NIH’s SMRB Recommends Creation of New "Addiction" Institute and Holds Initial Discussions on an NIH Strategy for Translational Research—NAEVR Comments on Potential Impact on Vision Research
September 16, 2010
On September 14-15, the National Institute of Health’s (NIH) Scientific Management Review Board (SMRB) held its fifth meeting to address NIH management and structure issues, which is its charter, as set forth by the NIH Reform Act of 2006. At the meeting, the SMRB:
The SMRB heard from a series of panels as it began its discussions about the development of an NIH strategy regarding translational research
NAEVR provided public comments on the NIH structural issue and the potential NIH translational research strategy since each will impact vision research at the National Eye Institute (NEI).
- Considered a report and recommendations from its Substance Use, Abuse, and Addiction (SUAA) Working Group and recommended to abolish the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to create a new "Addiction" Institute.
- Considered a report and recommendations from its NIH Intramural Research Program (IRP) Working Group and recommended not to take action at this time, since how the NIH Clinical Center is funded and interacts with the extramural research community could be affected by the SMRB’s recommendations regarding translational research (see below).
- Through its newly established Translational Medicine and Therapeutics (TMAT) Working Group, held initial discussions about the development of a comprehensive NIH strategy for translational research, as requested by NIH Director Francis Collins, M.D., Ph.D., at the SMRB’s May 18-19, 2010, meeting.
New "Addiction" Institute
The SUAA, which was asked to consider whether organizational change within NIH could optimize research into substance use, abuse, and addiction, offered two options in its report. The first reflected a structural change, which would abolish NIDA and NIAAA and establish a new "Addiction" Institute to include drug addiction research from NIDA, alcohol addiction research from NIAAA, tobacco addiction research from the National Cancer Institute (NCI), and gambling addiction research from the National Institute of Mental Health (NIMH), with non-addiction research portfolios from NIDA and NIAAA being transferred to other Institutes/Centers (I/Cs). The second option reflected a functional change in which NIH would create a trans-Institute Addiction Initiative, not unlike the NIH Neuroscience Blueprint. After lengthy discussion, the SMRB voted to recommend the structural option to Dr. Collins. If Dr. Collins accepts the recommendation, it will start a legislatively mandated series of reporting events within a specific timeframe, including notifying Congress of this change.
Although the final SMRB recommendation reflects an action more complex than a simple "merger" of the two Institutes and addresses a long-standing desire within some in the research community for an entity on addiction, NAEVR opposed "merging" Institutes in its public comments at the SMRB’s May meeting and at the September 15 meeting due to its concern that there may be greater pressure on NIH to merge or "cluster the budgets" of other Institutes. In 2001, then-NIH Director Harold Varmus, M.D. (who has subsequently returned to the NIH as the NCI Director) proposed to cluster the budgets/programs of the 27 I/Cs into six units, including a "Brain Institute" which would have incorporated the NEI. NAEVR has consistently opposed this action, including fighting a similar provision in the draft NIH reauthorization legislation in the 2004-2006 timeframe, since it feared that "front of the eye" corneal research could be minimized in a "Brain Institute."
During the SMRB’s discussions, Dr. Varmus supported the concept of an Addiction Institute and commented that "he’d be happy to see his 2001 proposal back on the table for consideration." As a result, NAEVR will stay vigilant on this issue.
NIH Strategy on Translational Research
Much of the two-day meeting was spent in initial discussion of how NIH coordinates it numerous initiatives regarding clinical and translational research-not only internally, but with other Department of Health and Human Services (DHHS) agencies [such as the Food and Drug Administration (FDA)], with other government agencies, with the private biomedical research sector, and with the patient and advocacy community. Representatives from these various sectors participated in a series of panels to address the challenges that NIH faces in this regard. Much of the conversation focused on the latest Congressional initiative, the Cures Acceleration Network (CAN), which was authorized as an NIH program within healthcare reform legislation and is currently proposed to be funded initially at $50 million in the proposed House and Senate’s Fiscal Year 2011 Labor, Health and Human Services, and Education (LHHS) appropriations bills, which have not yet been finalized (note that each of the I/Cs, including the NEI, was "tapped" to provide initial CAN funding). As many panelists questioned, what optimal role can NIH play in accelerating the development of a new therapies (especially drugs) with its $50 million pool of CAN funding when it costs private industry about $1 billion to bring a new drug therapy to market.
Although the TMAT has set an ambitious goal of year-end 2010 for development of a recommendation to Dr. Collins regarding an NIH translational research strategy, many SMRB members questioned whether this timeframe was realistic considering the complexity of this subject.
Since none of the panelists represented the vision space, NAEVR provided public comments about NEI’s collaborations trans-NIH, trans-DHHS, with other government agencies, with private funding organizations, and internationally to "smartly and effectively expand its research dollars to develop a rich repertoire of patient solutions," as stated by NAEVR Executive Director James Jorkasky. NAEVR also highlighted the Translational Research and Vision meeting, an NIH campus-based educational symposium held June 24-25, 2010, by the NEI to conclude its 40th anniversary, at which Dr. Collins acknowledged NEI’s leadership in clinical and translational research during his keynote comments.
|NCI Director Harold Varmus, M.D. commented that "he’d be happy to see his 2001 proposal back on the table for consideration" which would consolidate NIH’s 27 Institutes and Centers into six units
||At the meeting, NAEVR handed Lawrence Tabak, D.D.S., Ph.D. a congratulatory letter for his recent appointment by Dr. Collins as NIH’s Principal Deputy Director. Dr. Tabak, who previously served as the Director of the National Institute of Dental and Craniofacial Research (NIDCR), was an SMRB member in his prior role.