Instead, the NAS report offers some smaller fixes to boost multidisciplinary and innovative research programs without demolishing NIH’s open and decentralized structure, crafted through decades of “social and political negotiations,” according to the report. It suggests only two mergers, combining the National Institute on Alcohol Abuse and Alcoholism with the National Institute on Drug Abuse, and folding the National Human Genome Research Institute back into the National Institute of General Medical Sciences.

Many of the report’s recommendations focus on developing “trans-NIH initiatives.” These multi-institute programs, similar to those suggested by NIH Director Elias Zerhouni’s Roadmap proposal, would go beyond pooling funds to creating truly multidisciplinary research projects. To encourage these initiatives, the report also recommends strengthening the Office of the Director by giving it more control over its own budget and allowing it more leverage over the individual institutes’ funding.

The NAS report also called for the creation of a National Center for Clinical Research and Research Resources to improve collaboration between NIH-sponsored clinical research programs. The new center would replace the National Center for Research Resources and have its own deputy director.

Congress has already expressed interest in adopting some of the recommendations after scientists, advocacy groups and others have had a chance to weigh in. But as the NAS authors note, similar recommendations in a 1984 Institute of Medicine study led to few changes. The current report hopes to avoid that fate by requesting that Congress support an official public process for reorganizing the Institutes.

To read the full report, go to here.