITE. “This is an unparalleled opportunity to make change.”

The plan’s release comes after Collins in March apologized that the agency had not done enough to address racism.

The NIH doles out more than $40 billion in research dollars each year. The agency has been sharply criticized for entrenched disparities that see Black researchers funded at a rate barely half that of white researchers — 55%, a gap that has remained steady for the past decade.

NIH disparities chart
Graph showing the number of applicants for NIH R01 grants and funding rates by race. While the number of applicants from underrepresented minority scientists and their funding rates have increased in recent years, these grants are still funded at lower rates than white scientists.COLLINS ET. AL. CELL

The new plan includes a number of programs, many already underway, to close numerous racial, ethnic, and gender gaps at the institute. In a major focus on the “significant underfunding” of research on minority health and disparities, NIH leaders plan to spend $60 million on projects aimed at reducing health disparities and another $30 million to study and address the impact of structural racism and discrimination on minority health. This new funding is meant to help address the funding gap: One study suggested that topic choice — focusing on community-based research as opposed to mechanistic science — explains 20% of the racial funding disparity.

Many who have been on the front lines of work to increase diversity in science said that they were happy to see NIH addressing racism, but that NIH leaders needed to do far more work. “This report is a solid first step,” said Hrabowski, whose university’s Meyerhoff Scholars Program has produced the most Black undergraduates in the U.S. that go on to receive doctorates in the natural sciences and engineering. (Viral immunologist Kizzmekia Corbett, who led an NIH team that conducted groundbreaking research instrumental to Moderna’s coronavirus vaccine and is now at the Harvard T.H. Chan School of Public Health, is one famous graduate.)

Hrabowski chaired a National Academies panel investigating how to improve diversity in STEM a decade ago, when just 2.1% of people with doctoral degrees in science were Black. Today, it is 2.3%. “We really have not made much progress,” he said. “The question we have to ask our society — and NIH — is what will it take to change the culture?”

Hrabowski said he believed solving long-standing problems such as unequal research funding and low numbers of scientists of color would require far more funding than the report had pledged. He said universities also needed to work harder to increase the pool of scientists of color in a position to apply for NIH grants by supporting them from their undergraduate years through graduate school, postdoctoral positions, and their first faculty jobs.

Omolola Eniola-Adefeso, a Black professor of chemical engineering at the University of Michigan, has been sharply critical of funding disparities at NIH. In February, she and a large group of fellow women biomedical engineers wrote an editorial called “Fund Black scientists,” which cited evidence that Black scientists must spend twice as much time on grants in order to be funded at the same rate as white scientists and are less likely to receive tenure in part because they don’t receive as many large NIH grants such as R01s. “NIH must change course,” the group wrote.

Asked to review the new plan for STAT, Eniola-Adefeso said she found it disappointing. “There is nothing in that plan that is transformational,” she said. Even though the plan pledged to stop “siloing” diversity issues, Eniola-Adefeso said its focus on addressing funding disparities by increasing support for health equity research was itself siloing. “Health care disparities are important, but Black P.I.s are also interested in robotics, gene therapy, and CRISPR,” she said. “In some ways, that’s pigeonholing us. That’s saying you should tell a young Black girl who wants to study nanotechnology to study health disparities instead.”

She said the NIH needed to repair the grant review process that has led to so little funding for Black scientists and, if they could not do that, simply fund more Black scientists, regardless of what topics they study. Since there are so few Black principal investigators, reaching funding parity would require a minuscule part — just 0.07% — of the NIH budget, she noted. And, as the NIH agreed in its plan, diverse perspectives and research teams enhance scientific productivity. But a plan to fund Black investigators, she and her co-authors noted in their editorial, would likely cause a “backlash from loud and privileged members of the majority.” These types of uproars, they noted, are what allows racism to persist.

Eniolo-Adefeso said she was frustrated the plan had not adopted more of the suggestions outlined in her group’s editorial, such as prioritizing diverse research teams for funding and giving program officers the power to reevaluate grants of Black principal investigators who score highly but just below the threshold for funding, something she said the NIH does for research topics it prioritizes.

“We gave them things we know will work because we are their reviewers and applicants,” she said. She was happy to see that the NIH-wide BRAIN initiative, which funds neuroscience research, will, for the first time, use diversity of grantees as part of the grant scoring criterion. “I hope that’s a pilot project that is expanded to the entire NIH,” she said.

Bernard said the NIH was experimenting with other actions, not described in the plan, to close the funding gap, including increasing the diversity of grant review panels, removing the names of grantees from applications, and having all reviewers undergo implicit bias training. She said she and others would be looking closely to see whether the changes have an impact on funding rates. “We have a lot of work to do,” she acknowledged.

Manu Platt, a Black professor of biomedical engineering at the Georgia Institute of Technology, who has highlighted racism in science and academia in recent editorials and lectures, said he was excited, in some ways, about the plan. “I love that they are doing things. I like they are saying the word racism,” he said. But Platt said he wished NIH could work faster to increase funding to Black scientists to help keep them in tenured faculty positions. “It’s very difficult out there,” he said. “Funding Black investigators needs to be the linchpin.”

Platt, who was recently asked to advise the National Institute of Biomedical Imaging and Bioengineering on diversity issues, said his experience serving on funding review panels showed him that systemic racism plays a clear role, even though race is not listed on grant applications. “They look at where people trained, who they trained with, and what institution they’re at. If you’re at an HBCU (historically Black college and university) or a smaller institution, you get penalized,” he said. “And structural racism may be playing a role in why people are not being hired at those larger institutions to begin with. It all feeds forward.”

The NIH could easily prioritize funding for scientists from underrepresented groups, Platt said, as it does for early-career scientists to help them establish a funding track record and improve their chances of success and tenure. He said such a program would be a more direct route to increasing racial parity in funding than running programs to help improve the skills of minority scientists, such as grant-writing workshops.

“I’d like to see more programs that don’t want to fix the investigators but want to fix the system,” he said.

The NIH acknowledged in its plan that the 60 programs it previously had in place to address diversity had not done enough and that “widescale, systemic changes” that reached across the entire NIH were needed. NIH,” the plan states, “can no longer look the other way.”

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