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Genetics, Eliminating Health Gaps Among Priorities
President Calls for 5.6 Percent NIH Budget Increase in 2001

On the Front Page...

President Clinton asked Congress to appropriate more than $18.8 billion to NIH in fiscal year 2001. The request represents a $1 billion or 5.6 percent increase over the agency's current budget.


"By any measure, the amounts we received in FY 1999 and 2000 — both nearly 15 percent increases — were dramatic and unprecedented," said NIH acting director Dr. Ruth Kirschstein, in her opening statement at recent congressional budget hearings. "These generous budgets have allowed us to undertake many new and important programs and to improve conditions throughout the medical research enterprise...We feel confident of public support for our research enterprise, but are aware of our need to deliver to the public the two things it most wants from the NIH — research advances, year after year, that improve the health of all members of society and assurance that we spend the public's money wisely."

Four Areas To Be Emphasized

Among fiscal year 2001 initiatives, NIH identified four areas of research that offer particularly outstanding scientific opportunities to yield benefits in the future in the form of new knowledge and treatment and prevention strategies:

Genetic Medicine. Isolation and identification of genes that may, if mutated or absent, direct the production of abnormal proteins in human disease provide a critical step in developing new strategies for treating disease. Determining the genome sequence of a variety of organisms is essential to furthering the improvement of human health and the alleviation of disease.

Clinical Research: Bridging Basic Discoveries to Tomorrow's New Treatments. Today's bench research on molecules and genes is providing the foundation for future medical breakthroughs at the bedside. Clinical research is the cornerstone for the translation of basic science to better human health. NIH is setting in place a series of programs that will rebuild the clinical research base.

For example, NIH will expand research training programs to increase the number and quality of clinical investigators. A medical student research program will target third- and fourth-year medical students for didactic and "hands-on" patient-oriented research through programs coordinated by the General Clinical Research Centers.

In addition, public awareness of, and patient participation in, clinical research activities are critical to progress in this area. The newly created national clinical trials database will provide enhanced access to new information about such trials.

Fostering Interdisciplinary Research. New skills in the medical research workforce are needed to fully realize the potential of increased understanding of biological processes and behavior. NIH needs to assemble new teams of diverse and highly skilled researchers that can overcome technological hurdles and solve complex scientific problems. These challenging endeavors require expertise from many disciplines beyond the traditional ones of biology and medicine. These include computational sciences, mathematics, material sciences, physics, engineering and chemistry.

Eliminating Health Disparities. There are persistent, and often increasing, disparities in health among populations in the United States. The agency plans to expand its efforts to eliminate domestic health disparities in FY 2001. Coordination of the effort is being accomplished through the trans-NIH working group on domestic health disparities, which will develop a strategic plan. The plan is intended to enhance the support of biomedical, behavioral, and social science research on health disparities and the communication of research results to health professionals, communities and others. It will also address the need for expansion of the size and diversity of the scientific workforce committed to reducing disparities.

Within the Office of Research on Minority Health, a Coordinating Center for Health Disparities will provide leadership in the development of a trans-NIH strategic plan, as well as provide research grants and contracts in areas of science importance to fill the gaps not otherwise supported, related to health disparities and education and training for minorities and other disadvantaged socioeconomic groups.

Growth of Grants, Grant Sizes

Although funding medical research through investigator-initiated grants continues to be a priority of NIH, the agency needs to restrain the growth of awards and award sizes so as to control the growth of the commitment base and to avoid impeding its ability to undertake new initiatives.

NIH will restrain the growth of award sizes to a rate below the Biomedical Research and Development Price Index of 3.6 percent inflation. The FY 2001 request provides average cost increases of 2 percent over FY 2000 for competing RPGs. Non-competing RPGs will be increased by 2 percent on average for recurring costs.

Extramural research activities such as research project grants, centers and other research increase by approximately 5 percent to 6 percent. Research and development contracts increase by 9 percent.

New Neuroscience Center on Campus

Funds are requested for first-year construction costs of a National Neuroscience Research Center, to house outstanding intramural neuroscience research programs including those of the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health. The FY 2001 request is for $47.3 million. An advance appropriation of $26 million is requested for the second year of funding for the first phase of the center, estimated to cost a total of $73.3 million.

Bldg. 35, a 1-story structure adjacent to Bldg. 36, the current neuroscience facility, would be demolished and replaced with a 200,000-square-foot modern laboratory. The new laboratory space will allow interactions between investigators using similar techniques and equipment, as well as between investigators working at different levels of analysis.

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