The National Institutes of Health (NIH) today released its first agency-wide strategic plan in more than 20 years. Although the document is largely a roundup of what the agency is already doing, it has some NIH advisers wondering whether the plan promises too much.
Despite reservations from some NIH advisers, one lawmaker who called for the plan thinks it is just what Congress ordered. In a statement, Representative Andy Harris (R–MD) called the strategic plan “groundbreaking” and “an important first step toward increasing accountability and resource prioritization at NIH.”
NIH’s 27 institutes and centers prepare their own strategic plans every few years, but the agency generally does not do broader planning. The last time it formally tried in the early 1990s, under then-NIH Director Bernadine Healy, a rocky 2-year planning effort produced a controversial document that was ignored. But more recently, some members of the U.S. Congress have raised concerns that NIH doesn’t have an agency-wide planning process. In a 2015 spending bill, they asked NIH to come up with a 5-year strategic plan, and after about a year of deliberation the agency unveiled it today.
The 46-page plan describes four objectives: “advance opportunities in biomedical research” by funding fundamental science, treatments, and disease prevention; set priorities; enhance stewardship; and “managing for results.” Much of the report describes ongoing research and projects—from the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) neuroscience initiative championed by the Obama administration to efforts to train a surfeit of young scientists for careers outside of academic research. Last week during a preview of the report before the NIH Advisory Committee to the Director (ACD), one adviser asked whether there’s much new: It “seems like it’s pretty much what you’ve been doing,” said Yale University health care researcher Harlan Krumholz.
But NIH Principal Deputy Director Lawrence Tabak, who has headed the planning effort, insisted that document lays out a common approach for priority setting across all NIH’s components. NIH Director Francis Collins added that the plan aims in part to clear up “chronic confusion” in Congress by “articulating” how NIH already makes funding decisions.
Buried within it, the plan describes a few significant policy changes. As Collins announced last week, it ends a more than 20-year tradition of setting aside 10% of NIH’s budget for AIDS research, a requirement that sometimes had odd results. The set-aside “was an appropriate response to the crisis more than two decades ago,” but NIH “no longer sees value in this formula-driven approach,” the report says. (At the same time, the report lists as a top priority an AIDS vaccine that could end the pandemic.) The report pledges to improve how the agency uses the public health burden a disease imposes to help guide priorities, while cautioning that better data on disease burden is needed.
The agency also promises to do more to avoid overlap of projects across NIH institutes and with other agencies. And it will require that every NIH institute publish an annual “standard metric” for funding—a bar graph showing the number of grants with a given quality score that received funding. That data is highly sought after by investigators competing for scare funding dollars.
The plan ends by laying out 14 “bold predictions” for 2020, such as the launch of clinical trials for an influenza vaccine that works against all virus strains. Some ACD members worried that such specific goals may not be achievable and promise too much.