The truism that diversity is strength is borne out by the current health of the biomedical research enterprise in the United States. The past few years have seen a surge in philanthropic funding for biomedicine. Entrepreneurs who made their fortunes in high-tech industry have started giving their spare millions to leading researchers (see page 140), and established players such as the Howard Hughes Medical Institute (HHMI) have continued to grow.

With the budget of the National Institutes of Health (NIH) also on the rise (see page 134), there is much for bench researchers to celebrate. But the new philanthropists have done more than simply increase the resources available for biomedical research. They have also provided an alternative to the bureaucracy associated with traditional grant applications. Rather than asking researchers to fill in forms running to 25 pages or more, and subjecting these to careful, but cumbersome, peer review, some philanthropists have adopted an aggressive strategy of picking potential winners. For the researchers singled out, the experience is liberating. The treadmill of chasing federal research dollars is replaced by a refreshing focus on producing results.

It would be foolish to suggest that the NIH should abandon its traditional 'study sections', through which peer-review panels consider the merits of competing proposals. This system may be conservative and slow, but it is the most accountable way of ensuring quality control that we know. In a period of long-term budget growth, however, the NIH should consider whether some of its riches might be distributed using similar methods to those adopted by the new philanthropies.

There is otherwise a danger that the NIH will find itself becoming the second port of call for the most talented biomedical researchers. The HHMI supports only around 350 investigators, but these individuals account for a disproportionate number of the most highly cited papers. And if one of Silicon Valley's multimillionaires is prepared to give you hundreds of thousands of dollars to pursue a novel line of research, why bother waiting around for NIH funding?

There is also the long-term health of US biomedicine to consider. The NIH could argue that established foundations and the new philanthropies are already ensuring a diversity of modes of funding. But philanthropists can take away, as well as give. High-tech companies are already feeling the chill winds of an economic slowdown. And as their founders begin to feel the pinch, there can be no guarantee that they will continue pouring money into biomedical research labs.

In rising to this challenge, the NIH does not even have to invent a model of federal research funding. It could simply follow the example of the Defense Advanced Research Projects Agency (DARPA). This body hires temporary programme managers from academia, and gives them almost complete freedom to fund innovative, high-risk projects. Despite its lack of obvious accountability, Congress tolerates this model because DARPA contributes to national security. Do the potential gains for human health not justify spending a few hundred million dollars of the NIH's budget in a similar way?