Funding allocations for research at National Institutes of Health : hearing before a subcommittee of the Committee on Appropriations, United States Senate; One Hundred Sixth Congress, first session; special hearing.

The National Institutes of Health (NIH) is the single largest funder of health research in the United States, and research it has supported has been pivotal to the explosion of biomedical knowledge over the past century. As NIH's success has grown, so has pressure from advocacy groups and other members of the public to devote more spending to their health concerns. In response to a request from Congress, this IOM study reviewed NIH's research priority-setting process and made recommendations for possible improvement. The committee considered the: Factors and criteria used by NIH to make funding allocations. Process by which the funding decisions are made. Mechanisms for public input. Impact of congressional statutory directives on funding decisions. Among other recommendations, the book recommends that NIH seek broader public input on decisions about how to spend its nearly $14 billion budget; it also urged the agency to create new Offices of Public Liaison in the Office of the Director and in each of the 21 research institutes to allow interested people to formally take part in the process.

" NIH is the nation's leader in sponsoring and conducting biomedical research. In fiscal year 2012, NIH had a budget of almost $31 billion, over 80 percent of which was used to fund extramural research that supports scientists and research personnel working at universities, medical schools, and other research institutions. Twenty-four of NIH's 27 ICs that support extramural research are focused on particular diseases, conditions, or research areas, and these ICs have their own appropriations. Decisions about which projects are funded are made by these individual ICs. NIH reports funding for 235 research, condition, and disease categories in RCDC. GAO was asked to review NIH funding related to leading diseases and health conditions. GAO examined (1) how research priorities are set at NIH, and (2) NIH allocations of research funding across selected diseases and conditions. For five ICs-National Cancer Institute; National Heart, Lung, and Blood Institute; National Institute of Allergy and Infectious Diseases; National Institute of Diabetes and Digestive and Kidney Diseases; and National Institute of General Medical Sciences-GAO reviewed documents and interviewed IC officials about priority setting.

As the central office for NIH, OD establishes NIH policy and broad themes for the agency to pursue, such as ensuring a sustainable scientific workforce, based on national needs and scientific opportunities. In addition, the OD is responsible for coordinating the programs and activities that span NIH components, particularly research initiatives and issues involving more than 1 of the 27 ICs. OD is also responsible for ensuring that scientifically-based strategic planning is implemented in support of research priorities, and that NIH's resources are sufficiently allocated for research projects identified in strategic plans. NIH conducts and sponsors biomedical research through its ICs, each of which is charged with a specific mission.

National Institutes of Health: Fiscal Year 2013 Research Funding Allocations across Selected Diseases and Conditions