Reforming the NIH AIDS Research Program

607). This authorization ran out in 1991 and should be renewed. OAR currently serves in an advisory
capacity only. It cannot fulfill Its mission without additional resources, staff and authority.
1. Strenthenlng the OAf. When it is reauthoried, the OAR should be directed to develop a
meaningul long-range strategic plan for AIDS research at NIH. OAR should also be given the
budgetary authority to rnplement the plan by distributing the NIH AIDS research budget among
the 21 Institutes now canyhg out AIDS-related programs.
2. OAR Wretor. The OAR Director should be a Presidential appointee [as the NCI Director has
been since 19721. The OAR Director, in consultation with the new OAR Advisory Council
(OARAC; see #3) should be the lead executive overseeing the entire NIH AIDS research effort,
and should sIt on relevant Executive Branch AIDS task forces. The OAR Director should be an
outstanding scientist and a highly skilled admnbistrator. The OAR Director should report directly to
the NIH Director. The OAR Director, in consultation with OARAC, should develop the NIH AIDS
budget, inplement the strategic plan, and distrbut resources among the institutes. Directing the
OAR should be a full-tine job. Institutes should continue to develop and administer AIDS
research programs under their jurisdiction.
3. Advay Comine. OAR's new role necessitates an expanded advisory committee. The
current AIDS Program Advisory Committee (APAC) should be replaced with an OAR Advisory
Council (OARAC) of biomedical, behavioral and social scientists along with representatives of the
diverse HIV affected communities. OARAC will oversee the NIH AIDS budget, the strategic plan,
periodic program evauation [#5], and awards made from the OAR discretionary fund (#6]. OAR
will continue to chair the NIH AIDS Executive Committee (NAEC: institute directors and AIDS
coordinators), and should convene a community advisory committee.
4. Sftflc Plannip. The OAR should prepare an NIH Strategic Plan for AIDS Research which
must prioritize among critical sdientific Issues, evaluate current AIDS programs, suggest changes,
and recommend necessary resource reallocation or new programs. The Strategic Plan should
include critical questions, goals, timelines, obstacles, resource needs, and evaluation criteria
Annual budget priorities should reflect the strategic plan.
s. Prograi Evaluation. The OAR should conduct program evaluation of AIDS research across
institute lines. OAR should establish and staff NIH AIDS coordinating groups (representative of
relevant institutes) to cover pathogenesis, natural history and epidemiology, drug development
and clinkal trials, vaccine development, and behvioral 89research. OAR should assess existing
efforts, target gaps and redundancies, and Identify new opportunities for collaboration.
6. Fud At least $150 million should be made available to the OAR, acting in
consutatlon with OARAC, as a discretionary fund. This fund should be used to fund a)
emergency projects (such as tuberculosis), b) fast track research initiatives, or c) programs to fill
the gaps in current research. OAR could dietribute the funds through institutes or directly as
OARAC-approved awards, The discretionary fund should be exempt from routine procurement
rules on use of equnpment, facilities and civil service restrictions on personnel. The discretionary
fund could be used to pilot directed research projects, such as immune reconstitution.

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