Cato Podcast NIH's Lost Mission
Dec 2, 2025
John Early, a Cato adjunct scholar specializing in federal spending, and Terence Kealey, a clinical biochemistry professor and science policy advocate, delve into the National Institutes of Health's misalignment with its health mission. They argue that the shift from mission-led funding to basic science has hindered health improvements and crowded out private research innovation. Key issues discussed include inefficiencies in grant prioritization, the detrimental focus on underfunded diseases, and the need for reform towards measurable health outcomes.
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Mission Model Replaced By Pipeline Science
- NIH shifted from mission-focused research to a basic "pipeline" model that lacks health outcome goals.
- That strategic shift explains rising spending with slowing life-expectancy gains, argue John Early and Terence Kealey.
Mission Science Delivers Better Results
- Mission-driven science (clear goals) outperforms undirected basic science according to several historical examples.
- Terence Kealey cites NASA and targeted DoD-funded cancer efforts as more productive mission science.
Limit Government To Noncrowding Roles
- Avoid crowding out private-sector mission research by shrinking or refocusing federal grants.
- Let private and charitable actors lead mission-focused projects where market incentives suffice.