While US biomedical research funding generally allows researchers considerable freedom in determining the most promising topics to study, there have been some programs, such as the War on Cancer in the 1970s and Operation Warp Speed during the COVID-19 pandemic, that target funding at particular technologies or health objectives.

In The Therapeutic Consequences of the War: World War II and the 20th-Century Expansion of Biomedicine (NBER Working Paper 33457), Daniel P. Gross and Bhaven N. Sampat examine a historical precedent for top-down, targeted biomedical research. During World War II, when the high incidence of both disease- and injury-related military casualties created an urgent need for medical innovation, the US government established the Committee on Medical Research (CMR) under the Office of Scientific Research and Development (OSRD). CMR was charged with supporting research in a wide range of medical science and technology areas — with examples from antibiotics to blood substitutes and preservatives, human physiology in extreme environments, new injury treatment methods, and more.

CMR mobilized the nation’s scientific and clinical personnel toward solving specific military medical challenges, emphasizing speed and practical relevance over fundamental scientific value. The total cost — around $400 million in 2024 dollars — was only 5 percent of OSRD’s budget and less than 1 percent of the current National Institutes of Health (NIH) budget. Yet partly as a result of CMR’s work, the ratio of US military deaths from disease to those from combat injuries declined from 1.02 in World War I to 0.07 in World War II.

To evaluate CMR’s longer-term impact on biomedical innovation, the researchers use data from all 590 CMR contracts and data on biomedical scientific publications between 1930 and 1970 from Microsoft Academic Graph to compare trends over time in subjects that CMR supported to others. The researchers find that scientific activity in “existing” subjects — those with above-median numbers of pre-war publications — grew steadily before the war, accelerated during the conflict, and subsequently contracted, returning to approximately 1940 levels by 1970. In contrast, emerging subjects that were a focus of CMR research — those with below-median pre-war publications — saw little pre-war growth but substantially more postwar activity for at least a quarter century after the war, supported by new discoveries, capabilities, and research tools and methods generated by the CMR effort.

Beyond science, CMR also influenced the drug industry, ushering in a “golden age” of drug discovery: drug categories that were a focus of the CMR effort subsequently generated between one and two more drugs annually during the 1950s than others. CMR-supported firms were also more likely to file patents that referenced scientific literature, potentially indicating a shift from empiricism and trial-and-error drug discovery toward science-based innovation.

When CMR was disbanded after the war, the US Public Health Service absorbed its 40-odd remaining open contracts, which provided the foundation for the NIH extramural research program. Though NIH is now large and primarily supports undirected, bottom-up investigator-initiated research, the authors point to CMR’s example as indicative of the potential effects coordinated, directed approaches to biomedical research can have.

The authors acknowledge financial support from Duke University’s Fuqua School of Business, the Harvard Business School Division of Research and Faculty Development, and National Science Foundation grant 1951470.