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Summary:
The National Institutes of Health is the focal point for federal health research. An agency of the Department of Health and Human Services (HHS), it uses its $28.5 billion budget to support more than 200,000 scientists and research personnel working at over 3,100 institutions across the U.S. and abroad, as well as to conduct biomedical and behavioral research and research training at its own facilities. The agency consists of the Office of the Director, in charge of overall policy and program coordination, and 27 institutes and centers, each of which focuses on particular diseases or research areas in human health. A range of basic and clinical research is funded through a highly competitive system of peer-reviewed grants and contracts. The NIH appropriation in the past three years has shifted from marked growth to low or no increases. Congress doubled the budget in five years, from $13.6 billion in FY1998 to $27.1 billion in FY2003. Since then, growth has slowed to below the rate of inflation. The budget request for FY2007 is for $28.5 billion, roughly the same as the FY2006 level and a decrease of 0.2% below FY2005. In inflation-adjusted (2006) dollars, the FY2007 request is 8.7% below the FY2003 level. The House Appropriations Committee matched the request for NIH, and the Senate bill provided $200 million more (0.8% over FY2006). The only major increases in the proposals are for research related to pandemic influenza and to biodefense drugs and vaccines. The request would support some 650 fewer research project grants. The success rate for competing grant applications getting funded would be an estimated 19%, the same as FY2006, compared with 22% in FY2005 and 30%-32% during the doubling years. Currently, FY2007 funding is continued at the FY2006 rate. Appropriators and authorizers face many issues in working with NIH to set research priorities in the face of tight budgets. Congress accepts, for the most part, the priorities established through the agency's complex process of weighing scientific opportunity and public health needs. While the Public Health Service Act (PHSA) provides the statutory basis for NIH programs, it is primarily through appropriations report language, not budget line items or earmarks, that Congress gives direction to NIH and allows a voice for advocacy groups. Challenges facing the agency and the research enterprise, all aggravated by restrained budgets, include attracting and keeping young scientists in research careers; improving the translation of research results into useful medical interventions through more efficient clinical research; creating opportunities for transdisciplinary research that cuts across institute boundaries to exploit the newest scientific discoveries; and managing the portfolio of extramural and intramural research with strategic planning, openness, and public accountability. A reauthorization bill addressing some of these issues (H.R. 6164) passed the House in September 2006. Congress also monitors ethics rules on conflicts of interest and tracks the efficacy of procedures intended to make results of NIH-sponsored research accessible to the public. NIH's Internet home page is at [http://www.nih.gov]; budget information is at [http://officeofbudget.od.nih.gov/ui/HomePage.htm]; disease funding estimates are at [http://www.nih.gov/news/fundingresearchareas.htm]; and legislative issues tracking is at [http://olpa.od.nih.gov]. This report will be updated as events warrant.
