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Congress Holds Hearing on NIH Priority Setting

On June 2, the House Energy and Commerce Subcommittee on Health held its fifth hearing addressing NIH reauthorization. Panelists included NIH Director Elias Zerhouni, MD, National Institute on Drug Abuse Director Nora Volkow, MD, National Cancer Institute Director Andrew von Eschenbach, MD, and National Institute of Allergies and Infectious Diseases Director Anthony Fauci, MD. Subcommittee Chairman Michael Bilirakis (R-FL) indicated that criticism of NIH had arisen because the priority setting process is complicated and lacks transparency, particularly when it comes to the approval of individual grants.

Full Committee Chairman Joe Barton (R-TX) attended the hearing to express his concern that NIH might require structural changes to improve its flexibility and efficiency. Given that the $28 billion budget is spread among 27 institutes and center, the director has little direct control over much of the budget. He added that the goal of the Energy and Commerce Committee is to have a reauthorization bill this year. With few legislative days left in the current year, there is little chance that a bill will get through Congress this session, but would likely serve as a starting point for a reauthorization during the next session of Congress.

Dr. Zerhouni explained that multiple factors determine how research dollars are allocated, including public health needs, burden of disease, scientific opportunities, quality of research proposals, experience of applicants, and the ability to sustain research through adequate staffing and infrastructure.

While most of the questions concerned NIH organizational and structural issues and increasing public health challenges like obesity, Rep. John Shimkus (R-IL) and Rep. Joe Pitts (R-PA) again questioned why NIH continues to fund research that, "fails the common sense test."

Dr. Fauci responded to these questions, saying that, "obviously in areas such as HIV/AIDS, it's a sexually transmitted disease, it's a disease that's transmitted by injection drug use, by a variety of other mechanisms, so we cannot avoid addressing the issues that are at the very foundation of why millions and millions of people are getting infected."

"We're sensitive to the issues that you bring up; I'm really quite sensitive, and I mean that sincerely, but we need to let the science drive the questions if we're going to get a handle on this really devastating sexually transmitted disease," the NIAID director said.

Earlier, Rep. Henry Waxman (D-CA) stated that Congress and NIH should work together to refine broad areas of emphasis but that scientists and the peer review process should determine which specific research grants receive funding. Rep. Lois Capps (D-CA) added that, "some Americans engage in self-destructive behaviors and we should research it."

APA continues to monitor these issues and encourages all its members to show their support for peer review by signing the Petition to Congress in Support of Scientific Integrity that has been organized by the Coalition to Protect Research.

Read Dr. Zerhouni's testimony
Sign the petition
Back to SPIN June 2004

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