Reforming the NIH AIDS Research Program

Reformin the NIH AIDS Researc hProh ram
16 December 1992
"I have called for increases in funding for both AIDS-specific and general
biomedical research, and have pledged to reinvest every aollar cut from
defense R&D into civilian research..."
i-- Bill Clinton, Science. 10. 16.92. p 492
Current AIDS research efforts.supported by the National Institutes of Health (NIH) have enormous
productive potential locked inside an inefficient structure. The AIDS caseload climbs to over 50,000 new
cases per year, yet the research budget is fallings. Congress appropriated $1 077 billion for AIDS in FY
1993, yet the funds are to be spent by 21 separate institutes with little central coordination, The
distribution of AIDS research among many institutes has its benefits, since AIDS demands a
multldisciplinary response, but the current NIH structure fails to provide AIDS research with the
coordinating and planning functions carried out for other major diseases at their own disease-specific
institutes. Consolidating all AIDS research into a single institute would cause yet more disruption and
delay. How, then, can the strengths of the current A1DS research program be preserved while increasing
its efficiency? What new efforts are needed?
These recommendations are distilled from reports by the Institute of Medicine in 1991 and the Treatment
Action Group (TAG) in 1992.
Revitalizing the NIH AIDS research effort requires: 1) ft$iTU(CTURING; strengthening the NIH Office
f[AIDS Res~rch (QAf) and 2) RESOURCS: Inr ng the NIH AIDS reeareh budget.
I. RESTRUI TQRitN
The following changes [#1-7] should be authorized in the NIH Reauthonzation Bill (S 1 and its House
counterpart). The NIH Office of AIDS Research (OAR) was authorized by Congress in 1988 (PL 100.
Nil-H A1D sppa lang for PY 1993 is rising by 2,65%, non-AIDS pVrA t4 g bIy 105% INI i1 the biorn dacal
anndrch,J dvelopment price index (BRDPI) atluran,ate is,1% tCz n1' vtr.u Depattmentj
The AIte Rt.MwM._ird ram of the National nstltute o Ulalth. Report of c ttudy by a C.ommit.oe of the
Institute of Mu~tiap (TOM), National Academy 're s, Washinstn, DC, 4 4$, Crogg Consalvas Mark
Harrtngton for TAG, New York, NY USA. AIDS Reamr|, at l. NIll A Crltic Rview. VIII Ln'rnauonai
Ct,,,ctuw,e~ on AIDS, July 1992.
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