The AIDS Research Program of the National Institutes of Health (1991) / Chapter Skim
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2 Managing the NIH AIDS Research Program
2 Managing the NIH AIDS Research Program
Pages 35-52
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From page 35... ...
generally, the multiplicity of activities being carried out by the various units and subunits of NIH add up to a coherent strategy. Such a reassessment should consider the changes needed in the current program structure as AIDS research matures and becomes more integrated with regular NIH activities.
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From page 36... ...
. In most cases, AIDS activities are carried out within the institute's regular organizational structure; only NIAID, because of the large size of its AIDS program (53 percent of NIAID's budget in fiscal year 1990)
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From page 37... ...
He chairs the NIH AIDS Executive Committee and represents NIH at the meetings of the PHS Executive Task Force on AIDS. He is also executive secretary of NIH's AIDS Program Advisory Committee and director of the Office of AIDS Research.
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From page 38... ...
At APAC's first meeting in February 1988, NIH director James Wyngaarden stated (1988:13~: This advisory committee will play a vital role in providing advice and counsel on the difficult research and science policy issues that we face as we move towards our goal of eradicating AIDS. These meetings will serve as an effective stage from which we can review our AIDS research activities in a comprehensive fashion and examine the direction, composition, and management of our efforts.
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From page 39... ...
OAR coordinates NIH intra- and extramural AIDS research, represents the NIH director on AIDS-related matters, and centralizes certain AIDS-related policy and operating functions, such as the development of the NIH annual budget request for AIDS and an AIDS research ~nfonnation system (PHS, 1989a:274~.
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From page 40... ...
is for AIDS programs (technology transfer meetings and loan repayments for NIH AIDS researchers) rather than for increased interinstitute program planning and coordination capacity.
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OAR participates in several coordination efforts among the institutes and between NIH and other agencies (OAR, 1990; PHS, 1989a:274-277~. For example, OAR · coordinated the development of AIDSTRIALS, the centralized information system for AIDS clinical trials involving NLAID, the National Library of Medicine, and the Food and Drug Administration; · oversaw development of NIH's policies for the medical management of employees exposed occupationally to HIV infection, in conjunction with the NIH clinical center, the NIH Division of Safety, and CDC (subsequently, OAR was involved in the development of a PHS-wide policy published by CDC [19903~; · coordinates NIH responses to congressional requirements, such as the plan to double the capacity of the outpatient AIDS programs of NCI and NIAID as called for in the Health Omnibus Program Extension Act of 1988 (P.L.
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, a national advisory council (the AIDS Program Advisory Committee) , an executive committee of senior program officials (the NIH AIDS Executive Committee)
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C7 ~ O Recommendation 2.2: AIDS program evaluation processes should be strengthened and linked closely to planning and budgeting processes to ensure that, first, questions of the highest priority are addressed adequately at all times; second, all studies being supported are still relevant and are as productive and efficient as possible; and third, resources are redeployed, sometimes across institutes, in response to research advances and breakthroughs or as time and experience indicate that some programs are more and some less successful than others In achieving their goals. The Office of AIDS Research should work closely with the Division of Planning and Evaluation in the NIM Directors Office to coordinate evaluations of AIDS research programs in the various institutes.
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From page 44... ...
Not in question, however, is the need for a high-level advisory function, and the committee urges NIH to strengthen its processes for external advice on overall level of effort, balance among research areas and mechanisms, and research opportunities and needs in the AIDS research program. For the institutes, this role is played by the national advisory councils; for the AIDS program, this function should be the role of the AIDS Program Advisory Committee.
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From page 45... ...
In particular, OAR will need some additional planning and evaluation staff, including several senior-level scientists who can assist the associate director for AIDS research and APAC in monitoring the AIDS research agenda, assessing progress, identifying scientific gaps that need to be addressed, and coordinating the review of institute research initiatives. Strengthening Executive Authority and Flexibility The AIDS program is the first major research program to be managed by the Office of the NIH Director rather than by a single institute.
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From page 46... ...
The committee is convinced that an important component of the current strength and success of the NIH AIDS research program is the unique leadership provided by Anthony Fauci, associate director of NIH for AIDS research and director of NIAID. Having the same person as director of NIAID, which receives nearly half the NTH AIDS budget, and associate director for AIDS research is administratively unorthodox, because it poses potential conflict of interest problems when questions of interinstitute coordination, budget allocation, and assignment of program jurisdiction arise.
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From page 47... ...
MANAGING ME NIH AIDS RESEARCH PROGRAM well. Nevertheless, because of the already substantial and still growing workload of each position, and the potential for bias in mediating conflicts among institutes, the committee believes that the joining of these positions should be reconsidered at such time as the current incumbent steps down.
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From page 49... ...
MANAGING THE NIH AIDS R~;SEARCH PROGRAM Director Deputy Director Deputy Director for Extramural Research and Trainings Deputy Director for Intramural R~esrch Associate Directors for: —Extramural Research and Training —Intramural Affairs —A~;nist~ation —Medical Applications of Research -International Research —Communications -Clinical Care -Program Planning and Evaluation —Rcacarch Scrmces —klDS Research . National National Heart.
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JO - ~ .~ ct v ~ in )
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From page 51... ...
and financial analysis 9;) ivision of Financial Management)
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From page 52... ...
In Annotated Agenda, 1st Meeting of the AIDS Program Advisory Committee, February 26. National Institutes of Health, Bethesda, Md.
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