What is NIH efficiency?

"only 0.54% of the entire NIH annual budget request was dedicated towards Aging Biology" [1]

Among transhumanists, there is a relatively common viewpoint about very low efficiency of NIH funding.
People often believe that even ~0.1% of NIH funding (~$40mln/year) could make almost a revolution in aging research if given to the wisely chosen research directions/people (for example, to Aubrey de Grey research).

Another viewpoint defends NIH in this situation[2] arguing that NIH are not fools and traitors with absolutely wrong priorities, but simply are more cold-blooded and realistic to see what at this stage is realistic to develop, and what is still more fantasy, which requires first a large amount of preparatory work to implement.
This, of course, can be doubted. But it's probably a good idea to write arguments pro and contra.

Also, it's really strange that NIH hasn't created some well deserved intramural institute for SENS research to Aubrey de Grey.

100 random NIH grants analysis

I downloaded the table of all NIH grants for the year 2022[3] (with total 65305 grants), and selected 100 random grants. To get a representative sample of what NIH money is being spent on.

Overall, of the 100 random NIH grants with a total budget of $67.5M, 34 grants are quite normal grants for age-related diseases, with a total budget of $14.8M (~22%). Of these, 3 grants (~$0.9M) on cancer, 5 grants (~$2.7M) on heart and vascular, 7 grants (~$3M) on dementia and brain aging, 11 grants on immunity (~$5.3M, not so sure about research relevance here). 8 grants on other aging-related issues (~$2.8M). In addition to these 34 grants, there are another 5-6 cancer grants ($1.4-2.1M) on the verge of relevance (since very rare cancers, or something else not quite right).

There is one very voracious $18M grant (more than all 34 age-related grants combined) to create an ECHO coordination center to study how genetics and environmental factors affect children's health. The project description lacks specific details: https://reporter.nih.gov/project-details/10488700

Compare those $18M to 8 grants totaling ~$1.2M for research on childhood diseases (most of which are for very rare diseases). In addition, there are 7 more grants with ~$2.9M for rare diseases (not necessarily in children).

Continuing the topic of voracious grants, $5.5M goes to something related to gunshot wounds: https://reporter.nih.gov/project-details/10611747

$2.6M to gather statistics on why African-Americans in the U.S. are more likely to suffer from dementia and strokes: https://reporter.nih.gov/project-details/10337292 (of those, $2M are NIA funding).
$1.9M to test how much less likely non-smokers, papilloma vaccinated and screened people from four U.S. Appalachian states (Ohio, Kentucky, West Virginia and Virginia) are to get cervical cancer.

7 grants of ~$3.0 million for obesity research,
7 grants of ~$4.2 million for other diseases not really relevant to healthy lifestyle people (smoking, tuberculosis, suicide, etc.).

5 grants with $2.1M for neuroscience (the one not about dementias, but about studying how the brain works), 5 grants with $2M for women's reproductive health, 5 grants with $2.3M for organizational issues (of which $1.5M is to make different minorities competitive for R01 grants), and another 12 grants with $5.1M for various other things.

Full analysis with all calculations and details is here: https://rizzoma.com/topic/03b325d94029d8e8dba23042b17573c3/0_b_cd2h_c5rh6/