technologies is the National Institutes of Health (NIH) model of research-grant allocation and funding: almost all research (except small projects funded by contracts) is initiated by individual investigators, and the decision as to merit is made by a dual-review system of detailed peer review by experts in each subfield of biomedical science.

In this system, a grant is given to an individual investigator, essentially regardless of the investigator's academic rank or position, as long as he or she is given principal- investigator status by his or her institution. Almost all institutions grant principal- investigator status to scientists at the beginning of their independent careers, almost always after completion of a postdoctoral fellowship. Individual investigators in universities, medical schools, and research institutions are thus empowered to be individual entrepreneurs. They are not subject to any type of review or control of their chosen research subjects by department chairs, other faculty colleagues, or other scientific colleagues in their institutions.

This system has prevented the development of hierarchical research groups of the sort that are seen in many other countries, and it has fostered innovation and independent research initiatives to an amazing degree.

Another major source of funding of immunology (and other biomedical subjects) is the Howard Hughes Medical Institute (HHMI). HHMI selects and retains investigators (rather than projects) largely on the basis of their track record. HHMI-selected investigators are widely regarded as among the most distinguished and productive in the field at both the senior and junior investigator levels. A key to the process has been the selection of external reviewers solely on the basis of their scientific accomplishments and their standing in the field. HHMI provides superb infrastructure for its scientists, who are staff members of HHMI, but whose laboratories are integrated into major academic and research institutions, mainly in the United States. The HHMI scientists are much freer to follow their imaginations and to change the course of their projects than NIH funded investigators, in that the principal evaluation of HHMI investigators is based on productivity, whereas NIH evaluates progress mainly on prescribed projects. The funding of HHMI investigators has substantially enhanced their productivity and has relieved the pressure on NIH to fund meritorious other projects. Additional private sources of immunology funding in the United States are the American Cancer Society, the Juvenile Diabetes Foundation, the Arthritis Foundation, and the Multiple Sclerosis Society.

Funding for training grants for predoctoral fellows and postdoctoral fellows also comes from a wide variety of institutes of NIH and from private sources. Both types of funding have, over the last 40 years, influenced how science is organized in the United States. There are two major results of this entrepreneurial, individual-based system:

  • It has led to the development of multiple centers of excellence in immunology and many other fields of biomedical research at many centers around the country.

  • Many key research centers are based in or closely attached to large medical centers. This stimulates the expansion and application of immunology to many clinical problems and the study of many problems in basic immunology.

Because immunology research in the United States is based largely in medical institutions and because research, training, and clinical activities go on in parallel in these institutions, interdisciplinary research, development of clinical applications, and the application of basic immunology in solving clinical problems have all been fostered.

Further, NIH and several private funding agencies to foster basic scientific training for clinically trained people. Many medical schools have people in their departments of medicine,



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