Scientific Opportunities and Public Needs Improving Priority Setting and Public Input at the National Institutes of Health (1998) / Chapter Skim
Currently Skimming:
Priority-Setting Process
Priority-Setting Process
Pages 43-52
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From page 43... ...
Although this diversity has contributed to a research establishment of great vitality and research productivity, it has led to an administrative structure that prevents uniform oversight and planning, hinders coordination of programs that involve several or all of the institutes, and obscures public comprehension. For example, from the short descriptions that each institute and center provided, the committee saw substantial differences in their priority-setting processes, such as the extent to which and how they involve outside groups.
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From page 44... ...
The central element of the NIH planning process is the annual meeting of the NIH Leadership Forum, composed of the NIH director, the institute directors, and NIH administrators responsible for major trans-NIH research and management issues (e.g., women's health, rare diseases, and alternative medicine)
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From page 45... ...
. Thus, the NIH director is unable to communicate directly to Congress, early in the budget process, his or her independent judgment regarding the best use of NIH funds in the coming year.2 One outcome of this process is that the NIH director at times has been found to be in the position of defending a budget request that is lower than the congressional mark or that reflects priorities that differ from those of Congress and perhaps even those of NIH itself (for example, if a special research directive was issued by DHHS or the White House)
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From page 46... ...
the director was given the ability to transfer up to 1 percent of funds across institute lines, and (2) the director was given a discretionary fund with which to seed selected areas of research.5 In addition, the director has played a more active role in priority setting by requiring the institute directors to receive part of their budget increases through an initiative called the NIH Areas of Research Emphasis (described below)
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From page 47... ...
In 1995, 1996, and 1997, the NIH director transferred $8.4 million, $24.8 million, and $33.8 million of a possible $110.5 million, respectively. Examples of accomplishments resulting from the receipt of transfer funds include construction of a map of the rat genome; establishment of a national resource for small-angle X-ray scattering and X-ray spectroscopy; establishment of an NIH consortium for research in neurodegenerative and brain disorders; collaborative efforts in programs related to bone, cartilage, and dental diseases; projects in the neurobiology and genetics of autism; and improved preparedness for rapid responses to emerging diseases.
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From page 48... ...
For example, the FY 1999 budget increase is more than $1 billion. Of that increase NIH plans to use 52 percent, or $598 million, to support the six Areas of Research Emphasis, including the biology of brain disorders, new approaches to pathogenesis, new preventive strategies against disease, new avenues for the development of therapeutics, genetic medicine, and computers and advanced instrumentation.
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From page 49... ...
PRIORITY SETTING AT THE INSTITUTE LEVEL Although the NIH director can influence priority setting through participation in the annual budget process, the use of blue ribbon panels to recommend new or reorganized programs, and the use of budgetary authority to launch crosscutting areas of research emphasis, the levels of funding for most of the budget, and therefore the research allocations, are determined at the institute level. NIH is a very large, complex, and decentralized enterprise in which most programming and budgeting activities come from the bottom up.
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From page 50... ...
in its priority-setting and planning process, with a mix of members including intramural and extramural researchers, NCI and other federal officials, consumer and patient advocates, and representatives of professional societies and organizations. Still others employ rigorous and well-structured internal and external planning reviews.
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From page 51... ...
More recently, NIH has been making decisions on priorities and Finding allocations that are more centralized than in the past; that is, NIH is looking across traditionally independent institutes and centers and focusing on certain crosscutting needs and opportunities where joint or unified action is desirable. This trend stems from the growing realization that common biological processes underlie diseases that were previously seen as different or that important diseases and other health problems are more complex than was previously thought, affect more organs and processes than was previously realized, and happen to be addressed in more than one institute.
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From page 52... ...
, a review of ACD membership reveals that these reserved slots are not being filled with enough public members consisting of individuals from organized voluntary groups, individuals active in advocating for those with specific diseases or medical conditions, and members of organizations and individuals who represent population groups with special or disproportionate health problems. Not having more public members Mom these groups is a missed opportunity and has resulted in the perception of some groups that NIH does not encourage public input at the highest levels.
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