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The National Institutes of Health (NIH) grant-making process is slow, even during a pandemic

StatNews reports that the NIH is “a slow-moving glacier” and that the agency’s “sluggish and often opaque efforts to study long Covid draw patient, expert ire.” The news get worse: Congress allocated $1.2 billion to study long COVID, but “so far the NIH has brought in just 3% of the patients it plans to recruit.” The major defense of one NIH employee? The $1.2 billion effort is moving “much faster than we’ve done anything else before” and the NIH’s “usual pace can be even slower.” How reassuring. Unfortunately, the NIH’s Covid-19 response is typical; as we wrote in August 2021, the federal grant-making apparatus is so slow that the private “Fast Grants” initiative attempted to do just what its name implies: make grants fast. And it did: within days at first, and then within two weeks. By contrast, the NIH has never learned how to go fast, and, as far as we can tell, neither have other federal agencies (although HRSA did eventually kick out some telemedicine money faster than we’d have imagined).

Why haven’t federal agencies learned to go fast? I think part of the answer is poor feedback mechanisms. No federal agency goes out of business from moving slowly—no one loses a job, money, or anything else. If even a pandemic can’t shake NIH out of their torpor, what will? A war? Maybe. We couldn’t even bother to make substantial modifications to the absurd clinical trials process during the COVID-19 pandemic, and instead relied primarily on throwing more money at the problem, while NIH continued to crawl at a snail’s pace.

America does the same thing with infrastructure construction: instead of reforming and eliminating bureaucratic rules to reduce the cost of building new infrastructure, we attempt to throw money at the problem until we manage to (partially) bulldozer our way through it. The problems being that the “throw money at it” solution takes way too long, costs too much, and leaves us with too little infrastructure at the end. But there is no single Directly Responsible Individual (DRI) for bureaucratic rules, so nothing changes—much like the stalled COVID study. The StatNews article notes that “A group of two dozen COVID-19 experts recently released a report that excoriated the NIH’s progress as well, noting that recruiting for the study has been painfully slow” and that “The experts argued the Biden administration should create a long COVID task force to hold agencies accountable for progress.” Unless the task force has the power to fire, demote, and restructure, it’s unlikely to achieve much.

Speed is important for many reasons, one being that the faster you can do something, the more you can do of the thing, and the sooner you can get feedback. One sees this feedback process—sometimes called the “Observe, Orient, Decide, and Act” (OODA) loop—in all sorts of endeavors: as the loops tightens, more of the thing gets done, or learned. In computer programming, for example, compiling or deployment that used to take hours or days now happens instantly, allowing for fast feedback to programmers, and letting the programmers get better, fast. Something similar is true in writing: the faster a person writes and gets useful critical feedback, the quicker the revision process becomes (assuming the editor is good and the writer in an improvement mindset).

The opposite is also true: as noted above, our bloated infrastructure rules from laws like the National Environmental Policy Act (NEPA) and California Environmental Quality Act (CEQA) mean that building things like subway or light rail line extension takes a decade and costs billions of dollars. So we build that infrastructure with such agonizing slowness that we never get network effects going, and most people talk of “toy trains” that “go to nowhere,” and, unfortunately, they have a point: if it takes 10 or more years to build a few miles of rail, most people are going to scoff at that rail. The road to improving the U.S.’s transit emissions starts with reforming NEPA. The law is supposedly designed to improve the environment, but instead it locks in the current system, which is not very climate friendly—the law is having the exact opposite of its intended effect.

By the time the NIH completes its studies, the studies might not matter any more. It’s like a person taking five years to decide to ask someone to get married: by the time person 1 asks, person 2 may already be married and have kids. If you wait sufficiently long, opportunities disappear.

Failure to study COVID with sufficient speed will leave people suffering, and possibly dead. That is bad. Despite it being bad, no one seems able or willing to attempt to overcome the problem.

If you don’t think speed and attention matter, try writing anything substantive with interruptions every few minutes: you’ll never get anywhere, and the end result will be unpalatable.

I wish I had a solution to these problems, but I don’t. The normal grant-making process works on a “good enough” basis, and it is typically more about redistributing money to favored communities and populations of focus than truly achieving the nominal goal of whatever the grant-funded program happens to be. Once you realize that, the rest of the system’s apparent peculiarities fall into place. Unless and until Congress wants to make substantial changes to how the federal government works, I think we’re likely to see business-as-usual continue. By far, the most successful part of the federal response to COVID was Operation Warp Speed, which rapidly kicked money to the usual suspects, in the form of pharma companies, and made pre-committments to buy large numbers of vaccine doses even if the clinical trials didn’t work out, such that trials could be conducted quickly and, if the money is “wasted” on ones that don’t work out, that “waste” is trivial relative to the amount of benefit from even a single successful trial.

Warp Speed operated at warp speed, while the NIH is still ambling along in a buggy. That’s been our experience with federal grant-making agencies: they stroll along, and nothing can or will hasten them. That’s a shame, because the country and world face real problems. As with NEPA and CEQA, however, many problems are mandated by legislators, or increased by the rule-making machinery, and no one with sufficient clout seems interested in solving them. These problems also don’t map neatly to right or left ideological talking points. The answer to whether we need “more” or “less” government, for example, is that we need more efficient and effective government, which is neither “more” or “less:” it’s orthogonal to that question, and the solutions aren’t amenable to sound bites.

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June Links: College Degrees, Federal Acronyms, NIH Grant Writers, Savings, Chairs, GeekDesk, Teaching, Teen Moms and Teen Pregnancy Prevention, and More

* A college diploma isn’t worth what it used to be. To get hired, grads today need hard skills.

* Let’s play “Count the Acronym” in this sentence, from the ACF’s Transitional Living Program and Maternity Group Homes: “The Family and Youth Services Bureau (FYSB) is accepting applications for the Transitional Living Program (TLP) and for Maternity Group Homes (MGH) funding opportunity announcement (FOA). TLPs provide an alternative to involving RHY in the law enforcement, child welfare, mental health, and juvenile justice systems.”

* Someone found us by searching for, “how do you keep your youthbuild grant”. Here’s how: by providing the services you promised to provide and filling out your DOL reports thoroughly and on time.

* Another person found us by searching for “expert nih grant writer”. You’ve come to the right place!

* Why Are Teen Moms Poor? Surprising new research shows it’s not because they have babies. They have babies because they’re poor. Emile Zola more or less got this point in 1885 in his masterpiece, Germinal.

* Why the U.S. has an artificially low savings rate: we take money from the young, who might save for later and have a low discount rate, and give it to the elderly, who want to spend it now because they have a high discount rate.

* Against chairs. I want a GeekDesk.

* Bertrand Russell’s 10 Commandments for Teachers; I try to follow them, especially the one about arguing via authority.

* Learning that works: rethinking vocational education. This is positive step, and I’m noticing more and more people making these kinds of arguments.

* The Real E-Publishing Story: It’s Not the Millionaires, It’s the Midlist.

* Game over for the climate, which is one of those important articles you won’t read.

* “As an outsider I hear plenty of what America does wrong, I want to hear what they do right.”

* The World as We Know It Is About to End, Say Some Really Frightened Scientists.

* A lot of what’s wrong with public schools can be surmised from How did this parent end up in jail? Kelley Williams-Bolar just wanted her kids to go to a safer school — then her story took an unexpected turn.

* The great Verizon FiOS ripoff.

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National Institute of Health (NIH) grant writers: An endangered species or hidden like Hobbits?

Type “NIH Grant Writers” into Google and look at what you find: pages and pages of “how-to” sheets with no actual grant writers.

That’s not surprising: trying to become a specialist NIH grant writing consultant would be really, really hard because the niche is sufficiently small that one couldn’t easily build a business solely around NIH grants. And the people who could or would want to write solely NIH grants are employed by universities or big hospitals and aren’t available for consulting.

You probably won’t be able to find a specialist in NIH grant writing even if you think you should find one. Isaac addressed this problem in “No Experience, No Problem: Why Writing a Department of Energy (DOE) Proposal Is Not Hard For A Good Grant Writer:” “Looking for qualified grant writers is about the same as looking for unicorns: don’t make a hard problem insolvable by looking for a unicorn with a horn of a certain length or one that has purple spots. Be happy to find one at all.”

He used the same unicorn language in “I Was Right:”

Two of the qualified SGIG [Smart Grid Investment Grant] callers did not “believe” and presumably kept searching in the forest for the perfect, but ephemeral, grant writing “unicorn” I described in my original post. One caller became our sole SGIG client for this funding round. The application process culminated in a finely crafted proposal that went in on the deadline day.

The proposal got funded, even though we’d never written a Smart Grid proposal before—and neither had anyone else. How’d we do it? Through the same means described in “How to Write About Something You Know Nothing About: It’s Easy, Just Imagine a Can Opener,” which explains how an attentive generalist learns to write a proposal for unfamiliar programs (and remember: all programs are unfamiliar when they first appear; this was certainly true for Smart Grid applicants). The same principles apply to all proposals; the trick is finding someone who understands and can implement those principles on a deadline.

Such people are as rare as the ones who know a lot about NIH grant writing. If you created a Venn diagram of the two, you’d probably have almost no overlap. If you were going to set up a business writing NIH proposals, you’d need at least three very unusual skills: able to write, able to hit deadlines, and health knowledge, ideally through getting a PhD or perhaps a research-oriented MD. But that would be really, really time consuming and expensive: MDs don’t come cheap, and even family docs make six figures after residency. The kinds of people capable of being NIH grant specialists are either an endangered species that’s seldom seen or hidden like hobbits in the modern world, who can vanish in a twinkle and apparently aren’t on the Internet.

In short, you’re not going to find them. We explain this fairly regularly to people who call us looking for “experts” and “specialists” in grant writing for particular fields, but they often don’t believe us, despite our seventeen years of experience.

EDIT: We’ve also worked for clients who’ve sat on NIH panels, and many say that, if they can’t figure out what the proposal is about within ten minutes of starting, they don’t even read the rest of it. You may see a blog post on this subject shortly.

Our Experience Trying to Hire Grant Writers

There’s one other reason we’re skeptical that you’ll find many specialized grant writers, let alone general grant writers: we’ve hired a lot of grant writing stringers, and most of them turned out to be not particularly great grant writers.* The best one had no unusual training at all—he was a journalist, which meant he understood the 5Ws and the H and was accustomed to writing against inflexible deadlines. Most thought they could write proposals, but they couldn’t pass the test Isaac describes in Credentials for Grant Writers from the Grant Professionals Certification Institute—If I Only Had A Brain.

The number of people out there who claim they can write against deadlines or pretend they can is vastly larger than the number of people who actually can. If there’s something strange, and it don’t look good, who you gonna call? Ghostbusters! If you’ve trying to understand a RFP, and it don’t look good, you know who to call. Alternately, you could keep searching until the deadline has passed, in which case the probability of you not being funded is 100%.


* This was mostly before my time, however; once I got to college, I tended to write more proposals, and the frustrations of stringers weren’t worth the benefit for Isaac. In addition, I’m mostly inured to his sometimes acerbic commentary by now. Seliger + Associates has not used stringers for well over ten years.