"Every university is being asked to provide a better way for faculty across disciplines to work together on solving the major health problems," Ford said.
Despite reduced funding, the university maintained the research infrastructure the grant created, though it has meant hiring freezes, fewer pilot projects and uncertainty for researchers planning future studies, Ford said.
"Even senior researchers are finding it more difficult," said Gerald Stacy, administrative director of Hopkins' Institute for Clinical and Translational Research, which manages the translational grant funds and programs there. "As our budget gets smaller, more people are saying, 'Can you help me?' "
For researchers like Hendrix, it could hurt the quality of experiments. The inpatient beds he used for past studies allowed him to explore new drugs in a controlled setting, eliminating potential bias from unknown variables.
Those beds have been available since the 1980s, funded by a different NIH grant that preceded the translational program. But now that they fall under the translational grant, there could be "huge implications" if that money isn't renewed, Hendrix said.
"That will necessarily limit the kinds of studies I can do, the amount of information I can get and it reduces the quality of information I can get," he said. "I won't have the same level of confidence I would have if I truly controlled for as many variables as I would like. It's very important for us that we have these inpatient beds."
The NIH scored grant applications in June, even though the decisions aren't expected until September. Ford said Hopkins officials had received their scores and were cautiously optimistic.
For University of Maryland officials, the prospect of landing a clinical and translational research award means an opportunity to amplify continuing research. The university's grant application was filed on behalf of a consortium that includes its own health system, the University of Maryland, College Park, Coppin State University, Morgan State University and Pennsylvania-based Geisinger Health System.
"The advantage of getting the CTSA and putting it under one umbrella would allow a lot of synergies to be created," said Dr. Alan Shuldiner, who leads the consortium along with Dr. Stephen Davis, both endocrinologists and research scientists at the university. "The money is important, of course, but it really creates the glue to create synergies across our institutions."
University officials would not release their grant application, which the NIH doesn't make public unless it is approved. Its website describes the consortium as seeking not just to promote translational research but advancing interdisciplinary education and work with the community to target and reduce health care disparities.
Budget cuts at NIH likely mean that any grant awards will be less than in the past. NIH officials still are weighing how the cuts might affect specific programs, but institutions like Hopkins expect translational grants to be 8 percent to 10 percent smaller.
The cuts also surely will hit the traditional NIH grants that so many researchers rely on. The hope is that success of the clinical and translational research resources will mean all research enterprise runs at a lower cost and produces more significant results — life-saving medicines and treatments — said Dr. Christopher P. Austin, director of NIH's National Center for Advancing Translational Sciences, which oversees the translational grant program.
"One of the challenges for us is to figure out how to morph our system," Austin said.
Research has historically been more focused on diagnosing problems, but the system needs to change to effectively learn how to fix those problems, he said.
But some in Congress have questioned how well the translational grants make use of NIH dollars.
In a report released in June that Congress mandated last year, the Institute of Medicine recommended that NIH consolidate the program's leadership, do more to spur collaboration among institutions and establish clearer standards for evaluating grantees and the program as a whole. The NIH is working on the recommendations.
But research advocates acknowledged that it will take time for such a broad effort to revamp research to show results.
"You want the CTSAs to be nimble and to be transformative. Of course, that's the hope," said Ann Bonham, chief scientific officer for the Association of American Medical Colleges. "As much as we would like for that to change overnight, it can take a few years to do that."
The effort dates back seven years, to 2006 under Dr. Elias A. Zerhouni, then-director of the NIH. The research is known as "translational" science for evolving laboratory experiments into drugs and other therapies that can be tested on and ultimately prescribed to humans.
Johns Hopkins joined the effort a year later, adding about $40 million in new grant money to its pool of more than $600 million it receives from NIH annually. Now 61 institutions participate.
"It's a big idea and a big plan," Hopkins' Ford told The Baltimore Sun in 2007. "And hopefully, it won't collapse under its own weight."