What the NIH is willing to fund has very little bearing on its impact to society as well. You can have a disease that has significant impact to millions of live

What the NIH is willing to fund has very little bearing on its impact to society as well. You can have a disease that has significant impact to millions of lives and it will have $1 million in funding while another that has less impact and has 1/1000th of the sufferers receives $100s of millions. The way the funding is assigned is not in anyway based on the merit of the disease being studied and how many lives it would save or improve. Even labs on the NIH revered institutions list struggle to get funding for the unloved diseases that really need more money. There was a assay diagnostic that showed energy deficits at a cellular level in ME/CFS and long covid and the NIH passed on funding it, for the third time in a row. That impacts millions upon millions of sufferers of a very real and growing condition. Its so bad that the bulk of funding in a lot of cases comes from private donations and organizations like the open medicine foundation which are tiny but in comparison to funding from the NIH its substantial. The NIH has done a terrible job at assigning research funds from what I can see, a system of appropriate merit would make a lot more sense otherwise no progress will be made in extremely debilitating and painful and unknown to the public conditions.