Congress let the NIH drop the HIV/AIDS set-aside: Implications for NIDA?

Dec 15 2015 Published by under Drug Abuse Science, NIH, NIH Budgets and Economics

Jocelyn Kaiser reported in Science Insider:

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.

Whoa. Big news. This is an old Congressional mandate so presumably it needs Congress to be on board. More from Kaiser:

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.... 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.

Emphasis added. An act by omission is good enough for gov'mint work, eh? Congress is on board.

@jocelynkaiser was kind enough to link to relevant NIH budgetary distributions:

As you can see, NIDA devotes about $300M to HIV/AIDS research. The annual NIDA budget allocation is about $1B so you can see that something on the order of 30% of the NIDA budget is (and has been) devoted to this Congressional Mandate.

Wait, whut? What about that 10% mandate above? Yep, the HIV/AIDS money has not been evenly distributed across the ICs.

Now, I don't know exactly when and how all of this shook down. It was FY 1987 when the NIAID budget went up by something like 47% when other similarly sized ICs didn't see such a large percentile increase. Clearly 1986 was when Congress got serious about HIV/AIDS research. We can't assess the meaning of

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.
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.

from this article. It is a little frustrating, to be frank. But...on to the NIDA situation.

NIDA doesn't appear in the NIH tables until FY1993 because it didn't actually join the NIH until 1992. Nevertheless that history page on NIDA notes:

1986: The dual epidemics of drug abuse and HIV/AIDS are recognized by Congress and the Administration, resulting in a quadrupling of NIDA funding for research on both major diseases.

There are many ways of looking at this situation.

Some in the NIDA world who are not all that interested in HIV/AIDS matters complain bitterly about why "A third of our budget is reserved for HIV/AIDS". Our.

Another way of looking at this would be "If Congress mandated NIH devote 10% of its budget to HIV/AIDS but NIH did this by incorporating NIDA with its existing HIV/AIDS funding then the entire rest of NIH is shirking its response to the mandate on the back of NIDA".

And yet a final way of looking at this* would be "Dude, NIDA wouldn't even have this money if not for Congress' interest in funding HIV/AIDS research so it isn't 'our' funding being diverted to HIV/AIDS research."

Is this important? Yes and no.

The news is potentially huge for those who seek to get the HIV/AIDS funding via NIDA grants and for those who seek non-HIV/AIDS funding. It makes matters slightly better for the latter and worse for the former. Right? If there is no special set-aside, the latter folks now have at least a shot at that $300M that had been out of reach for them. This consequently increases the competition for those who have HIV/AIDS relevant proposals. Who are presumably sad right now.

But it all depends on what Collins plans to do with his newly won freedom. Back to Kaiser:

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.

However the article only then talks about $65M being reprioritized. What about the rest of the 10% of the ~$30B / yr NIH budget? No idea.

So I want to know a few things. Is the $300M in the NIDA budget that goes to HIV/AIDS part of this 10% overall NIH mandate? If so, will Collins try to claw that back for some other agenda?

If a miracle occurs and it stays within NIDA, will Nora Volkow use this new-found freedom to ease the pressure on the non-HIV/AIDS researchers by letting them (ok, "us") get a shot at that previously-sequestered pool?

Or will Volkow use it to pay for the latest boondoggle initiatives of ABCD and BRAINI?

The way I hear it, this latter is likely to happen because up to this point all other NIDA initiatives are being squeezed** to make ABCD and BRAINI happen.

Obviously I would prefer to see Volkow choose to use this new freedom a little more democratically by spreading the love across all of the portfolio.

*this has been my view for some time now.

**this manifests, IME, as profound pessimism on the part of POs that anything in the grey zone (which is robust reality at no-public-payline-NIDA) will be picked up because all spare change is going to the two aforementioned boondoggles.

27 responses so far

  • Grumble says:

    ABCD, BRAINI et al are just as much boondogles as any other RFA. Just larger scale.

  • drugmonkey says:

    Scale makes it very different.

  • doctorD says:

    A related issue is that NIH has narrowed the definition of what counts for HIV research. More than 50% of NIDA's HIV awards do not meet the new definition. The NIDA AIDS office anticipates that NIH will redirect NIDA AIDS $ to other NIH priorities.

  • drugmonkey says:

    Yeah. *what* priorities? That is the question.

  • AcademicLurker says:

    The set-aside made sense back when it was originally implemented, but phasing it out is overdue.

  • drugmonkey says:

    NIH and Congress are not known for responding nimbly and anticipatorily to changing needs in terms of research expenditure/health impact balance, now are they?

    We should all recognize however that there is some self-correction. The very fact that the NIH and congress have decided that some research funded under the AIDS/HIV umbrella has moved too far away from the goal suggests scientists have been creative, in aggregate, about repurposing the grants' directions.

    The way I formulated it for people in my own field who were complaining was "Two Aims for HIV/AIDS, one Aim for the drug-related phenomenon you are interested in, sounds like a good plan".

    I'll be saying about the same thing to my peers if they complain about the new broad #SABV mandate too.

  • jmz4gtu says:

    This is happening now at the NIA. Congress is increasingly throwing money at Alzheimer's Disease, and so everyone is trying to shoe-horn it into their grants, cause the paylines are much better (delta=~5%). I'd be curious how the reviewers, SROs and POs, respond to these attempts.

  • Jonathan says:

    The AIDS mandate was one of the banes of my existence when I was a policy drone at NIH, since I ended up being in charge of come up with an AIDS portfolio at an IC that was not really interested in funding actual AIDS research. It was not a 10% mandate - we claimed about $7 million a year, out of a total budget of ~$500 million (intra- and extramural).

    You are correct that NIH decided to tighten up what could or couldn't be called AIDS-relevant, mainly because of declining paylines and budgets. However, if you couldn't justify a full AIDS portfolio, you did not get to spend that money on other research. The cash belonged to OAR (Office of AIDS research) and if you couldn't justify your portfolio, they didn't transfer the cash over and your budget went down. Needless to say that was not something that an IC Director was prepared to let happen.

    Now (thank fuck) I don't have to deal with coming up with tenuous justifications for projects that might, if you squinted hard enough and the light coming off the moon was just the right shade of blue, be considered somewhat AIDS-relevant.

  • Neuro-conservative says:

    Have you looked at the slides prepared by OAR?

    Hard to interpret the competing agendas underlying the terse bullet points, but it looks like OAR is trying to redirect funds to more core HIV/AIDS projects, so that it won't help the individual ICs at all. Maybe I am missing something.

    This is a really critical distinction - if the the funds are going to be redirected to other AIDS projects, it will have the net effect of *reducing* the funding available for NIDA investigators and others (eg, NIMH, which is also a big player). On the other hand, if the total OAR budget will be reduced below the 10% level, then we can see those funds ultimately redirected towards some mix of independent investigators and boondoggles such as BRAINI that are more consistent with the core mission of the respective ICs.

    Perhaps Jonathan or DataHound or someone in the know can clarify?

    The slides do make clear where the $65M figure comes from - it is a small percentage of "low priority" (non-core) extramural grants funded by OAR *that are coming up for competitive renewal in the next year*

  • jmz4gtu says:

    Whoohoo, more money for everyone. Make it rain:

    Of course, we're still down relative to 2003, but baby steps.

  • Neuro-conservative says:

    Apropos the original thread topic, about half the new money is going into boondoggles, and half to regular R01s. Still, a big win.

  • jmz4gtu says:

    I asked this before, but didn't really get any answers, so I'll try again. Should they really be awarding more R01s, or increasing R01 size instead? I've read that the average R01 has lost a ton of its purchasing power, and its not like we need to encourage another boom of faculty hiring just as the number of applications was beginning to fall off.

    In other words, if the Cull has begun, should they stop it, or let it run its course?

  • Neuro-conservative says:

    I don't think a one-time increase of this size will set off a boom in faculty hiring. But I agree that it would be timely to increase the modular to $300K.

  • Philapodia says:

    I know several labs that are functioning just fine on $250K R01s, and while I do understand that purchasing power has gone down over the years, a quarter of a million bucks per year still a lot of money. You can stretch it quite a way if you're being fiscally responsible.

    I would prefer that more modular R01s be awarded instead of increasing the award size, since you're losing a lot of talented scientists due to the lack of money and increasing the award size really only helps increase the bottom lines of those who were going to get funded anyway. Just because someone's idea are not hitting the low payline doesn't mean they are complete crap and don't deserve funding, it means that other ideas were a priority at that moment with limited funds available. Increasing the number of $250K awards increases the breadth of the NIH portfolio, which is a good thing IMHO.

  • drugmonkey says:

    $50K is a lot of money and you can stretch that quite a ways if you are fiscally responsible. [and happen to do cheap research].

    I would prefer more R03s get awarded so more people could feel good about being "NIH funded" [even though not much actual research would occur].

    Increasing the number of $50K awards would increase the breadth of the portfolio which is a good thing [that has no limit].

  • drugmonkey says:

    Btw, in order to restore purchasing power to where it was when modular budgeting was first invented, the limit should be put to $375K per year.

  • Baltogirl says:

    I agree with Philopodia- having many more 250K awards - which is sadly well below the standard R01 award these days- would enable funding of many more proposals.
    Anything that increases percentile funding is great in my book. Then we could all stop spending 90% of our time writing proposals and actually do some science.
    To me, fifty thou is really too little to do much with after salary is paid. But what about a new mechanism for a small project- a 100K grant? I put in such a "tiny R01" in October- let's see how it does.

  • Mobio says:

    In a perfect world I would argue to increase modular limit.
    But given that we don't live in that alternative universe 250K
    is better than zeroK.

  • drugmonkey says:

    Sometimes not doing the necessary surgery lets the patient die.

  • drugmonkey says:

    Baltogirl- what is the end game? Do you acknowledge that at some point you give a whole lot of people grants so that everyone can be a winner but then nobody can actually do science?

    31% less purchasing power...and I wrote that in 2012.

  • Philapodia says:

    "Do you acknowledge that at some point you give a whole lot of people grants so that everyone can be a winner but then nobody can actually do science?"

    None of us is advocating Oprahfying grants (You get a grant, you get a grant, everyone gets a grant!!), and I think this statement is a slippery slope argument that ignores the fact that not everyone "needs" to do expensive experiments (i.e. animal experiments). Lots of folks can do very good work just fine on a single modular R01. Many if us don't do animal work and our research can be done "relatively" inexpensively, and if more small-town grocers could get grants at $250K/year then a lot more diverse knowledge could be obtained. More expensive animal experiments are obviously necessary, so perhaps they should be non-modular?

  • drugmonkey says:

    Maybe the "cheap" research should be limited to R03s?

  • Philapodia says:

    You very well know that the major direct costs expenditures on grants are salaries, not research materials. Two post-docs salary + fringe and a portion of faculty salary + fringe will easily eat up $150K before any "cheap" science even gets done. Therefore you have to write and review 4 R03s at the current $50K to get an R03 equivalent to do science. Seems a lot more inefficient than writing a single R01 at $250K or detailed budget for higher direct cost requests.

  • drugmonkey says:

    Oh now you are worried about "inefficiency"? When it hits you....

  • drugmonkey says:

    First principle of every NIH fix proposal: whatever works for my particular research program and desired career arc should be made much, much easier. Anything less makes the system inefficient. Any more is an outrageous waste of money to benefit insiders based on their politics and fraudulent reviews.

  • Philapodia says:

    Someone's knickers are in a twist :). Perhaps we should just get rid of modular budgets all together and everyone has to write a detailed budget for what they need and can justify. More work for everyone, but also everyone gets what they need if chosen for funding, and losing purchasing power due to inflation becomes less if an issue. just a thought...

  • drugmonkey says:

    1) the modular budgeting process has a lot in its favor.

    2) traditional budgets also receive reductions upon funding.

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