AIDS Research at the NIH: A Critical Review

(CCSQ) concemrning AIDS for African-American women (AAW)."

Funding and Future Plans. NCRR AIDS spending reached a peak in 1989 at $67.6 million, which fell to
$46M in 1990 and $47M in 1991. Current services (that is, the cost of existing programs from last year
plus inflation) for FY 1992 cost $52 million. Yet the President included just $51.5M in his budget for NCRR
AIDS research. The present administration is starving the basic and clinical research infrastructure -
including the AIDS infrastructure. NCRR sought the additional $100 million for the following programs:
* $20 million for primate models for vaccine studies;
* $45.7 million to build extramural AIDS research facilities.
* $8.3 million to buy sophisticated high technology machines for shared use'
* $5.2 million for new pilot studies (BRS program).
* 17 million to expand the General Clinical Research Centers (GCRCs);
* $6.4 million for new initiatives at the RCMI sites;
Recommendations:
* After several years of unusual growth, the AIDS research infrastructure is shrinking drastically. New
initiatives must compete with ongoing programs funded since 1987. New ideas go begging, while
old ones are drastically slashed. Congress and the Administration should grant NCRR its requested
$100 million to accelerate vaccine animal model research, appropriate technology, renovate and
build new research facilities, and expand the RPRC, GCRC and RCMI systems.
* Congress should provide NCRR with (1) the $20 million it requested to extend the RPRC AIDS
program; (2) the $17M it requested to enhance AIDS research at the GCRCs [this would help allay
the NIAID ACTU funding cuts; and (3) the $6.4M it requested to enchance AIDS research at
minority institutions through RCMI awards.
11/4. National Heart, Luna. + Blood Institute (NHLBI)
NHLBI started out as the National Heart Institute (NHI) in 1948 when President Truman signed the National
Heart Act. In 1969 the NHI became the National Heart and Lung Institute (NHLI), and in 1976, the institute
received its current title. NHLBI is the second largest institute at NIH (only NCI is larger) and for FY 1991
had a total budget of $1,126,942,000. NHLBI supports and conducts basic and clinical research on
cardiovascular, pulmonary and hematological diseases, and administers demonstration and education
projects on their causes, prevention, diagnosis and treatment. NHLBI also sponsors research on the use
of blood and bone marrow for transfusions and transplantation, including a blood resources program
concerned with the management of the US blood supply. NHLBI's current director is Claude Lenfant, MD.
NHLBI's 5 divisions are: Heart and Vascular Diseases; Epidemiology and Clinical Applications; Lung
Diseases; Blood Diseases and Resources; and Intramural Research. In addition, the Office of Prevention,
Education and Control functions as the institute's technology transfer arm, relaying the results of heart,
lung, and blood research" to an eagerly waiting world. NHLBI spent $46.4 million on AIDS research in
1991. For next year, it requested $66M, but the President offered just $48.2M, barely above the level of
current services. NHLBI supports research on the pulmonary, hematological and cardiovascular
complications of HIV infection, and sponsors research designed to assure the safety of the nation's blood
supply.
In FY 1991, NHLBI disbursed $39,544,729 in extramural AIDS awards.

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