Demonstrators at a 2012 march for AIDS research and treatment in Washington, D.C.

Demonstrators at a 2012 march for AIDS research and treatment in Washington, D.C.

Greta Hughson/aidsmap.com/Flickr (CC BY-NC 2.0)

NIH’s 10% set-aside for AIDS begins to slip in 2016

After more than 20 years of holding HIV/AIDS research funding at a fixed 10% of its overall budget, the National Institutes of Health (NIH) will let that level slip this year. Newly public data on grant funding success rates reflect one impetus for abandoning the set-aside: At many institutes, AIDS grants have been much easier to get than non-AIDS funding, suggesting that officials were struggling to find ways to spend the money.

In the early 1990s, when the HIV/AIDS epidemic was still exploding, Congress and NIH agreed to keep the portion of NIH’s budget devoted to HIV/AIDS steady at roughly 10% year after year. But some institutes have since struggled to find ways to spend their AIDS allocation, sometimes stretching the definition of AIDS research or loosening quality standards. And recently, some members of Congress have questioned whether the special treatment for this disease still makes sense at a time when AIDS deaths in the United States have fallen.

Last year, NIH Director Francis Collins announced that the agency would shift its AIDS funding to focus more directly on vaccines and treatments. And in December 2015, with Congress’s agreement, the agency formally stepped away from the 10% formula.

The results can be seen in NIH’s budget request for fiscal year 2017. The agency is holding AIDS funding flat this year at the 2015 level of $3 billion and expects to keep it there in 2017 (p. 3 here). As a result, because NIH’s budget rose nearly 7% last year, and NIH is requesting another bump next year, the portion going to AIDS will fall from 10% in 2015 to 9.3% this year and could drop to 9% in 2017.

Also this year, the agency is shifting $154 million from expiring AIDS grants towards the new priorities, says Collins—a major disruption for a set of researchers who must now apply for non-AIDS money to continue their work. NIH expects to move another $60 million to $70 million per year in coming years.

Success rate data that ScienceInsider obtained in response to a public records request help explain why the AIDS set-aside has been unpopular at NIH. (Click here to see a graph.) At six institutes that received the lion’s share of AIDS funding, the portion of reviewed grant proposals that were funded was generally 4 to 5 percentage points higher for AIDS grants than for all grants. (The National Institute of Mental Health was an exception.) For example, at the National Institute on Drug Abuse, which spent $300 million on AIDS in 2014—totaling 30% of its overall budget—about 23% of AIDS proposals won funding, compared with only 18% of grants overall.

NIH notes that a higher success rate for AIDS doesn’t always mean the quality bar was lower; certain institutes may have spent AIDS funds for a specific topic that attracted only a few proposals that were of very high quality. Still, at some institutes, program officers have had to get creative about how to spend AIDS funding

*Update, 24 February, 9:13 a.m.: The article has been revised to clarify that at several institutes, the difference in success rates for AIDS grants compared to all grants is 4 to 5 percentage points.

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