NIDA, and NIMH formally became part of NIH. Also in FY 1994, the process was somewhat confused because of the change in administrations.
The major difference with the review of the AIDS budget by the NIH office of the director (OD) was the level of detail and the focus on science. Most OD-level budget review focused on mechanisms and appropriate balance, while the AIDS review was conducted on a project-by-project or, at the least, area-by-area basis. The OAR director reviewed the plan and made recommended cuts. The institutes could appeal to him to reconsider specific decisions, or the institutes also could appeal to the NIH director. After this phase, the OAR director took the proposed AIDS budget request to the NIH director and associate directors for final review. At this stage, the review broadened to include issues of program balance, mechanism balance, and magnitude of resources requested (both AIDS and non-AIDS), as well as the question of scientific opportunity. Again, unlike the rest of the NIH budget, the AIDS review did include some consideration of specific projects.
According to staff at NIAAA, NIDA, and NIMH, the FY 1994 review process was more top-down and the AIDS and non-AIDS processes were more similar than they had been in the past. NIH was given a departmental mark for AIDS and for its total budget that it then allocated to the institutes based on judgments made by the OAR director for AIDS and by the NIH director for the total budget. Apparently, the decisions in both cases were made based on judgments about where the scientific payoffs would be greatest.
In addition to considering issues of overlap and duplication, appropriate use of mechanisms, program balance, and scientific opportunities, the OD also considered the specifics of projects or project areas, the quality of the science, and the likelihood of progress when determining the NIH AIDS budget allocations. In FY 1994, as in all preceding years, once the institute received its budget allocation, the determination of which specific projects to fund was mostly a function of the grant review process, which is described next.
The ADAMHA Reorganization Act of 1992 provided that the ADAMHA peer review systems, advisory councils, and scientific advisory committees utilized remain in effect through FY 1996 (ending September 30, 1996). The report language indicates that,