NIH drops special 10 setaside for AIDS research

first_img Click to view the privacy policy. Required fields are indicated by an asterisk (*) Email Sign up for our daily newsletter Get more great content like this delivered right to you! Country In a major shakeup for the HIV/AIDS research community, the National Institutes of Health (NIH) today announced it will no longer support setting aside a fixed 10% of its budget—or $3 billion this year—to fund research on the disease. The agency also plans to reprogram $65 million of its AIDS research grant funding this year to focus more sharply on ending the epidemic.The changes follow growing pressure in Congress and from some advocacy groups for NIH to reallocate its funding based on the public health burden a disease causes. In recent years, HIV/AIDS has been imposing a lower burden as death rates have dropped and treatments have improved.The changes are drawing a mixed reaction from the AIDs community and scientists. Although some scientists’ grants are now at risk, “there is broad support for the idea of oversight and review and a rigorous focus on the highest priority science with our precious research dollars,” says Johns Hopkins University epidemiologist Chris Beyrer, president of the International AIDS Society. More worrisome to his group and others is uncertainty about future increases for AIDs research.center_img Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe AIDS has received 10% of NIH’s overall budget since the early 1990s, when Congress and NIH informally agreed it should grow in step with NIH’s overall budget. But the need for each NIH institute to spend its annual AIDS allocation has led some institutes to stretch the definition of HIV research and others to relax quality standards. In addition, some patient groups and members of Congress have recently asked why AIDS receives disproportionately far more than diseases with higher death rates, such as heart disease and Alzheimer’s.Last year, Congress omitted instructions asking NIH to maintain the 10% AIDS set aside. NIH Director Francis Collins agrees: At a meeting of his Advisory Committee to the Director (ACD) today, he noted that no other disease receives a set proportion of the NIH budget and the argument that AIDS still deserves such a set-aside is “not a defensible one.”The end of the set-aside has “free[d] us up” to refocus NIH’s AIDs portfolio, Collins says. In August, the agency announced a new list of priorities that puts vaccines and therapies high on the list and research not directly related to HIV infection further down. NIH’s Office of AIDS Research (OAR) then reviewed AIDs grants coming up for renewal in fiscal year 2016 to see how they fit the new priorities.That review, presented today to the ACD by OAR acting director Robert Eisinger, found that about 20%, or 242 of 832, extramural grants fell on the low priority list (they made up 16% of the funding, or $65 million). They include basic virology and immunology and studies involving pathogens that don’t appear in the context of HIV infection. Among intramural AIDS-funded programs, a larger proportion—47%, or 26 of 56 projects—were deemed low priority; they totaled $6.6 million. (A contract for $1.26 million was also low priority.)OAR now plans to pass the low priority list on to institutes who will then notify investigators, who sometimes aren’t even aware that their grants are funded with AIDS dollars. If they do well in peer review, these studies may still receive funding from NIH, but it would have to come from non-AIDS dollars for which competition may be stiffer.The freed up $65 million will go into a “common pool” for AIDS research that institutes can compete for based on the new priorities, Collins says. “It will result in shifting the dollars around,” he said. OAR will continue this process for the next few years as grants turn over; if the same proportion of grants is deemed low priority in future years, the total could come to more than $400 million.ACD members were generally positive about the AIDS review. The reshuffling is “necessary” if “difficult” and “painful,” said virologist Ian Lipkin of Columbia University.Beyrer points out that the impact for now may be slight since it only affects about 2% of the overall HIV/AIDS portfolio. “Nevertheless if it’s your funding, it’s going to be very challenging for people,” he says. Mark Harrington, executive director of the Treatment Action Group in New York City, says while his group is generally supportive of the change, he worries that studies on infections that co-occur with HIV —such as tuberculosis—may go by the wayside and that could be “a real loss.”What worries AIDs groups more is what the end of the 10% set aside will mean for the AIDS budget. Collins says the numbers won’t shift in fiscal year 2016 because that budget is about to be approved by Congress. After that, even if AIDS no longer gets 10%, “HIV research should not be precluded from receiving any share of [an NIH] increase,” says Kimberly Miller of the HIV Medicine Association in Arlington, Virginia.One peculiarity of AIDS research will not change—that NIH must treat AIDS dollars as a distinct pot of money within its overall budget. That is because a 1993 law carved out a separate HIV/AIDS budget, Collins says. And undoing that law would take action by Congress.last_img

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