Panel Calls for NIH Makeover

A group of experts thinks U.S. biomedical research could be managed more efficiently with a few changes to streamline the $27 billion National Institutes of Health (NIH). The National Academies panel finds, for example, that some of NIH's 27 institutes should be merged. The report, released today, also calls for more multi-institute initiatives at NIH and limits on the terms of directors.

The study was requested by the Senate Appropriations Committee, which in its 2001 report wanted NIH to ask the National Academy of Sciences whether NIH's structure is "optimally configured for the scientific needs of the 21st century." In 2001, after stepping down as NIH director, Harold Varmus called for a leaner management--five institutes organized by disease.

The panel suggests only two potential mergers, however. The National Institute on Alcohol Abuse and Alcoholism should be combined with the National Institute on Drug Abuse because they both study addictions, the report says. And because the human genome sequence was completed in April 2003, the National Human Genome Research Institute could be folded back into the National Institute of General Medical Sciences. Before closing any institutes, however, Congress should require that the NIH director "initiate a public process" to consider scientific arguments and public views.

In addition, the report recommends that 5% of NIH's overall budget go to programs that cut across institutes, ramping up to 10% or more over 4 to 5 years. The director's office should also emulate the Department of Defense and create a program to quickly review and launch "high-risk exceptionally innovative research projects offering high potential payoff."

The panelists also think NIH could benefit from more turnover in leadership. It recommends a term limit of 5 years for institute directors, and a 6-year limit for the presidentially appointed NIH director. Terms could be renewed just once, instead of the current open-ended terms.

Other recommendations touch on controversial directives issued during the Bush Administration (Science, 11 July, p. 148). Responding to the perception that politics is influencing the selection of members of advisory committees, the report says panelists should be chosen "solely" based on their scientific or clinical expertise or commitment regarding an issue. Efforts to consolidate management functions or contract out science-related jobs should be done only after careful study shows that such moves will not undermine research.

A Senate staffer calls the report "extremely helpful" and notes that many steps could be implemented by appropriations committees "fairly quickly." But some observers were not impressed. "There are a lot of good ideas, but they never really took on the issue of how NIH would be ideally configured," says Varmus, now chief of Memorial Sloan-Kettering Cancer Center in New York City.

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Prepublication copy of the report

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