affiliated with the AIDS research centers also are supported with additional R01s from NIAAA, NIDA, or NIMH. Currently, NIMH is funding five AIDS research centers, each with a different focus, ranging from the basic cellular mechanisms underlying ADC to basic and applied research on HIV risk behaviors.

THE NIH CONTEXT

Total NIH funding increased more than 100 percent between 1983 and 1993 (from $4.3 billion to $10.3 billion). While growth in AIDS research in the same period appears to be explosive by absolute measures, it reflects the requirement to respond rapidly to a new disease with major public health implications. Seven NIH institutes (including NIDA and NIMH) together received the vast majority of AIDS funding during this period: 90 percent of the total AIDS budget for FY 1992 and over 90 percent of the cumulative total since 1983 (Figure S.4).

While NIAAA, NIDA, and NIMH represent a significant portion of the NIH AIDS budget, their funds are distributed quite differently from most of the other institutes. In FY 1992, NIAAA, NIDA, and NIMH together comprised approximately 20 percent of the total NIH AIDS budget (NIAAA was a relatively minor portion of this). According to estimates for FY 1993, the three institutes continued to account for 11 percent of the total NIH budget and 20 percent of the AIDS budget. Yet they funded more than 97 percent of NIH's AIDS-related behavioral research, 64 percent of surveillance, 54 percent of neuroscience and neuropsychiatric research at NIH, and over 30 percent of health services research and research training (as defined by categories used by the Public Health Service). On the other hand, NIAAA, NIDA, and NIMH account for less than one percent of the funding for therapeutic agents and 12 percent of the funding for biomedical research, two categories that together represent nearly 60 percent of the total NIH AIDS budget. It is clear that NIAAA, NIDA, and NIMH play a critical role in the overall NIH AIDS research agenda and in its biobehavioral and behavioral agenda in particular.

After reviewing the content and management of the AIDS research portfolios of the NIAAA, NIDA, and NIMH in Chapter 6, the committee makes several recommendations:

6.1 The committee recommends that NIAAA, NIDA, and NIMH each establish a position for a full-time AIDS coordinator. The coordinator should be provided appropriate resources



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