This comprehensive plan is meant to be the basis for developing the annual budget requests for AIDS research. The director of OAR (not the director of NIH) is required to develop a full-funding budget that provides for the "… amounts necessary for the agencies of the National Institutes of Health to carry out all AIDS activities determined by the Director of the Office to be appropriate, without regard to the probability that such amounts will be appropriated" for each fiscal year. This budget (called the "professional judgment budget" or "bypass budget") is to be submitted from the director of OAR directly to the president for review and submission to Congress. The NIH director, the secretary of HHS, and the AIDS Advisory Council should all have the opportunity to comment on, but not change, the budget before it is submitted. In addition, the director of OAR is required to submit another budget package as part of the normal federal budget cycle. This budget package is to include the full-funding budget, a budget based on current activities and those initiatives for which there is the most substantial need, and other budgets as appropriate. The director of NIH and the secretary of HHS are required to consider all such budget estimates when recommending their annual budgets to the president.

When AIDS funds are appropriated to NIH by Congress, they will go directly to the director of OAR. The director will allocate to the individual institutes, centers, and divisions all of the funds received in accordance with the previously approved comprehensive plan for expenditures and appropriations. Funds to support existing AIDS activities, including "… projects or programs for which the Agencies have made a commitment of continued support," will be allocated by the OAR director within 15 days of his or her receipt of the funds. The director will then allocate the rest of the AIDS appropriations to the institutes, centers, and divisions within 30 days, if possible. This process will be in place beginning FY 1995.

The second major change in the budgetary process created by the NIH reauthorization bill is the emergency discretionary fund from which the director of OAR, in consultation with the AIDS Advisory Council, may make expenditures to support the AIDS research activities authorized by the legislation. This fund is designed to allow the NIH to respond to rapidly changing research problems and priorities, and grew out of concerns that inflexible budget rules may prohibit important and time-sensitive research (such as research on multi-drug resistant tuberculosis). The Act provides for the appropriation of up to $100 million in each of FY



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