The ADAMHA Reorganization Act provided that the ADAMHA peer review systems, advisory councils, and scientific advisory committees would remain in effect through FY 1996 (ending September 30, 1996).

In most ways, the review procedures of the former ADAMHA research institutes are similar to the procedures at NIH. ADAMHA, like NIH, used a dual review system that separated technical and scientific assessment of projects from subsequent policy decisions concerning programmatic, scientific areas in which projects would be supported. This dual technical and programmatic review has been retained at the institutes. The scientific review process is kept separate from funding in part to ensure that program officials are not involved in making determinations on the scientific merit of research applications.

The first level of grant review is conducted by technical experts, largely from outside the federal government, and is designed to evaluate competing applications based on scientific and technical merit. The second level of review is conducted by advisory councils to assess the quality of the first-level review and to offer recommendations based on the relevance of the research to the institute's mission. The recommendations of both levels of review are advisory to the federal government and the final funding decisions reside with the institute director. Funding decisions are based not only on scientific merit and policy consideration, but may also consider administration policy, funding availability, and other factors.

Although the ADAMHA Reorganization Act mandated that the review processes (both at the first and second levels) be maintained through 1996, it is not yet clear how AIDS research applications at the three institutes will be reviewed when this period ends.

Given the composition of the NIH-wide AIDS study sections, some have expressed concern that applications related to the biobehavioral and social-behavioral research foci of NIAAA, NIDA, and NIMH—that is, the cross-disciplinary focus—will not fare well should the three institutes be subject to the overall NIH review process. While it is too soon to determine if this concern is well founded, the committee is aware that such concern is widespread among the institute program staff and the external research community.

It is the perception of many people, including some members of the committee and researchers interviewed for the study who have

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