Focus Session

"Health in the Balance: Shaping the Research Agenda: Establishing Priorities for NIH Research in a Time of Constrained Resources"

Moderator

Allen Spiegel, M.D.
Dean, Albert Einstein College of Medicine of Yeshiva University

Speakers

Alan Krensky, M.D.
Director, Office of Portfolio Analysis and Research, National Institutes of Health

Allen Lichter, M.D.
Executive Director and CEO, American Society for Clinical Oncology

Krensky and Lichter Spiegel

This panel addressed the challenges of balancing and shaping scientific and public health priorities at a moment when two historic events have transpired. The first, addressed by Alan Krensky, M.D., director of the National Institutes of Health's Office of Portfolio Analysis and Research, is the establishment of a new organization and capacity within the NIH for coordination, analysis, and support of "high-risk, high-payoff" research. The second event, principally addressed by Allen Lichter, M.D., executive vice president and CEO of the American Society for Clinical Oncology and former Dean of the University of Michigan School of Medicine, is a protracted period of "flat funding" for federal support of medical research.

Allen Spiegel, M.D., dean of Albert Einstein College of Medicine, introduced the session, referencing his own experience as a former director of NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Spiegel emphasized that federal research is supported by taxpayer money with the objective of improving public health.

To ensure that research discoveries lead expeditiously to improvements in health, and to ensure that significant opportunities are appropriately targeted, the NIH has sought through its Roadmap for Medical Research and other mechanisms to create "synergistic interaction" among NIH's 27 institutes and centers, and to create a more nimble and focused organization.

Krensky described the new organization and its strategy for fomenting "high-risk, high-payoff" research. Crucial to this strategy is that all projects begun by the office will cease funding after five years (unless adopted by another institute or agency).

Lichter noted that the NIH has operated without significantly increased appropriations since 2003 (and the end of the NIH doubled budget), resulting in appreciable loss of purchasing power. Ironically, this decline has come at a time of substantially increased capacity for research and training, and at a time of unprecedented progress in treatment of and survival rates for cancer. As a result of the fiscal situation, the National Cancer Institute has limited enrollment in group cooperative clinical trials and other translational activities, and even inactivated some trials.

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