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National Institutes of Health FY 2003 Budget

Managing Biomedical Research to Prevent and Cure Disease in the 21st Century: Matching NIH Policy with Science Joint Hearing before the Senate Committee on Health, Education, Labor and Pensions and House Committee on Energy and Commerce October 2, 2003. 11.8%. National Institutes

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National Institutes of Health FY 2003 Budget

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  1. Managing Biomedical Research to Prevent and Cure Disease in the 21st Century: Matching NIH Policy with Science Joint Hearing before the Senate Committee on Health, Education, Labor and Pensions and House Committee on Energy and Commerce October 2, 2003

  2. 11.8% National Institutes of Health National Institutes of Health Spending Outside NIH Spending Outside NIH 85 % (83% Extramural Research) 3.2% Management National Institutes of Health FY 2003 Budget (Total Budget: $27.2 Billion)

  3. Coronary Heart Disease Age-Adjusted Death Rates: Actual and Expected United States, 1950-2000 500 ~ 1,329,000 Projected Deaths in 2000 400 300 815,000 Deaths Prevented in 2000 Deaths per 100,000 200 100 ~ 514,000 Actual Deaths in 2000 0 2000 1995 1990 1985 1980 1975 1970 1965 1960 1955 1950 Year

  4. 90 80 70 60 50 40 30 20 10 0 Estimated U.S. Incidence of and Mortality from AIDS1981-2001 Incidence 1993 Nearly 3 times the number of vaccines in Phase I since 2001 Deaths More than 80 new drugs in development Prevalence Number of Cases/Deaths (Thousands) Number of Cases or Deaths 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 Year Adjusted for reporting delays

  5. The 2003 SARS outbreak andThe doubling of the NIH budget • Increased investments in Human Genome • Better DNA sequencing technology • Finished the Human genome faster • Allowed powerful ways to identify Microbes and Viruses thru their genomes • Cause of SARS identified in record time!

  6. Evolving Challenges Acute to chronic conditions Aging Population Health Disparities Emerging Diseases Biodefense

  7. IMPERATIVES FOR NIH • Accelerate the pace of discoveries in the life sciences. • Need for more rapid translation from laboratories to patients • Need for novel approaches that are orders of magnitude more effective. • NEED FOR NEW STRATEGIES “NIH ROADMAP “

  8. New Pathways to Discovery Research Teams of the Future Re-engineering the Clinical Research Enterprise NIH RoadmapThree CORE Themes

  9. COMPLEXITY OF BIOLOGICAL NETWORKS OF MOLECULES

  10. Architecture of an 11,000 kDa pyruvate dehydrogenase complex 475 Å J. Milne and S. Subramaniam, National Cancer Institute, NIH

  11. Multi-disciplinary teams • Larger, coordinated, • resource-sharing teams • Combine physical, biological and information sciences • High Risk/ High Impact NIH Roadmap Research Teams of the Future Scale and complexity of 21st C. research require new organizational models for scientific teams

  12. Integrated Clinical Research Networks Clinical Research Informatics Training Public Trust Translational Research NIH Roadmap Re-engineering the Clinical Research Enterprise “We need to more quickly translate our discoveries into practice.”

  13. Regional Networks Local Networks National Network National Clinical Research System AK HI

  14. Roadmap Implementation • All NIH ICs made the corporate decision to have a common pool ofresources that will be used for all current and future investment in the Roadmap initiative • $128M in FY 2004 • Over $2.1B cumulative by FY 2009

  15. CHALLENGES FOR NIH • Revolutionary and rapid changes in Science • Increasing breadth of mission and growth • Complex organization with many units ( 27 institutes and centers, multiple program offices- OWHR, OAR, ORD….) • Disease, organ, life stage…. • CONVERGENCE OF SCIENCE

  16. Ideas from Individual Scientists Scientific Review Institute National Advisory Councils NIH Grantees Group of Scientists Evaluate Scientific Merit Access programs Approve applications Public Members Provide policy advice NIH receives ~43,000 research project grant Applications each year ~30 percent of NIH applications succeed in gaining research funding WORLD CLASS PEER REVIEW SYSTEM

  17. EFFECTIVE PORTFOLIOMANAGEMENT Science Public Health Society

  18. NIH Ideas People Resources

  19. Standard Model Laboratory Research Clinical Research Public Health Translational Research Population Research

  20. The Way it Should Work Patient-oriented Clinical Research Laboratory Research Clinical Trials Population-based Clinical Research

  21. Better management of portfolio • Better management of organizational resources of NIH • Improved governance

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