their willingness to work on AIDS-related problems, but it also will damage the reputation of existing research. Over time, that may imperil continuing public support for business as usual, if the federal research establishment is perceived to be unresponsive to the requirements of the AIDS epidemic.

CONCLUSION AND RECOMMENDATIONS

CONCLUSION

The development and management of the AIDS programs at NIAAA, NIDA, and NIMH takes place in a larger context. This context includes legislative and budgetary processes that are often in flux but still wield control over the resources available to manage the institutes' programs. In recent years, the most significant changes in this regard have been the structural reorganization of ADAMHA, which moved the institutes to NIH, and the new budgetary authority of the Office of AIDS Research at NIH, which changed the nature of how dollars will be allocated for AIDS research at the individual institutes. These changes were superimposed on the already complex budget process that governs all federal spending and together produced a climate of uncertainty for the management of the AIDS research programs at NIAAA, NIDA, and NIMH.

To maintain some stability, the institutes were allowed to retain their existing grant review procedures for four years (through FY 1996). This was seen as important for ensuring the continued support of behavioral and social research that historically had been better at ADAMHA than at NIH. The fact that this situation will be revisited in FY 1997 raises some concerns about how the cross-disciplinary research so important for advancing knowledge in HIV prevention and intervention will fare in the future.

RECOMMENDATIONS RELATED TO THE CONTEXT OF AIDS RESEARCH

5.1 The committee recommends that NIAAA, NIDA, and NIMH develop new programs and grant review procedures to encourage and facilitate innovative, collaborative, and cross-disciplinary proposals.

5.2 The committee recommends that the NIH task force charged with streamlining peer review consider alternative scoring schemes that would favor cross-disciplinary and innovative research proposals.



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