In its oversight of roughly $35 billion in 65,000 exterior biomedical analysis awards in 2023, the US Nationwide Institutes of Well being (NIH) did not constantly observe unused funds or act when monetary and progress studies from grant recipients had been late, a brand new Authorities Accountability Workplace (GAO) report says.
These findings, launched late final week, may compromise the NIH’s capability to detect misspending and be certain that its grants are awarded in applicable quantities, the authors stated.
Company could not present latest staffing information
In compiling the report, the GAO reviewed company insurance policies, paperwork, and information via 2023, checked NIH monitoring information, and interviewed federal officers, together with these from 4 NIH institutes chosen based mostly on components reminiscent of funding, staffing, and mission. The chosen entities had been the Nationwide Most cancers Institute, the Nationwide Institute on Ageing, the Nationwide Institute on Minority Well being and Well being Disparities, and the Nationwide Eye Institute.
GAO requested, however NIH couldn’t present, details about the impact of latest administration actions on oversight staffing ranges.
The NIH is the biggest public funder of biomedical analysis in the USA, and greater than 80% of its funds funds exterior analysis on health-related subjects. The report consists of the 25 NIH institutes, facilities, and places of work that fund exterior analysis.
The $35 billion in grants awards to universities and different establishments in 2023 was a rise of almost 30% from 2014, after adjusting for inflation. In 2023, the NIH additionally employed about 400 individuals, a 20% improve over 2014.
However in February 2025, President Donald Trump ordered company leaders to arrange to fireplace employees on a big scale, which occurred within the ensuing weeks, together with large cuts to NIH-funded analysis. In March, the “GAO requested, however NIH couldn’t present, details about the impact of latest administration actions on oversight staffing ranges,” the report stated.
NIH agrees with suggestions
As a part of its oversight of grant awards, the NIH opinions recipients’ monetary and progress studies to, for instance, monitor progress and decide whether or not recipients have a plan to deal with issues. However the GAO discovered that the NIH does not all the time shut out awards when recipients do not adjust to coverage by submitting a closing report inside 1 12 months of venture completion.
With out an informational useful resource or monitoring requirement, NIH can’t be assured that it’s implementing carryover practices successfully and maximizing its funding for higher-value tasks.
Practically 1,000 closing progress studies (about 0.2% of awards constituted of 2014 via 2024) had been delinquent. “NIH has made latest efforts to raised guarantee well timed closeout, but it surely has not recognized or addressed the components that contribute to late studies,” the authors wrote. “Because of this, NIH can’t be certain that it’s holding recipients accountable and figuring out misspent funds.”
Sure grants can carry over unspent funds from one funds interval to the following. “If NIH determines that some funds are usually not wanted, it could possibly limit the recipient’s capability to robotically carry over funds sooner or later,” the report stated.
Furthermore, the NIH hasn’t developed an informational useful resource to assist recipients make the very best resolution about carryover. Nor does it require establishments to trace even giant unused balances, that are widespread. “With out an informational useful resource or monitoring requirement, NIH can’t be assured that it’s implementing carryover practices successfully and maximizing its funding for higher-value tasks,” the GAO famous.
Based mostly on the report findings, the GAO really helpful that the NIH determine and tackle components behind delinquent closing monetary and progress studies in revised steerage, develop an informational useful resource for managing unspent funds, and require NIH institutes and facilities to observe unused balances throughout their award portfolios. The NIH agreed with all three suggestions.
