Reduced funding and increased competition among a larger body of active researchers also affects countries other than the United States, and fields other than the biomedical sciences.
Here in the United Kingdom, those of us who use the Engineering and Physical Sciences Research Council (EPSRC) for funding have witnessed a similar scenario to that described in your News Feature 'Closing arguments' (Nature 457, 650–655; 2009): a smaller fraction of assessed grants are being funded and we have reached the stage where there is — for all practical purposes — a lottery to determine which of the many excellent proposals submitted will be successful.
The amount of money that is available for curiosity-driven research is also decreasing, as the government seeks to steer funding into areas of political priority. The response from the scientific community is, of course, to become more inventive about the potential applications of a given proposal.
I believe that the best way to maintain research activity is through diversity in both sources of funding and topic. You indicate that undue weight is given to National Institutes of Health funding (as opposed to general funding) in many US institutions as a requirement for tenure or promotion. This may further concentrate academics in attempting to access a finite pot, with a consequently reduced rate of success.
However, despite the disappointment that we may feel in not receiving enough funding to maintain our activity or research-group size at a desired level, we academics should recognize our privileged tenured position in times of economic hardship such as the present.
Further discussion is welcome at http://tinyurl.com/cf59fq.
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Derby, B. Diversity of funding sources and topics is key to survival. Nature 458, 281 (2009). https://doi.org/10.1038/458281a