Inequalities in the distribution of National Institutes of Health research project grant funding

Previous reports have described worsening inequalities of National Institutes of Health (NIH) funding. We analyzed Research Project Grant data through the end of Fiscal Year 2020, confirming worsening inequalities beginning at the time of the NIH budget doubling (1998-2003), while finding that trends in recent years have reversed for both investigators and institutions, but only to a modest degree. We also find that career-stage trends have stabilized, with equivalent proportions of early-, mid-, and late-career investigators funded from 2017 to 2020. The fraction of women among funded PIs continues to increase, but they are still not at parity. Analyses of funding inequalities show that inequalities for investigators, and to a lesser degree for institutions, have consistently been greater within groups (i.e., within groups by career stage, gender, race, and degree) than between groups.

Inequalities in the Distribution of National Institutes of Health Research Project Grant Funding

Previous reports have described worsening inequalities of National Institutes of Health (NIH) funding of principal investigators. We analyzed data through the end of Fiscal Year 2020, confirming worsening inequalities beginning at the time of the NIH budget doubling (1998-2003), but finding that trends have reversed over the past 3 years. We also find that career-stage trends have stabilized, with equivalent proportions of early-, mid-, and late-career investigators funded from 2017 to 2020. Women continue to constitute a greater proportion of funded principal investigators, though not at parity. Analyses of funding inequalities over time show that inequalities have consistently been greater within groups (i.e., within groups by career stage, gender, race, and degree) than between groups.

Exempting Health Research from the Consent Provisions of POPIA

The Protection of Personal Information Act 4 of 2013 (hereafter POPIA) has the potential to disrupt health research in South Africa. While the legal status quo is that broad consent by research participants is acceptable, POPIA requires specific consent for any processing of research participants' health and genetic information. However, POPIA offers mechanisms such as an exemption from specified measures which can potentially be used to ameliorate its impact. It is proposed that the health research sector should seek to utilise these mechanisms – in particular, a sector-wide exemption of all health research projects from the requirement of specific consent by research participants, subject to the conditions that: (a) a health research project must be approved by a health research ethics committee, and that (b) either specific, broad or tiered consent must be obtained for a health research project. Importantly, it would be counter-productive to approach such an application for exemption from the perspective of inconvenience for health researchers. Instead, an application for exemption must be approached from a human rights platform, and must be supported by solid evidence. Such evidence should include the results of empirical studies of South African research participants' preferences.

What Contributions, if Any, Can Non-Indigenous Researchers Offer Toward Decolonizing Health Research?

Four non-Indigenous academics share lessons learned through our reflective processes while working with Indigenous Australian partners on a health research project. We foregrounded reflexivity in our work to raise consciousness regarding how colonizing mindsets—that do not privilege Indigenous ways of knowing or recognize Indigenous land and sovereignty—exist within ourselves and the institutions within which we operate. We share our self-analyses and invite non-Indigenous colleagues to also consider socialized, unquestioned, and possibly unconscious assumptions about the dominance of Western paradigms, asking what contributions, if any, non-Indigenous researchers can offer toward decolonizing health research. Our processes comprise of three iterative features—prioritizing attempts to decolonize ourselves, acknowledging the necessary role of discomfort in doing so, and moving through nonbinary and toward nondualistic thinking. With a nondual lens, working to decolonize ourselves may itself be seen as one contribution non-Indigenous researchers may offer to the collective project of decolonizing health research.