NIH chief seeks overhaul, but lawmakers offer own plans

The director of the National Institutes of Health tried Thursday to sell his overhaul plans for the agency during a joint hearing of the Senate Health, Education, Labor and Pensions and House Energy and Commerce committees. But as usual when it comes to one of the most politically popular federal programs, members of Congress have some agenda items of their own.

NIH Chief Elias Zerhouni thanked the committee members for doubling the agency's budget over the past five years. He noted that the increase has resulted in some tangible and immediate benefits, including identifying the cause of Severe Acute Respiratory Syndrome "in record time."

But Zerhouni said the rapid pace of scientific advance has rendered outmoded NIH's "silo" structure, in which individual institutes and centers receive separate funding. "Often research done in one institute eventually finds its greatest application in the mission of another, illustrating both the convergence of science and its unpredictability," Zerhouni said. He cited as an example the cancer drug Gleevec, originally developed for heart disease.

Zerhouni's "road map" for the agency calls for more cross-institute, multi-disciplinary research initiatives, and a change in the way clinical research is conducted "to more quickly translate discoveries into practice." Harold Varmus, Zerhouni's predecessor who now heads New York's Memorial-Sloan Kettering Cancer Center, called for even more radical changes. Charging that the "proliferation" of new NIH institutes and centers "threatens the capacity of the agency to seize important opportunities and undermines the ability of the NIH director to lead," he called for fusing the agency's 27 institutes into five large units, with a sixth, "NIH Central," to be headed by the director himself.

Members, however, made it clear they have other priorities for NIH- particularly after bestowing such largesse on it over the past half decade. "With the dramatically increasing budget, it is also important to ensure that the American people get the most out of this massive investment of resources," said House Energy and Commerce Health Subcommittee Chairman Michael Bilirakis, R-Fla.

Energy and Commerce Chairman Billy Tauzin, R-La., who missed the start of the hearing after being called to the White House to consult on the energy bill, offered a statement in which he said Congress "may want to consider establishing a system of greater transparency of NIH research activities to guarantee that NIH is held accountable for taxpayer investments."

Democrats, for their part, decried the small size of the increase proposed for fiscal 2004. "Even with the increases provided by the Senate," said Health, Education, Labor and Pensions ranking member Edward Kennedy, D-Mass., "the number of new [research] grants would actually decrease by 75."

And Energy and Commerce ranking member John Dingell, D-Mich., complained about efforts to "outsource" some of NIH's functions. "Are we serving science, or are we serving a privatization ideology?" Dingell asked. "Outsourcing is an instrument of fear, and successful organizations do not use fear as their primary management tool," he said.