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NIH Reauthorization
New>> APS endorses NIH Reform Act of 2006
On July 19, 2005, the House of Representatives Committee on Energy and Commerce held a hearing to discuss reauthorization of the National Institutes of Health (NIH). All federal agencies require periodic Congressional authorization so that lawmakers can provide guidance and oversight, as well as to set funding levels. Authorization of the NIH falls under the jurisdiction of the Energy and Commerce committee in the House of Representatives, and the Health, Education, Labor and Pensions committee in the Senate. Although Congress should reauthorize the NIH regularly (every two years), the agency does not require reauthorization in order to function, and the agency was last reauthorized in 1993. In the absence of a reauthorization bill, appropriators in Congress often include authorizing language in the yearly spending bills for the agency.
The House Energy and Commerce committee, led by Chairman Joe Barton (R-TX) is looking to reassert its authority over the NIH and has circulated a draft reauthorization bill. The draft bill was discussed at the July 19 hearing at which Dr. Elias Zerhouni, NIH director, was the only witness. Outlined below are some of the more significant items contained in the first draft of the bill.
Structural Reorganization
The draft bill divides the agency’s many institutes and centers (ICs) into two broad categories: those that are mission specific and those that are science enabling. Mission specific ICs are those associated with a specific disease, organ or life stage. Among the 15 ICs in this category are the NHLBI, NIAID and NIDDK. Science enabling ICs are those that conduct basic science and training activities, those that deal with emerging disciplines, crosscutting issues and clinical and translational activities. NIGMS, NHGRI and NLM are among the nine ICs that fall into this category. The bill limits the total number of ICs to the current 15 mission specific and nine science enabling, and contains a number of provisions outlining the procedures for reorganizing, creating and abolishing ICs.
In addition to categorizing the ICs, the reauthorization would define four main entities within the NIH: the Office of the Director (OD), a newly created Division of Program Coordination, Planning and Strategic Initiatives (DPCPSI), the mission specific institutes and the science enabling institutes. The main purpose of the DPCPSI would be to coordinate trans-NIH activities and through this division, the director to have grant-making authority.
Director’s Authority
The bill outlines the authority of the NIH Director to include responsibility for program coordination, priority setting, and strategic planning for all research activities conducted or supported by NIH. The bill specifies that the Director will have an Advisory Council to provide advice on matters of research and policy. Currently the NIH director has the authority to use 1% of the total NIH budget to conduct trans-NIH activities. Under the new bill, the director’s transfer authority would increase, and while the draft bill did not specify that percentage, Dr. Zerhouni testified at the hearing that 5% would be an appropriate starting point. This is consistent with the recommendation of the Institute of Medicine from its 2003 report on organizational changes at NIH.
Appropriations
Under the current version of the reauthorization bill, Congress would specify the budgets of only the four entities listed above. This would be a change from the current system where Congress provides a specific dollar amount for each IC. In order to ensure some stability in the budgets, the committee may specify a minimum amount that each IC should receive. In addition to changing the way Congress funds the NIH on a yearly basis, there has been discussion of placing a ceiling on the overall budget growth of the agency over the next several years.
Reporting Requirements
The reauthorization bill directs NIH to develop an electronic system to code grants, which would also provide information on associated patents and publications. The bill eliminates some of the present reporting requirements and mandates a biennial report to Congress on the state of biomedical research, complete with a strategic plan and a catalog of research activities organized by specific disease categories.
In addition to the changes described above, the NIH reauthorization bill establishes two new demonstration programs: Bridging the Sciences, and High Risk, High Reward Research. Bridging the Sciences would allow the NIH director to make grants in consultation with the NSF and DOE to fund research at the interface of biological and physical, chemical, mathematical and computational sciences. The High Risk, High Reward Research program would provide funding for high-impact innovative research and encourage public-private partnerships. Both of these grant programs would require peer review.
Taken together, the changes included in the reauthorization bill are intended to allow the agency to have more flexibility to respond to changing and emerging needs in public health. In the past, NIH reauthorization has been stalled due to numerous and sometimes controversial additions to the bill by Members of Congress. The success of this bill will depend in part on whether Chairman Barton can maintain this as a “clean” bill. However, while NIH reauthorization has been a priority for Chairman Barton’s House Energy and Commerce committee, the Senate Health, Education, Labor and Pensions Committee has yet to take up the measure.
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