AIDS Research at the NIH: A Critical Review

* $1 M to develop transgenic mice to screen for antiretroviral drugs;
* $1.4M to develop and test "new stronger condoms";
* $775,000 for a case-control study of reversible contraception and HIV seroconversion in women;
* $250,000 to study the effects of spermicides and sex hormones on STDs and HIV in vitro;
* $650,000 for a comparative study of growth in HIV+ and HIV- children with hemophilia;
* $400,000 for a NAS panel on international issues and behavioral research;
* $775,000 for vaginal insertion product abrasion studies;
* $575,000 for a study of barrier contraception to prevent STDs in high risk populations;
* $775,000 for a prospective study of causes of mechanical condom failure among volunteers
recruited to use condoms and keep diaries for 6 months;
* $750,000 for immunodevelopmental studies of HIV+ infants;
* $750,000 for neurodevelopmental studies of HIV+ infants;
* $750,000 for studies of HIV transmission via human milk;
* $315,000 for studies of HIV+ women to assess how oral contraceptives affect progression;
The breadth and ambition of NICHD's requests stands out among the ICD's wishlist for FY 1993. Perhaps
this is because funding pattemrns for pediatric AIDS research have not yet suffered the plateau which has
afflicted adult AIDS research funds. It is notable how many of the questions NICHD seeks to address
relate to adult and adolescent sexual behavior, barrier methods, and women with HIV. These areas are
crucial, and have not been adequately addressed by NIH efforts hitherto. OAR cut $14 million from
NICHD's original request of $78 million; Mason cut $22 million more (to $42,466,000); Sullivan cut $4
million to the final President's request for $38 million. NICHD how has 28 AIDS FTEs and wanted to add
25 for a total of 53.
Recommendations:
* More behavioral and sexual studies should be supported.
* Mothers and families of HIV+ children should have access to research, including clinical trials,
conducted at NICHD funded sites.
IV6. National Institute of Neurological Disorders + Stroke (NINDS)
NINDS originated in 1950 as the National Institute of Neurological Disorders and Blindness (NINDB), and
evolved its present name in 1980. NINDS is the sixth largest funder of AIDS research at NIH, spending
$16.65 million on AIDS in 1991. President Bush slashed NINDS' 1993 budget request from $34M to
$18.6M. While substantially below the amount the institute originally requested and like most other
institute's budgets, barely over the amount needed to maintain current services, NINDS's 7.9 % increase
over 1992's budget is higher than other institutes. NINDS's extramural research is all funded under Mason
category IB: Neuroscience and Neuropsychiatric Research. NINDS supports basic and clinical research
on the neurological complications of HIV infection, including, but not limited to, AIDS dementia complex and
the opportunistic infections affecting the nervous system, and investigations of potential therapies for these
conditions. According the 1991 NIH "Annual Report to Congress," the goals of the NINDS's AIDS program
are:
* To study the natural history of HIV-1, with emphasis on its predilection for the nervous system;
* To discover how the virus enters and damages the brain and nervous system;
* To prevent or ameliorate the effects of the virus and of the opportunistic infections of the nervous

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