Scientific Opportunities and Public Needs Improving Priority Setting and Public Input at the National Institutes of Health (1998) / Chapter Skim
Currently Skimming:
Introduction
Introduction
Pages 13-28
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 13... ...
Senate authorization and appropriations committees requested that IOM present findings, conclusions, and recommendations "for improvements in the NIH research funding policies and processes and for any necessary congressional action." Specifically, the congressional committees asked that IOM "assess: · the factors or criteria used by NIH to determine funding allocations for disease research, . the process by which research funding decisions are made, · the mechanisms for public input into the priority-setting process, and .
|
From page 14... ...
with other health-related agencies of the federal government, including the Agency for Health Care Policy and Research, Centers for Disease Control and Prevention, Food and Drug Administration, Health Care Financing Administration, and Health Resources and Services Administration. NIH is the primary agency for research on health, accounting for 94 percent of DHHS's budget for health research and development (calculated from data from the National Science Foundation [NSF; 1997a:Table 83~.
|
From page 15... ...
How it allocates its resources among and within these activities-that is, how it sets priorities is of great importance to the public, the media, organized disease-specific interest groups, heals care providers, and researchers themselves because of widespread and deeply held interest in the impact of NIH on health and disease and on the productivity of the nation's health research enterprise (see Box 1-2 for a list of NIH constituencies)
|
From page 16... ...
There is a natural focus on the allocation of funding among He institutes and centers because each receives its own appropriation Tom Congress (the Office of the Director, Office of AIDS Research, and buildings and facilities accounts also receive separate appropriations; see Table C-1 in Appendix C) .~ The institutes and centers are the main organizational units of NIH, win only the Office of the Director of NIH being above them, providing overall leadership and direction and cross-institute coordination.2 iThe Division of Research Grants (recently renamed the Center for Scientific Review)
|
From page 18... ...
Each has a national advisory council with members representing the scientific community and the public to advise the institute director on policies and programs and to review and approve research grant applications. Institute directors are also advised on the intramural program by a Board of Scientific Counselors, consisting of nongovernment scientists with the appropriate expertise.
|
From page 19... ...
As NIH's press release for its FY 1999 budget request put it, "NIH's highest priority is the funding of basic biomedical research through research project grants. The emphasis on peerreviewed and competitively awarded RPGs allows NIH to sustain the scientific momentum of investigator-initiated research while providing new research opportunities" (National Institutes of Health, 1998a:7~.
|
From page 20... ...
For one thing, it involves determining whether the researcher has an application in mind. Even as rough estimates, however, the data indicate that, like other mission agencies of the federal government, NIH supports a substantial amount of basic research on the grounds that a growing science base will undoubtedly lead to better applications in the future.7 History has proven this to be so.
|
From page 21... ...
In the case of a disease, they include more than just those awards that mention a disease in the title or in a list of key terms for inclusion in the computerized database system containing information on research projects and programs supported by NIH and other DHHS agencies. They also include basic research that is related because it is studying a phenomenon implicated in the disease.
|
From page 22... ...
Despite limitations, these data are used by health groups and advocates to help assess how much effort NIH is putting into research on particular diseases, that is, as a measure of NIH priority setting. Disease-specific interest groups usually report on the rate of increase in funding for research on the disease in which they are interested and compare it with those for research on other diseases, and they may compare spending per afflicted person to argue that NIH is neglecting the disease in which they are interested.
|
From page 23... ...
NIH's success has earned it steady budget increases despite a tight overall federal budget in recent years. The NIH budget is $13.6 billion in FY 1998, and the administration has proposed an increase of 8.4 percent to $14.7 billion in FY 1999.
|
From page 24... ...
Third, the leadership of the health committees in Congress has become increasingly uncomfortable with intervening in research priority setting at NIH, for example, by mandating specific funding set-asides, new programs or institutions focused on a specific disease, or the use of particular research mechanisms or by trying to push research advances in specific areas in other ways. In part they may be reacting to feedback about the unintended effects of diseasespecific earmarking in the late 1980s and early l990s that added up to more than the overall increases and thus cut into the funding for other programs (Congress has always included earmarks in report language or less formally, but until recently, they rarely added up to a substantial share of the total budget increase that NIH received in any given year and so did not affect other research areas directly)
|
From page 25... ...
.9 The subcommittee heard testimony from the director of NIH and representatives of the scientific community in universities and industry who strongly encouraged Congress to resist pressures to become involved in how much NIH should spend on research targeted to specific diseases (see, for example, testimony by John W Suttie, president of the Federation of American Societies for Experimental Biology [U.S.
|
From page 26... ...
I have concerns about whether members of Congress have the scientific expertise to determine where the most promising areas of research are. By September 1997, the campaign by groups advocating for increased research on Parkinson's disease succeeded when the Senate voted to include the Udall Bill authorizing a $100 million program consisting of research centers, training grants, a patient information center, and other mechanisms in the FY 1998 appropriations bill.
|
From page 27... ...
The comments addressed many different topics or elements of the priority-setting process. Many called for more research funding allocations for specific diseases; others requested added emphases on certain types of research, such as environmental, interdisciplinary, clinical, or
|
From page 28... ...
Acknowledgments; Appendix C, NIH funding tables; and Appendix D, committee and staff biographies.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.