Monday, September 3, 2012
Beyond cutting out waste, it
has been obvious for decades that NIH should be reorganized. Institutes are
organized according to 19th century notions of disease, and the 27 institutes
and centers create duplication and institutional barriers to collaboration.
By themselves, reducing
duplication on infrastructure or administration may not be a huge money saver.
But reducing duplication in research efforts would be, and getting rid of the
research silos could allow much faster propagation of biologic insights from
one disease to another that are separated by organ system but united by
Institutes and centers are
created by Congress, often in response to lobbying by patient groups who want
more research funding dedicated to their disease. Eliminating or consolidating
them has proven much more difficult.
For example, it has taken
many years and a Herculean effort to merge the National Institute on Drug
Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism
(NIAAA), two institutes with missions that so obviously overlap that even
members of Congress should understand the benefits of combining them.
The task was proposed in a
joint report by the National Research Council and the Institute of
Medicine in 2003. It likely won't be completed until 2014.
As this pace, it could take
two decades to organize NIH according to modern ideas about the molecular basis
of disease. Austerity could be the driver that sets the process in motion
sooner than later.
- Susan Schaeffer