Enhancing the Vitality of the National Institutes of Health Organizational Change to Meet New Challenges (2003) / Chapter Skim
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2. The Evolution of NIH's Organizational Structure
2. The Evolution of NIH's Organizational Structure
Pages 33-50
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From page 33... ...
In FY 2002, NIH's budget funded 43,600 research grants and 1,600 contracts in universities, medical schools, and other research and training institutions in the United States and abroad and supported 16,700 full-time training positions.2 NIH employs about 17,700 full1In addition, there are appropriations for the Office of the Director and for Buildings and Facilities, for a total of 26 separate appropriations for NIH in the Labor/Health and Human Services Appropriations Act. 2These figures are based on the President's budget request for FY 2003 to the Labor/Health and Human Services/Education Appropriations committees.
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From page 34... ...
NIH supports about 50,000 researchers at 2,000 universities and colleges, health professional schools (medicine, dental, public health, pharmacy, and nursing) , teaching hospitals, independent nonprofit research institutes, and industrial laboratories in all 50 states and some other countries.
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From page 35... ...
FIGURE 2.1 Current Organization of NIH Institutes | | Assistant Secretary for Health -- Surgeon General Health Resources & Services Administration Agency for Toxic Substances . & Disease Registry National Human Genome Research Institute National Institute of Arthritis & Musculoskeletal & Skin Diseases National Institute of Dental & Craniofacial Research National Institute of General Medical Sciences National Library of Medicine National Center for Research Resources 35
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From page 36... ...
have intramural programs that perform basic and clinical research at the Clinical Center, in laboratory facilities on the NIH Bethesda campus, or elsewhere. Boards of Scientific Counselors advise each institute director on and oversee the performance of the intramural program and its researchers.
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From page 37... ...
Other centers conduct or support research and have been established as a result of legislation, for example, the Fogarty International Center. OFFICE OF THE DIRECTOR To carry out responsibilities that include planning, coordinating, and managing the programs of the 27 institutes and centers, the NIH director is assisted by units in OD known collectively as OD Operations.
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From page 38... ...
, and Office of Medical Applications of Research (1977) 1985 Office of Behavioral and Social 1995 Sciences Research Planning, coordination, evaluation, and funding of all NIH AIDS research and support of trans-NIH coordinating committees in areas of AIDS research Focal point for women's health research at NIH, including establishment of a research agenda; inclusion of women as participants in NIH-supported research; and support of women in biomedical careers Coordination of disease prevention activities, advice to director on disease prevention research; promotion and coordination of NIH-wide research on rare or orphan diseases and on the role of dietary supplements in health; work with institutes and centers to assess, translate, and disseminate results of biomedical research that can be used in delivery of health services Stimulation of behavioral and social science research throughout NIH and its integration with other research conducted or supported by NIH
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From page 39... ...
Although the NIH director has considerable influence with Congress and the Administration with respect to the overall budget of each institute and center, he or she does not have strong formal authority with respect to the operation of the institutes. Institute and center directors have considerable autonomy, but they probably recognize the benefits of having a strong NIH director in securing increased support from Congress and the administration.
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From page 40... ...
To begin the process, the institutes and centers work with the NIH director to develop their budget requests using guidance from OMB and HHS. The resulting budget is submitted through HHS and OMB to the President, and then appropriated by Congress, although numerous changes may be negotiated at many points along the way.
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The authorizing committees can and do originate specific pieces of legislation affecting the organization of NIH, such as the law creating NIBIB. But the appropriations committees are not required to fund mandates in authorizing legislation.
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, and the advisory councils established by law for each institute. The director's level advisory groups and ad hoc groups appointed to address particular issues provide NIH leaders with external views and advice on overall research needs and program priorities.
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The Evolution of NIH,s Organizational Structure 43
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Although the categorical nature of the institutes helps policy makers to allocate funding among broad areas of health research (such as cancer, heart disease, arthritis, brain disorders, child development, and genomics) , the structure and process of peer review are intended to ensure that research that is likely to be the most productive is funded.
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From page 45... ...
Of the 24 IRGs, 7 were recently reorganized and will be retained as is, 6 will be new, and 11 will be modified from existing IRGs.~° In addition, when the Alcohol, Drug Abuse, and Mental Health Administration's three institutes NIHM, NIDA, and NIAAA were reintegrated into NIH in 1993, the number of institutes with large neuro- and behavioral science research portfolios increased to five. This necessitated the complete restructuring of neuroscience and behavioral science review in 1996, which involved substantial participation by the extramural research community.
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From page 46... ...
described the interactions among the NIH leadership, congressional committees, and voluntary health associations. The philanthropist Mary Lasker, her associates, Florence Mahoney and Mike Gorman, and her friends in the medical research community, including Sidney Farber and Michael DeBakey, played an enormous facilitating role.
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From page 47... ...
Given this history, it is not surprising that DHHS Secretary Tommy Thompson has issued instructions to consolidate administrative functions, such as personnel management, communications, congressional liaison, and travel, throughout DHHS. The "One HHS" initiative has the stated goal of better integrating DHHS management functions across its operating and staff divisions.
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From page 48... ...
Treating crucial science management functions as general administrative services could do great harm to the NIH research enterprise. Moreover, the Committee finds the prospect of mandatory centralization of some administrative aspects of NIH's scientific mission contrary to a stated intent of the President's Management Agenda (OMB, 2002)
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From page 49... ...
Those who oppose making NIH independent of DHHS argue that it is important to keep NIH embedded in the department because the NIH mission of health research is an integral part of the DHHS mission and is analogous to the arrangement in other departments, such as the co-location of the Defense Advanced Research Projects Agency and other defense R&D organizations with the service organizations in DOD. Independent agency status for NIH would also risk eroding the strong political support that it enjoys in Congress and among the voluntary health organizations and might upset the productive relationships that exist among NIH's various constituencies, which may be very difficult to reestablish under new circumstances.
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From page 50... ...
Despite the similar processes and shared goal of its components, however, NIH is highly decentralized, and its priorities are influenced by a wide variety of key constituencies concerned with health and the vitality of the nation's biomedical research and development system. As a result, NIH's scientific portfolio is spread across a very large number of topics and fields among which it may be difficult to discern overall strategic goals or distinctive functions.
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