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US NIH chief gains greater power over budget
World Report
US NIH chief gains greater power over budget A new law that gives the director of the US National Institutes of Health control over a “common fund” could drain cash from vital disease-specific programmes, argue some patient groups and researchers. Do they have cause for concern? Nellie Bristol reports from Washington, DC.
www.thelancet.com Vol 369 February 24, 2007
In the face of the budget slowdown, some of the institutes are devising strategies to curtail activities. The NCI, for example, has drawn up plans that would eliminate 95 new clinical trials and reduce patient enrolment by 3000. “We’re in the process right now of stopping stuff and reducing the number of patients involved in clinical trials, reducing the number of clinical trials and not initiating phase II and phase III of trials that are already on the books”, Young said. Wendy Selig, vice president of legislative affairs for the American Cancer Society (ASC), said that although the ASC supports the creation of the common fund in principle, it is concerned about funding levels of cancer programmes and how the director will use his new authority. “We’ll have to see how it’s all implemented”, she said. NIH funding had doubled over the 5 years ending in 2003, but since then the budget has essentially remained flat. President Bush in his fiscal year 2008 budget, released earlier this month, calls for 0·2% to 0·4% increases for most NIH institutes and centres. With medical inflation running at 3·5% to 4% a year, the proposed increases amount to a cut, research advocates say. By contrast, the common fund would receive $486 million under the President’s plan, a 17% increase over levels proposed for fiscal year 2007. In overdue fiscal year 2007 funding recently approved by Congress, the bulk of an NIH increase, $483 million of $620 million, is tagged for the common fund. Alan Leshner, chief executive officer of the American Association for the Advancement of Science, supports the creation of the trans-NIH pool, which he says will ultimately reduce
fiscal pressures on the institutes, which now must contribute their own funds to NIH-wide activities. Appropriating that money directly to a common pool will stop the current practice in which institutes have to be “constantly kicking in” to pay for activities outside their own centres, he noted. In addition to establishing the common fund, the reform freezes the number of institutes and centres at NIH at its current 27. It also strengthens oversight and review of research activities and organisational structure. Zerhouni has said the disease-specific centre structure has created “silos” that prevent collaboration between scientists working on the same problems at different institutes and makes it difficult for NIH to respond quickly to scientific opportunities. The goal of reform, Zerhouni said in a recent interview with The Wall Street Journal, is to foster research independence by separating the “scientific process” from the “bureaucratic process”.
Nellie Bristol
The printed journal includes an image merely for illustration Reuters
A new law that gives the director of US National Institutes of Health (NIH) greater control over the agency’s budget could hurt already cashstrapped research programmes, say some patient advocacy groups and researchers. The reform, which President George W Bush signed into law last month, gives NIH director Elias Zerhouni control over a common fund that he can use to support crosscutting research initiatives that require the expertise of more than one NIH institute or centre. The fund is expected to grow to 5% of the agency’s annual budget— currently about US$28·5 billion—and could become even larger. At the moment, more than 80% of the NIH budget goes to extramural research and 10% goes to the NIH intramural programme. Zerhouni has long lobbied Congress for more control over his agency’s budget. In the past, much of the budgetary power rested with the directors of the agency’s 27 institutes and centres. Each institute is organised around a specific disease area such as cancer. This created a situation, Zerhouni has argued, in which it was difficult for the institutes to cooperate on multi-disciplinary projects that required a broad range of expertise. The result, Zerhouni says, is like having a hand with 27 fingers but no palm. But NIH is facing a pronounced slowdown in its annual budget increases, and critics of the law say that creation of the new fund threatens to siphon away money from important projects that are already being starved of cash. “The system is straining and this just adds additional strain to it”, said Robert Young, chairman of the Board of Scientific Advisors for the National Cancer Institute (NCI).
NIH director Elias Zerhouni lobbied Congress for more control of the NIH budget
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US NIH chief gains greater power over budget A new law that gives the director of the US National Institutes of Health control over a “common fund” could drain cash from vital disease-specific programmes, argue some patient groups and researchers. Do they have cause for concern? Nellie Bristol reports from Washington, DC.
www.thelancet.com Vol 369 February 24, 2007
In the face of the budget slowdown, some of the institutes are devising strategies to curtail activities. The NCI, for example, has drawn up plans that would eliminate 95 new clinical trials and reduce patient enrolment by 3000. “We’re in the process right now of stopping stuff and reducing the number of patients involved in clinical trials, reducing the number of clinical trials and not initiating phase II and phase III of trials that are already on the books”, Young said. Wendy Selig, vice president of legislative affairs for the American Cancer Society (ASC), said that although the ASC supports the creation of the common fund in principle, it is concerned about funding levels of cancer programmes and how the director will use his new authority. “We’ll have to see how it’s all implemented”, she said. NIH funding had doubled over the 5 years ending in 2003, but since then the budget has essentially remained flat. President Bush in his fiscal year 2008 budget, released earlier this month, calls for 0·2% to 0·4% increases for most NIH institutes and centres. With medical inflation running at 3·5% to 4% a year, the proposed increases amount to a cut, research advocates say. By contrast, the common fund would receive $486 million under the President’s plan, a 17% increase over levels proposed for fiscal year 2007. In overdue fiscal year 2007 funding recently approved by Congress, the bulk of an NIH increase, $483 million of $620 million, is tagged for the common fund. Alan Leshner, chief executive officer of the American Association for the Advancement of Science, supports the creation of the trans-NIH pool, which he says will ultimately reduce
fiscal pressures on the institutes, which now must contribute their own funds to NIH-wide activities. Appropriating that money directly to a common pool will stop the current practice in which institutes have to be “constantly kicking in” to pay for activities outside their own centres, he noted. In addition to establishing the common fund, the reform freezes the number of institutes and centres at NIH at its current 27. It also strengthens oversight and review of research activities and organisational structure. Zerhouni has said the disease-specific centre structure has created “silos” that prevent collaboration between scientists working on the same problems at different institutes and makes it difficult for NIH to respond quickly to scientific opportunities. The goal of reform, Zerhouni said in a recent interview with The Wall Street Journal, is to foster research independence by separating the “scientific process” from the “bureaucratic process”.
Nellie Bristol
The printed journal includes an image merely for illustration Reuters
A new law that gives the director of US National Institutes of Health (NIH) greater control over the agency’s budget could hurt already cashstrapped research programmes, say some patient advocacy groups and researchers. The reform, which President George W Bush signed into law last month, gives NIH director Elias Zerhouni control over a common fund that he can use to support crosscutting research initiatives that require the expertise of more than one NIH institute or centre. The fund is expected to grow to 5% of the agency’s annual budget— currently about US$28·5 billion—and could become even larger. At the moment, more than 80% of the NIH budget goes to extramural research and 10% goes to the NIH intramural programme. Zerhouni has long lobbied Congress for more control over his agency’s budget. In the past, much of the budgetary power rested with the directors of the agency’s 27 institutes and centres. Each institute is organised around a specific disease area such as cancer. This created a situation, Zerhouni has argued, in which it was difficult for the institutes to cooperate on multi-disciplinary projects that required a broad range of expertise. The result, Zerhouni says, is like having a hand with 27 fingers but no palm. But NIH is facing a pronounced slowdown in its annual budget increases, and critics of the law say that creation of the new fund threatens to siphon away money from important projects that are already being starved of cash. “The system is straining and this just adds additional strain to it”, said Robert Young, chairman of the Board of Scientific Advisors for the National Cancer Institute (NCI).
NIH director Elias Zerhouni lobbied Congress for more control of the NIH budget
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