Title page 1

Contents 2

Key Takeaways 1

Introduction 3

The Role of NIH in the Biomedical Innovation Pipeline 4

Mandate and Structure 4

Funding Basic Research 5

Bridging the Valley of Death 5

Case Studies of NIH-Enabled Breakthroughs 6

mRNA Vaccine Platforms 6

CRISPR-Cas9 Gene Editing 7

Targeted Cancer Therapies 8

Emerging Frontiers for NIH Investment 9

Artificial Intelligence in Drug Development 9

Synthetic Biology and Next-Generation Manufacturing 10

Pandemic Preparedness and Antimicrobial Resistance 11

Economic and Strategic Value of NIH 12

Return on Investment From Public Science 12

Building a Scientific Talent Pipeline 13

Catalyzing Regional Innovation Ecosystems 13

Strengthening U.S. Competitiveness and National Security 14

Advancing U.S. Global Influence Through Science Diplomacy 14

Threats to U.S. Biopharmaceutical Leadership 15

Proposed Cuts to NIH Funding 15

Global Competitors Are Rapidly Closing the U.S. Lead 15

Risk of Overreliance on Private-Sector and Philanthropic Funding 17

Recommendations 18

Sustain and Expand NIH Funding 18

Incentivize Public-private Partnerships 19

Improve Public Communication of NIH's Impact 19

Conclusion 20

Endnotes 21

Figures 12

Figure 1. Public investment in life sciences R&D, 2022 12