Panel: NIH changes needed

WASHINGTON, July 30 (UPI) -- A panel of scientists has recommended an overhaul of the National Institutes of Health to make better use of advances in science and medicine in recent years and speed new medications to patients.

The panel, convened by the National Academies of Sciences, proposed 14 recommendations to improve the management structure of the NIH, including more collaboration between the agency's 27 separate institutions. This is because it has become apparent in recent years that many diseases affect multiple parts of the body and research into these disorders would benefit from the involvement of experts from different fields of medicine and science.

The 21-member panel also called for the establishment of a special projects team to focus on projects that have a high likelihood of failure, but which could lead to quantum leaps in medical breakthroughs and cures if successful.

"We recommended major modifications that give NIH an avenue to pursue imminent strategic and time-limited research priorities that cut across all of the institutes and centers, as well as an enhanced ability to carry out risky but highly innovative special projects," Harold Shapiro, a professor of economics and public affairs at Princeton University and chair of the panel, said in announcing the report.

The hope is the restructuring will lead to synergistic research and "eureka" discoveries that will quicken the time it takes to turn basic research into new medical treatments.

"I think what these changes will do, if accepted ... will permit research to move more rapidly than it has and be translated more rapidly to improved healthcare services," such as new drugs, medical devices and prevention strategies, panel member Mary Woolley told United Press International. Woolley serves as president of Research!America, a group composed of medical researchers, representatives of pharmaceutical companies and patient advocacy groups.

"The thinking is that increasing working across departments and challenging people to think beyond their current disciplines ... will increase the chances of breakthrough discoveries," Woolley said.

The NIH, which funds most of the basic biomedical research in the United States, would not comment on whether it deemed the recommendations necessary or planned to incorporate any of them. Dr. Raynard Kington, deputy director of the agency, would only say, "We see (the panel's recommendations) as a starting point for a broader discussion about how we do our job."

A decision about which, if any, of the recommendations to incorporate would probably not come for at least a year, Kington told UPI.

However, Shapiro emphasized the need for the changes to happen almost immediately. "This needs to go right now," he said. "Business as usual at NIH is no longer acceptable in our view," he said.

Woolley noted it is not a matter of the NIH being mismanaged up until this point. Rather, she said, it is more that the agency needs to reorganize so it can capitalize on recent scientific progress.

The biomedical field has seen significant advances recently -- such as the completion of the Human Genome Project -- which were due in large part to a doubling of the NIH's budget over the past five years to $23 billion. Now, the agency can begin to incorporate some of those breakthroughs into their goal of finding treatments for disease, Woolley said. "They've been building up to the moment of cashing in on all the new resources that are available to science," she added.

Alan Leshner, chief executive officer of the American Association for the Advancement of Science and a member of the committee, said obesity research is one example of the types of disorders that would benefit from a cross-disciplinary approach. The condition has wide-ranging effects, such as arthritis, diabetes and heart disease.

Brain development represents another example of an area of medicine that could benefit from the input of experts, Lesher said.

"No one institution at NIH owns the brain or development," so understanding it will depend on a cross-section of experts from different institutions at the agency, he told UPI.

The panel likened the special projects team to the Defense Advanced Research Projects Agency, which conducts research for the Department of Defense that has a high likelihood of failure but which, if successful, could lead to dramatic advances in military technology. Successful DARPA projects include the Stealth fighter, the global positioning satellite system, the Internet and the Predator unmanned aircraft.

The panel recommended a specific mandate to take on risky, cutting-edge research is necessary to offset the traditional conservative attitude of the NIH and its desire to fund projects that have a high likelihood of success. The special projects team would report directly to the NIH director and would start off with an annual budget of $100 million, ultimately building up to $1 billion.

"We've got to put a higher premium on risk-taking, make it sought after and rewarding and look to it to produce true 21st century breakthroughs," Woolley said.

The NIH's management structure has come under fire by Congress in recent months. In March, the House Energy and Commerce subcommittee on oversight and investigations launched an inquiry into the agency's use of federal dollars appropriated for research. The subcommittee decided to launch the investigation in part based on its finding last year that the NIH was providing grants to the Coulston Foundation, an animal research facility in Alamogordo, N. M., that recently declared bankruptcy and had been cited by the Food and Drug Administration and the U.S. Department of Agriculture for regulatory violations.

The committee requested documents from the NIH pertaining to misuse of funds by its grantees or reports of fraud, waste, abuse or mismanagement of grants.

Judy Borger, spokesman for Congressman Jim Greenwood, R-Pa., who chairs the committee, told UPI the investigation was ongoing.

"The staff have received all the information requested in the letter ... and are going through that right now," Borger said. "It's pretty evident already there's going to be a need for a second letter and request additional documents," she said.

Earlier this month, the committee launched an investigation into the case of Edward McSweegan, a scientist at the NIH with a salary of $100,000 who claims to have been given no true tasks or responsibilities for the past eight years. McSweegan said he was demoted from his position as program officer for Lyme disease in 1995 for criticizing a Lyme disease support group and since then has been relegated to menial tasks such as preparing coffee and forwarding messages.

In a July 10th letter to the NIH, the committee said, "Based on these reports, and the Committee's continuing interest in concerns about whether NIH is wisely managing both its employees and its increased financial resources, we are initiating an examination of the allegations made by Dr. McSweegan and broader issues arising possibly from his allegations."