AIDS Research at the NIH: A Critical Review

Funding + Future Plans. NIGMS AIDS programs are the 7th largest at NIH, amounting to 2.1% of
NIGMS' total budget and 1.9% of the NIH AIDS budget. $9.9 million will be spent on rational antiretroviral
drug design and related structural biology in FY 1992, and $10.8 million in FY 1993. $5.825 million will
be spent on these training grants in FY 1992 and FY 1993. NIGMS requested $14.5M in new funds for
FY 1993, but the President awarded just $912,000. Among other things, these new funds would have
supported:
* $5.4 million in additional support for research enhancement and training (for a total of $11.7
million).
* $50,000 for additional structural biology and drug design awards.
Recommendations:
* NIGMS should document the specific contributions to AIDS, if any, being made in the
structural biology training award program. What guarantee is there that the trainees will
actually work on AIDS when they are finished?
* NIGMS should fund additional Minority Access to Research Careers (MARC) and Minority
Biomedical Research Support (MBRS) awards specifically for AIDS research.
11/8. Office of the NIH Director (OD)
The NIH Director "gives overall leadership to NIH activities and maintains close liaison with the DHHS
Assistant Secretary for Health in matters relating to medical research, research training, health professions
education and training, manpower resources, and biomedical communications... He [sic] also maintains
close communications with other constituents of DHHS in order to provide more effective program
relationships". The current NIH Director is Bemrnadine Healy MD, who took office in April 1991. Before
coming to NIH, Dr. Healy chaired the Research Institute of the Cleveland Clinic Foundation. In FY 1991,
the OD received $11,737,000 for AIDS. The OD requested $14,677,000 for AIDS in FY 1993 but will only
$14,372,000 in the President's budget. The OD AIDS budget supports 42 FTEs, half in OAR. Others work
in the Intramural AIDS Targeted Antiviral Program (IATAP), and the Protein Expression Laboratory (PEL).
The Office of AIDS Research. OAR was established by the Health Omnibus Programs Extension (HOPE)
Act of 1988. Anthony Fauci, MD, is its first director. OAR's Deputy Director of the OAR is Jack
Whitescarver, PhD. OAR's functions and responsibilities are: to coordinate NIH intramural and extramural
AIDS research; centralize various AIDS-related policy and operating functions; to represent the Director,
NIH, on AIDS-related matters; to develop and coordinate of the NIH AIDS budget request; to develop
information strategies with interagency collaboration to inform the public of NIH and PHS AIDS research
activities; to recommend solutions to ethicalegal issues; to foster national and international information
exchange with government, industry, and academia concerning AIDS research; to manage the NIH Loan
Repayment Program for AIDS researchers. The OAR coordinates the meetings of the AIDS Program
Advisory Committee (APAC) which advises the HHS Secretary, the Assistant Secretary for Health, the NIH
Director and the Associate Director for AIDS Research. Although OAR coordinates several advisory
committees, none seems to be concerned with detailed evaluations of existing programs. Broad research
priorities are legislated or pressured by Congress and the Executive branch (e.g. pediatrics, opportunistic
infections, vaccines) or by crises that can't be ignored any longer (e.g. tuberculosis).

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