1994, 1995, and 1996, and provides limitations and safeguards on the use of the funds. In particular, the projects supported by the funds must be peer reviewed; the funds must be used for a particular set of AIDS activities that constitute either a new project or additional AIDS activities for an existing project and for which the director has determined that there is a significant need; they cannot be used for more than two years for a specific set of activities; they cannot be used for purposes that were disapproved by Congress either explicitly or implicitly; and they cannot be used for construction or renovation, nor can they be invested. The director of OAR is required to submit to Congress annually a report describing how and why the funds were used during the previous fiscal year.


Funding of ADAMHA and NIH AIDS activities over time has taken place within the larger context of the overall federal budget process and has been directly affected by it. Appreciating the length and complexity of the budget process is critical for understanding the problems faced by rapidly changing and expanding research areas such as AIDS and by organizations that are in the process of restructuring, as were ADAMHA and NIH during the course of this study.

The overall budget process has been relatively stable over time and generally has operated similarly at ADAMHA and NIH. Although there were minor changes from time to time during the 1980s and early 1990s, and even with the reorganization of ADAMHA, the larger budget structure of PHS, HHS, the Office of Management and Budget (OMB), and Congress remained the same. In addition, PHS and HHS always had an unwritten policy of treating the research budgets of NIH and ADAMHA essentially the same.

At any one point in time, an institute (whether at ADAMHA, SAMHSA, or NIH) must consider its research program in relation to three separate budgets. This is illustrated in Figure 5.4, which displays the current budget calendar for an NIH institute.

At the end of calendar year 1993, the institute was in the midst of utilizing its current (FY 1994) funds (Execution), which were allocated through September 30, 1994. At the same time, the institute was involved in presenting and defending (Justification) its next year's budget (FY 1995) to reviewers ranging from OAR at NIH, HHS, OMB, and various committees within the Congress, as

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