Dr. Craig Hendrix is exploring a novel concept: whether antiviral drugs can be absorbed through certain areas of the body to prevent sexual transmission of HIV.
To test such hypotheses, Hendrix and his Johns Hopkins colleagues typically can put up healthy test subjects in hospital beds overnight, which creates a more effective experiment by allowing for more data collection and limiting outside variables. But volunteers in Hendrix's study are sleeping in a hotel between two long days of blood-drawing and CT scans because of a funding squeeze in a innovative federal grant program.
Elsewhere at Hopkins, researchers are in a holding pattern, unsure whether there will be funds for projects come fall, and young researchers hoping for small pilot grants to launch careers face long odds. The funding problem also could affect researchers at the University of Maryland, Coppin State and Morgan State, as they compete for a share of a National Institutes of Health program worth tens of millions of dollars.
The NIH program, designed to fund cooperative research and resource sharing that improves health or saves lives, funnels money to dozens of universities around the nation. Hopkins alone received $80 million over the past five years.
Recently, though, the Clinical and Translational Science Awards have come under pressure. After federal lawmakers criticized the awards for pulling money from other NIH priorities, a congressionally mandated report found the program needs more oversight to succeed.
Hopkins' record in the program also has come under scrutiny. The school sought a five-year extension in 2012 but came away with only limited stopgap funding, and must wait until next month to see what the next round brings. NIH has called for changes in the way Hopkins and other schools organize their work, according to a Hopkins official who oversees the grant.
"For very large organizations, that is difficult," said Dr. Daniel Ford, who oversees the grant as vice dean for clinical investigation at Johns Hopkins Medicine.
Pressures on the program come at a difficult time for NIH. The across-the-board federal cuts known as sequestration cut the Bethesda-based agency's budget 8 percent — about $1.5 billion.
"I have never seen a year where there is going to be such a need for advocacy around NIH funding," Ford said.
The grant program seeks to transform scientific enterprise from a model in which a scientist toils alone until a "Eureka!" moment into one that emphasizes collaboration, focused on working across disciplines to solve problems rather than individually just to identify them.
It pays for a central infrastructure of scientific resources and encourages researchers from different fields to collaborate. The infrastructure includes facilities such as the inpatient research beds as well as training opportunities and small pilot grants for young scientists.
Hopkins researchers who have used the translational grant money say it helped speed and coordinate their studies.
It paid for the shared services of a chemist and labs needed to develop synthetic molecules that could inhibit enzymes that can cause cancer or influence metabolism. Investors were drawn to the technology, which has been spun out of Hopkins to form Seattle-based startup Acylin Therapeutics.
Without access to the translational research grant's central resources, "it would have been very difficult for us to have made progress in any kind of time frame that we worked in that led us to getting the biotech company launched," said Dr. Philip A. Cole, a pharmacology researcher at Hopkins and co-founder of Acylin.
For researchers receiving pilot grants, the program helps them hurdle the challenge of receiving traditional NIH grants, which fund specific research for a defined period. The application processes for NIH grants can take two years with just a one-in-10 shot of succeeding.
To dole out the pilot grants, a panel of Hopkins administrators acts like a venture capital fund, reviewing applications for $100,000 pilot awards and looking for those that can develop some sort of product or treatment. The budget had allowed for about 10 such projects per year.
"You can't be too meek and stay in clinical research these days," said Dr. Josef Coresh, a professor of epidemiology who specializes in translational research using biostatistics. "You have to believe you're going to succeed."
Budget challenges threaten the ability to do that, researchers said.
When Hopkins sought a 5-year extension of its translational grant starting in fiscal 2012, the NIH instead offered a smaller one-year pool of money. NIH officials would not release documents detailing their review of Hopkins' performance, citing an exemption from public information laws.
But Ford said it involved a push to reorganize faculty and resources to reflect the grant's transformative mission.