“What we want is the most effective, state-of-the-art NIH in the 21st century that gets the biggest bang for the taxpayers' buck," said Rep. Joe Barton, R-Texas, who also said he would push for complete congressional reauthorization of NIH in 2004.

Although Barton acknowledged that Congress is partially to blame for the proliferation of NIH institutes over the past few decades, he and others at the hearing said NIH’s current structure poses problems for interdisciplinary research and keeps the NIH director from setting overarching budget and research priorities.

Rep. Henry Waxman, D-Calif, an outspoken critic of recent inquiries into NIH’s peer-review process, cautioned against too much congressional interference, saying that some “congressmen have given into the temptation to substitute their own scientific judgment” when it comes to NIH operations.

Testifying at the hearing with several of his institute heads, NIH Director Elias Zerhouni said NIH’s successes “have changed the landscape of the diseases we have to deal with” but agreed that NIH needs to expand trans-institute priority reviews like the recent Roadmap project (see HABIT, October 28, 2003) and “invest in modern decision making support systems.”

The hearing focused on how NIH institutes decide to allocate their funding and how responsive the institutes are to public health concerns raised by the public and congressional members. Subcommittee Chair Michael Biliraki, R-Fla., acknowledged that the process was complicated but also said that the issue has drawn public scrutiny “because NIH lacks transparency in many of its decision-making procedures.”

Zerhouni, along with NIAID Director Anthony Fauci, M.D., NCI Director Andrew von Eschenbach, M.D., and NIDA director Nora Volkow, M.D., gave short summaries of their budget processes and how they receive outside input on spending. Fauci warned that legislating structural changes for NIH might deprive the institutes of their flexibility, although he did support efforts to give more power to the NIH director.

To watch a Webcast of the hearing, go here.