Biomedical research is in particularly shaky and despairing condition these days. Its principle source of money, the National Institutes of Health, is immensely richer than any counterpart organization in any nation or combine of nations. But NIH can’t meet the demand for its grants, and in the grueling competition for budget shares, it has difficulty starting up new programs when it lacks money for sustaining the old ones.

Because that’s where the money is, scientists in record numbers are seeking NIH grants. But while the bankroll is big, it has grown very little since 2003, leaving NIH with a big decline in purchasing power. The system rings with alarms about conservatism and risk-avoidance in research, as money-seeking scientists vie for the favor of committees that rate their grant applications.

Politics gives and politics withholds, with little attention to the effects of starts and stops on scientific progress and careers. Not too long ago, a bountiful Congress began a fast-paced doubling of the NIH budget, raising the total from $13-billion in 1998 to $27.5-billion in 2003.

Joy filled the halls of science, and ground was broken at universities across the nation for more lab space to accommodate what was expected to be an era of continuing growth. Then, attention on Capitol Hill and at the White House turned elsewhere, and growth came to a near stop, leveling off this year at $29.3-billion. Since the doubling, the decline in NIH purchasing power is reckoned at 8 percent to 10 percent. Meanwhile, the number of applicants for grants doubled to 80,000, and success rates fell sharply.

That’s enough to make for tough times in grant land. But NIH has also embarked on pricey new endeavors that go under the heading of the Road Map for Medical Research, initiated by Elias Zerhouni shortly after he became director in 2002.

Pre-Road Map, NIH proudly relied heavily on individual scientists to seek support for work they deemed important. The process, known as investigator-initiated research, became enshrined in the NIH culture as the surest way to scientific breakthroughs. The Road Map assumes otherwise, and is specifically aimed at identifying gaps on the scientific landscape and orchestrating interdisciplinary and multi-institutional research to deal with them. It’s Big Science, team science, in contrast to investigator-initiated research, which is usually Little Science.

Amidst great apprehension and grumbling, the Road Map is slowly working its way to control of 5 percent of the NIH budget. At present, it accounts for 1.7 percent, or $495-million — money that NIH’s old timers regard as theirs. To identify and orchestrate the new programs, there’s a new office at NIH, which carries a title that chills the Little Science crowd: The Office of Portfolio Analysis and Strategic Initiatives, or OPASI. The staff there now numbers about 30, on the way to about 80. And there’s another organizational newcomer, the Council of Councils, made up of representatives from the councils attached to each of NIH’s 27 institutes and centers.

The 1998-2003 budget doubling was warmly welcomed by the scientific community. But some chieftains of science now rue the bonanza, feeling that moderate, steady growth is preferable to a sudden burst of money, followed by a steady state that erodes buying power.

But it’s not likely to get better soon. The lame-duck budget that President Bush sent to Congress holds NIH to its current level — $29.3-billion. Congress could go higher, but that’s doubtful given the rising deficit and the sinking economy.

What’s dangerously lacking in science is an effective planning process that commands political attention. Many shun the idea in the belief that anarchy is the best mode for science. Maybe it was a long time ago, but what we have today is neither anarchy nor central planning. Instead, we have a stumble-along process that suffices when money is plentiful but works poorly in hard times.

Since the NIH community complains in times good and bad, the current lamentations are generally regarded as more of the same. But they aren’t. This time, biomedical research is really hurting, really missing good opportunities for valuable advances.