Some 50 years ago the United States established a partnership between the federal government and research universities that made possible undreamed-of advances in our understanding of basic biological processes and the treatment of diseases. Today, however, the system of funding research through the National Institutes of Health reflects its age, and needs a dramatic overhaul.

It is, as President Obama promised during his campaign, a time for change, and nowhere is that change more needed than in the National Institutes of Health’s grant review and funding mechanism. As things stand now, the great majority of research funds go to long-established scientists who are doing good, yeoman-like work, but whose great, field-changing work may be behind them.

The most significant thing President Obama could do to ensure that America maintains its leadership position in the biomedical field is to cut by a decade — from 43 to 33 — the age at which promising young scientists receive their initial, career-establishing RO1 grant from the National Institutes of Health. To do that we need to strengthen the NIH grant peer-review mechanism to ensure that it rewards innovation and risk taking, rather than placing the vast majority of its bets on sure things that, while they are likely to succeed, will only provide incremental advances in understanding and treatment of disease.