House Moves to Reauthorize NIH

Congress is preparing to do something it hasn't done for more than a decade: reauthorize the National Institutes of Health. The House Energy & Commerce Committee initiated the process by releasing a "discussion draft" of NIH reauthorization legislation and by holding a hearing on that draft. On the Senate side, the Health, Education, Labor & Pensions Committee has indicated that it will take up the issue this fall.

Typically done every few years, reauthorization gives members of Congress an opportunity to reassess the mission and activities of a given federal agency and legislate any changes it believes are needed. For NIH, however, it's been 12 years since Congress last passed a reauthorization bill. In that time, the agency's budget has more than doubled to nearly $28 billion, and the number of institutes and centers has climbed to 27, making management of the agency a significant challenge.

At the July 19 House hearing, Energy & Commerce Committee Chairman Joe Barton (R-Texas) acknowledged NIH's growth and noted that reauthorizing NIH was a very high priority for him--as evidenced by his preparation of the discussion draft bill. "We've doubled the agency's budget but have not done anything to improve management," he said.

NIH Director Elias A. Zerhouni, who was the only witness at this first hearing, noted that finding a "better way" for the agency to work is "at the core of ensuring continued scientific progress in an era when scale and complexity of the problems we are facing require constant innovation, increased interdisciplinary efforts, and a balanced portfolio of basic, translational, and clinical research investments across all NIH institutes and centers." He expressed his commitment to working with the committee on this legislation.

TO HELP FIND that better way, and to improve the agency's management, Barton's draft bill builds on a 2003 Institute of Medicine report that looked at the agency's structure (C&EN, Aug. 4, 2003, page 8). For example, the IOM report recommended and the draft legislation includes the creation of a new division of program coordination, planning, and strategic management within the Office of the Director. This new division would serve as a coordinating office for evaluating scientific progress in the context of public health priorities. Also consistent with the IOM report is the draft's call for an increase in the percentage of the overall NIH budget that the NIH director can move from institute to institute or use to fund transagency initiatives.

This latter issue of transfer authority has some stakeholders worried. "We feel that there is a lot of money that could be coming out of the institutes," says Jon Retzlaff, director of legislative relations at the Federation of American Societies for Experimental Biology. He notes that increasing the percentage of transferable funds from the current 1% to a suggested 5%, added to the other trans-NIH initiatives that institutes and centers already contribute to, could make it "problematic for the institutes and centers in terms of planning or satisfying their grantees."

Another aspect of the draft that is raising questions is the proposed regrouping of NIH institutes and centers. The discussion draft proposes to collapse NIH's institutes and centers into two groups. The first group contains 15 institutes that the committee has characterized as "mission-specific," such as the National Cancer Institute. The other group contains nine institutes and centers that have been deemed "science enabling," such as the National Institute of General Medical Sciences. The number of institutes and centers in both groups would be capped at the current level.

At the hearing, Zerhouni testified that the proposed splitting of the agency into two groups has "resulted in the perception that one category is more significant than another." Every institute and center does equally important research and would work with the committee to clarify this point, he stated.

Perceptions aside, this consolidation of institutes and centers has an important impact on Congress--it translates to fewer items that Congress must deal with during the budget process. In fact, the draft reduces NIH's more than two dozen individual appropriation line items to just four: the two groups of institutes and centers, the Office of the Director, and the to-be-established coordination and planning division.

"It's not clear to me what this is going to accomplish," says Mary Woolley, president of public health advocacy group Research!America. "The concern I have, and I know others share, is that this is going to distance Congress from their constituents" by moving congressional appropriators a step away from setting funding levels for each institute and center, she explains."

ONE ASPECT of the draft that is being welcomed by NIH and its stakeholders deals with streamlining reporting requirements. The draft directs the NIH director to set up a searchable electronic system to uniformly code research grants and activities. NIH must also report to Congress every two years on the agency's activities.

As the Energy & Commerce Committee gathers feedback on its draft and works toward a formal bill introduction, Retzlaff and Woolley are both optimistic that their concerns are being heard. Both note that the committee has been very inclusive and open to input so far and the members expect that to continue.

Woolley recommends that the committee approach any changes in a stepwise fashion. "Going one step at a time is probably a better and more accountable way to proceed than adding quite a lot of new authorities and then looking back a year or two or three from now and trying to figure out which ones worked and which ones didn't," she says.

"We are all waiting to see how this will proceed," says Harold E. Varmus, president and chief executive office of the Memorial Sloan-Kettering Cancer Center and former NIH director. But Varmus tells C&EN that "the draft legislation is definitely heading in the right direction." According to him, the draft is right in giving the director more authority over how NIH is run and in stabilizing the number of institutes and centers.

Varmus cautions, however, that developing appropriate legislation requires "some thought and is not something that can be rushed through," adding that more discussions are needed within the scientific community as well as more hearings before passing any legislation.