A congressional spending panel has backed scientists running a $516 million network of bench-to-bedside research centers in their fight with the National Institutes of Health (NIH) in Bethesda, Maryland, over how it manages the network. It’s the latest step in a long-running tug-of-war over the direction of the Clinical and Translational Science Awards (CTSAs) program.
The CTSAs were created in 2006 by then–NIH Director Elias Zerhouni as part of his larger push to turn lab findings into treatments. In 2012 they became the lion’s share of the new National Center for Advancing Translational Sciences (NCATS) at NIH. Since then, CTSA investigators have clashed repeatedly with NCATS Director Chris Austin.
Austin began adding a clinical trials innovation network and other elements to the CTSA program, an expansion that CTSA investigators feared would come at the expense of their centers' budgets. Austin has also begun trimming the length of renewed awards, from 5 to 4 years, for centers that don't do as well in review. Rumors earlier this year that NCATS wanted to eventually cut funding for the CTSA program, from about 90% to 50% of the overall NCATS budget, heightened tensions. (NCATS Deputy Director Pamela McInnes told ScienceInsider that no such plans exist.)
In recent years the number of active CTSAs, now called hubs, has hovered between 57 and 62, with most awards ranging between $3 million and $10 million a year. The money supports training programs, regulatory expertise, and other resources needed to conduct translational research. “The 64 [current and past] CTSA hubs include the nation’s most experienced and creative senior investigators, and very large investments and commitments from their host institutions," explains Harry Selker, leader of the CTSAs at Tufts University in Medford, Massachusetts, and chair of the Clinical Research Forum, an advocacy group in Washington, D.C., that represents the CTSAs.
CTSA leaders took their concerns to influential members of the Senate Appropriations Committee, including the chair of the panel that funds NIH, Senator Roy Blunt (R–MO), and another senior appropriator, Senator Richard Shelby (R–AL). Missouri and Alabama both host CTSAs, which are located in more than half the states.
The legislators proved to be a receptive audience. “In the last several years there have been significant concerns about the program's management—from the number of CTSA hubs to the strategic vision of the program,” said an Appropriations Committee staffer. And that concern found its way into a report accompanying a 2018 spending bill approved by the full committee earlier this month.
“The Committee is deeply concerned about NCATS’ management of the CTSA program,” the report declares. “[NCATS] appears to be both ignoring congressional intent regarding the number of CTSA hubs as well as attempting to erode financial support for the hubs."
The report also took issue with NCATS's plans to change the “configuration and funding structure” of the CTSAs without input from Congress and stakeholders. The legislators ordered NCATS to set the length of hub awards at 5 years starting in fiscal year 2017, which ends this week, and prohibited it from decreasing the number of awards.
The spending directive reflects only the views of the Senate panel, not its House of Representatives counterpart or the entire Congress. But McInnes says the institute is happy to comply immediately. “With the encouragement of the Senate appropriations committee, we revised the plan for fiscal year 2017 and decided we could make all [this year's] awards for 5 years," she says. That means six of 11 awards this year will be extended from 4 years to 5 years. McInnes says NCATS can find the additional funding as long as its budget doesn’t shrink.
NCATS is considering possible changes for future awards, but "it's still very early in the process" and no decisions have been made, McInnes adds. In any case, she says the number won't go down below the current 57. “We feel comfortable with the number. We feel we have a nice range in term of the distribution and range,” she says.