House Panel Questions NIH
Plans To Address Conflicts of Interest
May 14, 2004 - In a hearing
marked by frustration at times bordering on anger, the House
Energy and Commerce Subcommittee on Oversight and Investigations
May 12 grilled NIH Director Elias Zerhouni and the chairs
of his Blue Ribbon Panel on the agency's responses to allegations
of conflicts of interest regarding consulting arrangements
between NIH employees and industry.
Opening statements by subcommittee members were uniformly
critical of NIH, the Blue Ribbon Panel on Conflict of Interest
Policies, and the Department of Health and Human Services
(HHS). Subcommittee Chair James Greenwood (R-Pa.) set the
tone by noting the "revolving door" has become a
"swivel chair" that is a new form of "honest
graft." Blaming "non-disclosure policies and slow-rolling
by HHS lawyers," Mr. Greenwood said the subcommittee
still does not know how much money is involved. Because of
this inability to get specifics, he said the committee would
send letters to the pharmaceutical companies to get information
on the dollars involved. Mr. Greenwood stated the current
investigation into NIH practices would extend "well beyond"
the hearing scheduled for May 18 because of HHS's obstinacy
in releasing the data.
Turning to the Blue Ribbon panel, Mr. Greenwood noted its
work was limited by time and not examining individual cases.
He called the panel's report "a useful step, but only
a first step." He also expressed disappointment with
the panel's lack of analysis. Noting the panel's report "blithely
accepts" the premise that these arrangements are necessary
for recruitment and retention of senior scientists, Mr. Greenwood
asked, "Where are the data" on turnover. He also
asked about the benefits of the consulting agreements and
"what drugs were not developed" because NIH employees
were working for drug companies.
Rep. Peter Deutsch (D-Fla.), the ranking member on the subcommittee,
was equally tough, saying "NIH may have fallen victim
to greed." He added the full extent of the "corruption"
is unknown because of stonewalling by HHS. He also took the
"so-called Blue Ribbon panel" panel to task, saying
it blatantly refused to look at individual cases. He said
Dr. Zerhouni should suspend all NIH ethics officials and all
scientists involved in these agreements "until there
can be a real investigation, perhaps by the Inspector General."
Full Committee Joe Barton (R-Texas) began by noting that
NIH has not been reauthorized in over 10 years. He said that
NIH has been less than cooperative, and that the committee
will get the requested information either through cooperation
or coercion. Mr. Barton said at a minimum the consulting arrangements
at NIH need to be reported and may need to be banned. He said
NIH grants should be given on merit, not because of honoraria
received by NIH employees. He also vowed to re-establish oversight
similar to that under former Chairman John Dingell (D-Mich.).
Dr. Zerhouni reviewed the steps he has taken and will take
to address these issues. He outlined the four principles underlying
his plans to improve NIH's ethics program:
1) Enhance public trust in NIH by preventing conflicts of
interest through the restriction of financial relationships
employees may have with outside organizations;
2) Increase levels of transparency in the NIH ethics program
by requiring much more internal as well as public disclosure
of the details of financial relationships employees have with
outside organizations, including consulting arrangements and
awards;
3) Balance NIH's ability to recruit and retain the best scientific
expertise while expediting the translation of research advances;
and
4) Establish effective monitoring and oversight of employee
activities.
Blue Ribbon Panel co-chairs Bruce Alberts, Ph.D., and Norman
Augustine, Ph.D., presented combined testimony, with Dr. Augustine
talking about the panel's process and Dr. Alberts reviewing
specific recommendations. Dr. Augustine acknowledged the easiest
action would have been to call for an outright ban on these
agreements, but emphasized that NIH scientists must have the
ability to participate in academic activities. He cautioned
that "if a unique set of rules were to be enacted that
is so inconsistent with the established practices of the scientific
community, it could drive talented individuals away from NIH
as an employer and at the same time discourage the dissemination
of knowledge."
Dr. Alberts noted that the interactions with industry without
conflicts of interest are necessary and should be permitted.
He said the benefits of these interactions flow both ways,
and NIH scientists gain by knowing what industry is doing.
He also expressed concern about conflicts of commitment. He
also said the panel was headed toward recommending full public
disclosure until it was informed of the prohibitions against
such disclosures under the Federal Privacy Act.
Questions from committee members focused on the lack of cooperation
by HHS in providing information on the dollars involved in
these arrangements, the need for NIH scientists to participate
with industry and why they receive such large sums of money,
and the reasonableness of the dollar and time limits proposed
by the panel.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
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