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Managing Biomedical Research to Prevent and Cure Disease in the 21st Century: Matching NIH Policy with Science Joint Hearing before the Senate Committee on Health, Education, Labor and Pensions and House Committee on Energy and Commerce October 2, 2003

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Managing Biomedical Research to Prevent and Cure Disease in the 21st Century: Matching NIH Policy with Science Joint Hearing before the Senate Committee on Health, Education, Labor and Pensions and House Committee on Energy and Commerce October 2, 2003. 11.8%. National Institutes - PowerPoint PPT Presentation

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Page 1: National Institutes of Health FY 2003 Budget

Managing Biomedical Research to Prevent and Cure Disease in the 21st Century: Matching NIH

Policy with Science

Joint Hearing before theSenate Committee on Health, Education, Labor

and Pensionsand

House Committee on Energy and Commerce

October 2, 2003

Page 2: National Institutes of Health FY 2003 Budget

National Institutes of HealthFY 2003 Budget

(Total Budget: $27.2 Billion)

11.8%

Spending Outside NIHSpending Outside NIH

85 %(83% Extramural Research)

3.2% Management

National Institutesof Health

National Institutesof Health

Page 3: National Institutes of Health FY 2003 Budget

Coronary Heart DiseaseAge-Adjusted Death Rates: Actual and Expected

United States, 1950-2000500

400

300

200

100

01950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000

Dea

ths

per

100,

000

Year

~ 514,000 Actual Deathsin 2000

~ 1,329,000 Projected Deaths in 2000

815,000 Deaths Prevented in 2000

Page 4: National Institutes of Health FY 2003 Budget

Q u a r t e r - Y e a r * A d j u s t e d f o r r e p o r t i n g d e l a y s

Number of Case

s or Deaths Prevalence

1 9 9 3 d e fi n i t i o ni m p l e m e n t a t i o n

Adjusted for reporting delays

0

10

20

30

40

50

60

70

80

90

81 83 85 87 89 91 93 95 97 9982 84 86 88 90 92 94 96 98 00 01

Year

Incidence

Deaths

Nu

mb

er o

f C

ases

/Dea

ths

(Th

ou

san

ds)

1993

Estimated U.S. Incidence of and Mortality from AIDS

1981-2001

More than 80 new drugs in development

Nearly 3 times the number of vaccines in Phase I since 2001

Page 5: National Institutes of Health FY 2003 Budget

The 2003 SARS outbreak and

The doubling of the NIH budget• Increased investments in Human

Genome

• Better DNA sequencing technology

• Finished the Human genome faster

• Allowed powerful ways to identify Microbes and Viruses thru their genomes

• Cause of SARS identified in record time!

Page 6: National Institutes of Health FY 2003 Budget

Acute to Acute to chronicchronic conditions conditions

Evolving Challenges

Health DisparitiesHealth Disparities

Emerging DiseasesEmerging Diseases

Aging PopulationAging Population

BiodefenseBiodefense

Page 7: National Institutes of Health FY 2003 Budget

IMPERATIVES FOR NIH

• Accelerate the pace of discoveries in the life sciences.

• Need for more rapid translation from laboratories to patients

• Need for novel approaches that are orders of magnitude more effective.

• NEED FOR NEW STRATEGIES “NIH ROADMAP “

Page 8: National Institutes of Health FY 2003 Budget

NIH RoadmapThree CORE Themes

• New Pathways to Discovery

• Research Teams of the Future

• Re-engineering the Clinical Research Enterprise

Page 9: National Institutes of Health FY 2003 Budget

COMPLEXITY OF BIOLOGICAL NETWORKS OF MOLECULES

Page 10: National Institutes of Health FY 2003 Budget

Architecture of an 11,000 kDa pyruvate dehydrogenase complex

475 Å

J. Milne and S. Subramaniam, National Cancer Institute, NIH

Page 11: National Institutes of Health FY 2003 Budget

Scale and complexity of 21st C. researchrequire new organizational models for

scientific teams

NIH RoadmapResearch Teams of the Future

•Multi-disciplinary teams•Larger, coordinated, resource-sharing teams•Combine physical, biological and information sciences•High Risk/ High Impact

Page 12: National Institutes of Health FY 2003 Budget

NIH RoadmapRe-engineering the Clinical Research

Enterprise

“We need to more quickly translate our discoveries into practice.”

Integrated Clinical Research NetworksClinical Research InformaticsTrainingPublic TrustTranslational Research

Page 13: National Institutes of Health FY 2003 Budget

National Clinical Research System

Regional NetworksLocal NetworksNational Network

HI

AK

Page 14: National Institutes of Health FY 2003 Budget

Roadmap Implementation• All NIH ICs made the corporate decision to

have a common pool of resources that will be used for all current and future investment in the Roadmap initiative

• $128M in FY 2004

• Over $2.1B cumulative by FY 2009

Page 15: National Institutes of Health FY 2003 Budget

CHALLENGES FOR NIH

• Revolutionary and rapid changes in Science

• Increasing breadth of mission and growth

• Complex organization with many units

( 27 institutes and centers, multiple program offices- OWHR, OAR, ORD….)

• Disease, organ, life stage….

• CONVERGENCE OF SCIENCE

Page 16: National Institutes of Health FY 2003 Budget

Ideas fromIndividualScientists

ScientificReview

InstituteNational Advisory

Councils

NIHGrantees

NIH receives~43,000 research

project grantApplicationseach year

Group ofScientistsEvaluate

Scientific Merit

~30 percent of NIH applications

succeed ingaining research

funding

Access programsApprove applicationsPublic MembersProvide policy advice

WORLD CLASS PEER REVIEW SYSTEM

Page 17: National Institutes of Health FY 2003 Budget

Science Public Health

Society

EFFECTIVE PORTFOLIOMANAGEMENT

Page 18: National Institutes of Health FY 2003 Budget

IdeasPeople

Resources

NIH

Page 19: National Institutes of Health FY 2003 Budget

Standard Model

Laboratory Research

Translational Research

Population Research

Clinical Research

PublicHealth

Page 20: National Institutes of Health FY 2003 Budget

The Way it Should Work

Laboratory Research

Patient-oriented Clinical Research

Population-based Clinical Research

Clinical Trials

Page 21: National Institutes of Health FY 2003 Budget

• Better management of portfolio

• Better management of organizational resources of NIH

• Improved governance