managing the grants that are subsequently funded by NIH (it does not include the intramural research program). The extramural grant program is the largest and fastest-growing part of NIH's research effort. Research management and support also includes the capacities that need to be expanded to improve research priority-setting activities at NIH, such as new or expanded Offices of Public Liaison, the new Director's Council of Public Representatives in the Office of the Director, increased consumer participation in all NIH advisory bodies, and improved collection and analysis of disease-related data.

Resources invested in these underfunded functions not only should help NIH to fulfill its mission of improving the nation's health but should also improve the effectiveness of public oversight of its activities, thus enabling Congress and interest groups to observe and participate in a process that is more transparent and more satisfactory. This in turn may catalyze a change in which NIH and the consumers of health research work together rather than against each other and in which Congress lets NIH (informed by stronger public input) set research priorities.

Recommendation 12. Congress should adjust the levels of funding for research management and support so that NIH can implement improvements in the priority-setting process, including stronger analytical, planning, and public interface capacities.

Any additional resources needed to implement this recommendation do not necessarily have to affect the total amount appropriated to NIH. The recommendation is meant to affect the cap on research management and support funding within NIH budgets, if Congress elects to impose caps in future appropriations as it has in recent years.