[Letter to Edward M. Kennedy from Robert Petersdorf]

FE '., 15:42 HMC 2450 Ni ST. H.:..WASH. D.C. F'
Robert G. Petersdorf.
President
ASS ION OF 2450 N TREE NW
AMRCAN W/NGIJtN IE 2007-26
February 1, 1993 MEDICAL COILEGES TELE (22)828o460
PotIV' brand tax transmittal memo 7671 # M' p* '
The Hononrable Edward M. Keinedy e ' -
United States Senate c c -,..
315 Russell Senate Office Buildmg ngPone
Washington, DC 20510 -
r)ear Senator Kennedy:
As President of the Association of American Medical Colleges (AAMC), which represents all 126
accredited U.S. medical schools, nearly 400 of the nation's major teaching hospitals, and 91 academic
and professional societies, I wish to raise several concerns with the provisions contained in Title XVIm
of the National Institutes of Health Revitalization Amendments of 1993 (S. 1).
The Office of AIDS Research in the National Institutes of Health has done an admirable job in
coordinating the important research effort needed to find the cure for this terrible disease. We applaud
the intent of strengthening this effort even further. However, as passed by the Senate Labor and Human
Resources Committee on January 27, S.1 mandates that funds for AIDS-related research activities be
appropriated directly to the Ofice of AIDS Researcitat the N~I for subsequent transfer to the individual
institutes, centers and divisions. The bill also establishes a discretionary fund for the Office, and permits
the Office to authorize the employment of full-time eiuivalent employees (FTEs) notwithstanding any
other provision of law relating to the number # f FTEs.
The Association's conicerns are several-fold in nature:
First, the impact of these modifications of the existing budget and employment practices at the NIH
are at best unknown. For example, it appearbs from the language in the bill that only funding for
non-co4peting activities (the commitment base) would go directly to the institutes. Appropriated
funds for new and competing awards in existing programs and for new initiatives would be
distributed by the Office of -IDS Research at the discretion of its director. The uncertainty of
funding for new programs created by this approach may well hamper rather than facilitate planning
and irplementation of suca programs. Further, the Association is concerned that adding an
additional level of administration to the process of appropriating money to the individual institutes
may unnecessarily delay funds to scientists, and actually slow research. Consolidating the funding
throujh the Office of AIDS Research also may have serious consequences for the institutes' ability
to respond quickly and efficiently to emerging research needs.
The proposal for a discretionary fund for the Director of AIDS Research is cause for concern

because it is unclear what is meant by "baseline AIDS research spending." If the discretionary fund
is to be derived from funds appropriated above the commitment base, it is conceivable that, in a
year with a minimal increase in funding, money for all new initiatives would be included in the
discretionary fund, raising the possibility that the start of such activities would be delayed because of
the additional administrative steps in the process.