The proposed cuts to the National Institute of Health’s (NIH) budget cuts revealed by the White House in March 2017 has caused an uproar in scientific circles. Scientists and concerned citizens have rightly pointed out that such cuts will impede the development of life-saving drugs and discourage young researchers from pursuing careers in science.

What is missing in this discussion, however, is how those cuts will affect the internal dynamics of what remains of the research enterprise.

The proposed cuts come after a decade of flat budgets that were rarely adjusted for inflation. This funding environment has left academic science saturated, and has naturally led to increased competition. For example, the success rate for NIH grants has been steadily declining while the average age for first time recipients of NIH grants is increasing.

The increased competition to win over NIH grants will lead to a spike in scientific publications – the primary evaluation metric for career progression in academia. This trend has already been seen over the past decade. The number of new biomedical papers indexed in PubMed has been increasing exponentially while the buying power of the NIH budget was steadily decreasing.

The increase in publication volume will come at the cost of quality. Publications will be rushed and trainees pressured even more to generate positive results. Therefore, increased competition will further extenuate the irreproducibility crisis already taking hold in academic science. The rise in academic competition has undoubtedly been a major contributor to the irreproducibility crisis in biomedicine. After all, the ‘publish or perish’ mantra which defines academia is a direct consequence of how competitive it has become.

Some might argue that decreased funding will lead the overflow of scientists to transition into the private sector. However, this view might not be in line with current trends. Many pharmaceutical companies are exploring external innovation models and are downsizing internal research capabilities.

If the quality of research output declines, further cuts to the NIH budget will become justified. After all, the rationale behind the substantial investment in biomedical research is based on its potential impact on society and the biotechnology sector. If the return on investment on research crosses into the negative, the government might explore other approaches beside the NIH to spend its annual 30 billion dollar contribution to biomedical research.

The NIH should consider this scenario when planning its response to the proposed budget cuts. Its priority should be to ensure that research quality would not be impacted by any sharp fluctuations in its allocated budget.

Fortunately, the NIH is currently taking steps in this direction. It dedicated a section within its 2017 budget request focused on how to improve quality and reproducibility. Also, it has recently implemented measures to cap the number of grants any one scientist can receive.

However, there is more to be done. The NIH should leverage its extramural grants to initiate a cultural shift by encouraging academic institutions to explore alternative models for evaluating scientists. For example, by placing less emphasis on the volume of publications and more emphasis on quality may cause a cultural shift that raises publications standards. Also, including teaching and community outreach as evaluation criteria will increase the value of academic research to society. Finally, establishing confidential channels for whistleblowers and enacting regulations to protect them may be of great value to scientific funders. Whistleblowers can point out misconduct and fraud far before papers are published dampening negative publicity.

The NIH needs to use the next few years as an opportunity to strengthen its foundations and fine-tune its internal dynamics. Therefore, the challenge facing the NIH is not in how to maintain its current level of operation, but how to prevent these cuts from impacting research quality. If quality decreases, more cuts will be proposed as a consequence which could potential lead to the collapse of the largest biomedical research enterprise in the world.