House Panel Examines NIH
Structure and Priority Setting Process
June 4, 2004 - The House Energy and Commerce Subcommittee
on Health conducted a hearing
June 2 that explored how the National Institutes of Health
(NIH) sets its research priorities and whether structural
changes are needed to help the agency function better. Subcommittee
Chairman Michael Bilirakis (R-Fla.) opened the hearing by
saying NIH's process for setting priorities "lacks transparency,"
and that he wanted to initiate a dialogue with the witnesses
on how the institutes work together to determine NIH's research
agenda.
The subcommittee heard from NIH Director Elias Zerhouni,
M.D., and three institute directors: Anthony Fauci, M.D.,
National Institute of Allergy and Infectious Diseases; Andrew
von Eschenbach, M.D., National Cancer Institute; and Nora
Volkow, M.D., National Institute on Drug Abuse. Dr. Zerhouni
summarized how NIH allocates its resources, focusing on reducing
the current and future burden of disease as one measure for
setting priorities. He emphasized the need for better information
systems to analyze the research portfolio and provide modern
decision support systems to the institutes and centers. He
also said there is a need to institutionalize a regular trans-NIH
priority review and planning process (such as was done with
the NIH Roadmap) that would draw upon a common pool of funds.
The institute directors explained how their institute's priorities
are set and modified in response to changes in scientific
opportunity and public health needs.
Full Energy and Commerce Committee Chairman Joe Barton (R-Texas)
said he was not concerned as much about NIH's peer review
process as with the way the agency's 27 institutes and centers
had been created. He reiterated his pledge to have a bipartisan
legislative package to reauthorize the NIH "in this Congress."
Chairman Barton's questions focused on whether Congress should
develop a reorganization plan for NIH or provide statutory
authority for the agency to reorganize itself. All of the
witnesses agreed that NIH should be given the flexibility
to evolve or adapt to scientific opportunity. Subcommittee
Chairman Bilirakis noted that all of the witnesses' answers
suggest there is some need for change in NIH's organizational
structure
On the issue of NIH's support for controversial studies of
sexual behavior, Reps. Henry Waxman (D-Calif.) and Lois Capps
(D-Calif.) urged Congress to resist injecting politics into
science. Reps. John Shimkus (R-Ill.) and Joseph Pitts (R-Pa.)
expressed concern about how Congress can justify such research
to constituents suffering from other diseases. Rep. Shimkus
said these grants need to pass a "common sense test."
Rep. Pitts went further; saying some of these grants "are
of questionable value," and asked what authority the
institutes have to stop funding for grants. Dr. Zerhouni explained
that funding cannot be stopped unless no progress has been
demonstrated on the grant or the funds are used "inappropriately."
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
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