Flush with success in creating an atom bomb, the U.S. federal government decided it should start funding nonmilitary scientific research. government report entitled Science, the Endless Frontier provides the justification for doing this. It makes the case that science is the responsibility of government because new scientific knowledge vitally affects our health, our jobs, and our national security (Bush, 1945). Accordingly, the government established a Research Grants Office in January 1946 to award grants for research in the biomedical and physical sciences. It received 800 grant applications that year. The Research Grants Office is now known as the Center for Scientific Review (CSR), and it processes applications submitted to the National Institutes of Health (NIH) and other agencies in the U.S. Department of Health and Human Services (HHS). In 2005, CSR received 80,000 grant applications.The SystemInvestigators seeking an NIH grant submit a 25-page Research Plan that begins with an abstract placed in a half-page box on the form. The Specific Aims of the project, preferably two to four, come next (recommended length, 1 page). The applicant must show that these objectives are attainable within a stated time frame. As one NIH center (the National Cancer Institute) advises in its online Guide for Grant Applications, A small, focused project is generally better received than a diffuse, multifaceted project. The other components of the Research Plan are Background and Significance (3 pages); Preliminary Studies the applicant has done (6-8 pages); Research Design and Methods (about 15 pages); and, if applicable, Human Subjects and Vertebrate Animals considerations. The investigator must also submit a detailed budget for the project on a separate form.The Center for Scientific Review triages applications it receives. cursory appraisal eliminates one-third of the applications from any further consideration, and it selects the remaining two-thirds for competitive peer review. CSR sends each application to a Study Section it deems best suited to evaluate it. Peers in Molecular Oncogenesis, Cognitive Neuroscience, Cell Structure and Function, Hematopoiesis, HIV/AIDS Vaccine, and 167 other Study Sections review grant applications. Each Study Section has 12-24 members who are recognized experts in that particular field. Members meet three times a year to review 25-100 grants at each meeting. Two members read an application and then discuss it with the other section members who collectively give it a priority score and percentile ranking (relative to the priority scores they assign to other applications). An advisory council then makes funding decisions on the basis of the Study Section's findings, taking into consideration the [specific NIH] institute or center's scientific goals and public health needs (Scarpa, 2006). CSR's slogan is Advancing Health through Peer Review.With a budget of $28 billion, the director of NIH reports that it currently funds 22 percent of all the grant applications it reviews (Zerhouni, 2006). Among these, multi-year R01 grants are the mainstay of research by medical school faculties. And in 2005, the NIH funded only one in eleven (9.1%) of the unsolicited R01 research grant applications it reviewed (Mandel and Vesell, 2006). In 1998 the NIH funded 31 percent of its grant applications, and since 2003, grant appropriations have lagged behind inflation (Zerhouni, 2006). The National Science Foundation awards $6 Billion in grants each year. This independent federal agency funds 28 percent of the 40,000 annual grant proposals it receives.Twenty-six federal granting agencies now manage 1,000 grant programs. Even clinical trials of drugs, vaccines, and devices, where industry may profit from the outcome, have come under the purview of government. Zarin and colleagues (2005) reviewed ClinicalTrials.gov records and found that the federal government currently funds 9,796 (51%) of the 19,355 interventional trials being conducted. …