Welcome to the Cato podcast. My name is Ryan Bourne, and I'm Cato's R. Evan Schaff Chair for the Public Understanding of Economics.

Today I'm delighted to be joined by Cato adjunct scholar John Early.

Glad to be here.

And Terence Ceeley, another Cato adjunct and professor of clinical biochemistry at the University of Buckingham.

And I'm delighted to be here.

So today we're joined by Terence and John, because we're going to talk about their provocative new Cato paper,

Mission Lost, how NIH leaders stole its promise to America.

And it's a really highly critical, evidence-based look about the use of

taxpayer funds by the National Institutes of Health, which is, of course, the primary federal agency

in the United States for biomedical and health research. Now, for a bit of context here, NIH

today employs roughly 18,500 people. It pushes about 84% of its budget out as

extramural grants. And last year it had a budget of around $50 billion funding hundreds of

thousands of researchers across thousands of institutions. So any changes to its mission or to its

metrics has pretty big consequences.

And this is a really great paper. I think it takes a really in-depth look at the 2024 NIH

budget. And I just really think from a Cato perspective, it's a great case study in the cause

of downsizing federal spending. So, John, I mean, this is a really provocative title,

but if NIH leaders stole the agency's promise to America,

what was the NIH's original promise to America?

Well, NIH frequently repeats that its purpose is to reduce the incidence of disease and of death in the

American population.

But it doesn't really manage to that objective.

...