Monday, December 6, 2010

NIMH, NIDA, and NIAAA Institute Directors Briefing at the 49th Annual Meeting of the American College of Neuropsychopharmacology (ACNP)

MIAMI, Fla. — Presentations were made yesterday afternoon to attendees of the ACNP 49th Annual Meeting by Tom Insel, Director, National Institute of Mental Health (NIMH), Kenneth Warren, Director, National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Nora Volkow, Director, National Institute on Drug Abuse (NIDA).  The Institute Directors briefed ACNP meeting attendees on Institute priorities and budget issues.

Dr. Insel spoke first and focused on strategic and budgetary themes.  He remarked that there is some frustration in Congress regarding the return on the financial investment that has been made to support research.  He suggested that NIH research needs to become more like the research program maintained by the Defense Advanced Research Project Agency (DARPA), that works off of directives and is focused on innovation.

He reported that NIMH Council recommended that it is important to stop conducting large studies that yield small effects, and that there should be a focus on methods standardization, data integration, and data sharing.  Insel also noted that NIMH is committed to preserving the New Investigator R01 pipeline, and this year is funding New Investigator R01s up to the 25th percentile.

In terms of budget issues, he said that the President’s FY11 budget proposed increased funding by 3.2%, but that actual budget increases have been below the level of inflation for the last 5 budget years.  Importantly, only a fraction of each year’s budget, ~25% for NIMH, goes into new awards, with ~75% already committed to existing programs.  If the President’s FY11 budget is approved, then the current funding line for new applications would be ~21% funding.  However, because Congress is working on a Continuing Budget Resolution, the current funding line is ~17.8%.  And, if the budget is funded at FY08 levels, the preference of some Congressional leaders, the new application funding level would reduce to a scary ~13.3%.  This could mean a ~30% cut in the number of newly funded projects.

To offset this grim possibility, Insel mentioned that NIMH is considering a number of options including shifting some resources from intramural to extramural programs.  He remarked that we are in the best of times scientifically and the worst of times financially.

Dr. Kenneth Warren of NIAAA spoke next and noted that he was glad to be speaking after Dr. Insel, who provided a perspective on a budget environment that affects all NIH Institutes.  Dr. Warren outlined the NIAAA mission and reported that the President’s FY11 budget request for NIAAA called for a 2.7% budget increase but the Senate markup called for only a 2.5% increase, both below inflation levels.  He then noted that the final budget could be flat or worse than flat.

Dr. Warren then spoke about the Scientific Management Review Board’s recommendation to form a new addiction research institute, and noted that the NIH Director appointed a task force to be led by NIH Principal Deputy Director Lawrence A. Tabak, D.D.S., Ph.D. and National Institute of Arthritis and Musculoskeletal and Skin Diseases Director Stephen I. Katz, M.D., Ph.D., to develop a new institute model by summer 2011.  Warren remarked that he had been told that those appointed to be task force members would “have no skin in the game”, presumably to eliminate conflicts of interest, but he expressed concern that the task force may not have all the expertise needed to formulate an optimal structuring plan.  Dr. Warren urged the audience to volunteer their time and advice, if requested by the task force, to consult on the structuring plan.  He then outlined a the timeline for the process, indicating that the structuring plan would have to be completed by summer 2011 in order to be able to start in FY 2013.

Dr. Warren spent the balance of his time discussing NIAAA accomplishments and priorities.

NIDA Director Dr. Volkow spoke last, agreeing with Dr. Insel in that these are extraordinary times scientifically.  She remarked that science is advancing at speeds not seen before because of open access to research data via the internet.  She termed the budget picture “challenging” and “competitive”.  She noted that the proposed NIDA budget is about $1 billion, but could be rolled back to FY2008 levels.  NIDA is considering a pre-emptive measures to respond to this possibility, and among other actions is not going to commit to new large program projects that run for long time periods.

She then focused on the SMRB recommendation to form a unified addiction institute, and indicated that she was “delighted” with the recommendation.  Dr. Volkow said that in her opinion, dividing research on alcohol from that on other drugs is bad, because of the high comorbidity between alcohol abuse and abuse of nicotine and illicit drugs.

Dr. Volkow noted that most animal models of alcohol abuse don’t include nicotine, which is relevant clinically and scientifically because of the high comorbidity of alcohol abuse and smoking, and because nicotine is neuroprotective and also can trigger alcohol relapse.  She noted that more alcoholics die from smoking-related diseases than from alcohol-related diseases.

She observed that supporters of NIAAA and NIDA research programs all are afraid that funding for these research areas will be reduced in an integrated institute, and that it will be critical to include mechanisms in a new institute structure that minimize inappropriate allocations.

Dr. Volkow lamented that the restructuring process has resulted in a polarization between NIDA and NIAAA, but that it is important to start working together to figure out how to best integrate resources and manage the change.  She also appealed to the audience to serve as consultants if asked to help provide guidance on integration.

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