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Bird’s Eye Overview of NIH and Some of Its Challenges Norka Ruiz Bravo, PhD Deputy Director for Extramural Research, NIH Peer Review Advisory Committee 24 January 2005

3 Today’s conversation What is the NIH?  Many answers - depend on one’s perspective… How does NIH work?  Governance; management & operations; science What are NIH’s key challenges?  Management and operations  Science and science management

4 What is the NIH? NIH is the Nation’s leading medical research agency. Goal: Acquire new knowledge to help prevent, detect, diagnose, and treat disease and disability NIH Extramural  Over 105 Nobel Prize winners trained & funded by NIH  Over half of all American Nobel prizes  The NIH Bethesda is the largest research organization in the world  6000 scientists  Over 50 members of the National Academy of Sciences, 5 Nobel Prizes  11/27 directors (and 3 members of the Office of the Director) are members of the Institute of Medicine

5 16% NIH In-House 6,000 Scientists $2.8 Intramural = 10% $1.0 RM&S = 4% $0.9 Other (NLM, OD, et al.) = 3% TOTAL BUDGET $28.8 Billion FY 2005 Funding By Mechanism (dollars in billions) Spending Outside NIH $24.1 Spending at NIH $4.7 84% Outside NIH 212,000 Scientists & Other Personnel (Supports over 212,000 Scientists & Other Personnel) (Supports over 2,800 Institutions Nationwide) NIH is comprised of 27 Institutes and Centers

6 The nation’s leading medical research agency - Role in Major Medical Achievements ~ 407,000 Projected Deaths * Deaths Per 100, Year ~ 166,000 Actual Deaths  Coronary Heart Disease Age-Adjusted Death Rates: 241,000 Deaths Prevented in Deaths per 100,000 Year ~ 514,000 Actual Deaths in 2000 ~ 1,329,000 Projected Deaths in 2000  Reduction in Stroke Age-Adjusted Death Rates: 815,000 Deaths Prevented in 2000

7 Office of the Director * National Institute on Alcohol Abuse and Alcoholism National Institute of Arthritis and Musculoskeletal and Skin Diseases National Cancer Institute National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Dental and Craniofacial Research National Institute on Drug Abuse National Institute of Environmental Health Sciences National Institute on Aging National Institute of Child Health and Human Development National Institute on Deafness and Other Communication Disorders National Eye Institute National Human Genome Research Institute National Heart, Lung, and Blood Institute National Institute of Mental Health National Institute of Neurological Disorders and Stroke National Institute of General Medical Sciences National Institute of Nursing Research National Library of Medicine Center for Information Technology Center for Scientific Review National Center for Complementary and Alternative Medicine National Institute of Allergy and Infectious Diseases Fogarty International Center National Center for Research Resources Clinical Center National Institute of Biomedical Imaging and Bioengineering National Center on Minority Health and Health Disparities No funding authority

8 How does NIH work? Decision making processes  Governance  Peer review Management and operations  Achieving administrative efficiencies  Co-evolving policies and operations w/ the science and scientific approaches Science  Trans-NIH research

9 How does NIH work? Dr. Elias Zerhouni Steering Committee Nine IC Directors Facilities Working Group Management & Budget Working Group Info. Technology Working Group Intramural Activities Working Group Extramural Activities Working Group PastCurrent + 33 other committees NIH Governance

10 How does NIH work? The peer review process is the cornerstone of NIH Peer-review process  Independent - done by outside reviewers  Highly competitive- <30% get funded Scientific and Public Advisory Structure  Each institute has an advisory council - 2/3 scientists and 1/3 public representatives  Director NIH is advised by 2 separate committees: Council of public representatives, and the Advisory Council to the Director

11 How does NIH work? Achieving administrative efficiencies  A-76 Division of Extramural Activities Support  Grants management processes  Grants management systems (IT)

12 Achieving Administrative Efficiencies (A-76) OER OAO DEAS Hub A Hub B Hub C DQADAS Other OER Offices

13 Achieving Administrative Efficiencies Grants management processes Information technology systems

14 How does NIH work? Co-evolving policies and operations w/ science and scientific approaches Molecules > Systems Reductionism > Integration Single investigator > Teams Single discipline > Multiple disciplines Allow more than one co-PI on applications and awards and recognize the contributions of PIs and other key personnel on the project

15 What are NIH’s key challenges? Management and operations Science and science management The next generation – New investigators, clinician scientists Knowledge-based management of science

16 What are NIH’s key challenges?

17 What are NIH’s key challenges? NIH funding is extremely competitive Out of the applications for renewal of research project grants (RPG’s)… 50% are funded 50% are not funded

18 New investigators: First major independent research support occurs at a later age

19 Number of new investigators entering and leaving the system - pretty steady until doubling

20 New investigators are entering system at higher rate than experienced are leaving it

21 New investigators compete for ~ a 25% share of the NIH pie 0% 20% 40% 60% 80% 100% Competing New Investigators Competing Experienced Investigators Non-Competing Awards

22 Addressing one of NIH’s key challenges Resources for New Investigators  Help w/ the grant application process  NIH institute and center policies relating to new investigators  Data on new investigators  Presidential Early Career Award in Science and Engineering link  Links to non-NIH resources  Etc. Ideas welcome:

23 Acute to Chronic Conditions Health Disparities Emerging Diseases Aging Population Biodefense Evolution of public health challenges

24 Scientific challenges for NIH - themes New Pathways to Discovery Re-engineering the Clinical Research Enterprise Research Teams of the Future

25 What is the NIH Roadmap? Framework of priorities that the NIH as a whole must address in order to optimize its entire research portfolio. Set of initiatives that are central to extending the quality of healthy life for people in this country and around the world. Vision for a more efficient and productive system of biomedical and behavioral research.

26 What are NIH’s key challenges? Management and operations Knowledge-based management of science  Developing modern decision support systems and tools to facilitate our operations and processes and analyze the NIH portfolio of research so that NIH can identify the research priorities that it must address as a whole  What is a decision support system (DSS)?  Also know as “Business Intelligence/Data Driven Decision Support System/Executive Information System Class of computerized information systems Support decision-making activities Five basic types, each driven by: Data, knowledge, documents, communications, and models

27 Knowledge Management – what are we talking about?  Involves identifying a group of people that have a need to share knowledge; developing technological support to enable sharing; and creating a process for transferring and disseminating that knowledge.

28 How does KM technology work? Depends – there are many tools for the various aspects/functions of KM and the kind of data (structured or unstructured): some NIH-relevant examples of KM functions to the right Modeling Collaborative group support Portals & interfaces Data & text mining, searches

29 Knowledge Management – how would NIH benefit from application of KM? Disease coding Peer review  Referral and assignment of applications  Identification of peer reviewers Portfolio analysis  Scientific trend analysis  Clinical relevance recognition tools Need-to-know-based security screening Clinical Center – clustering of clinical research

30 The ideal NIH Decision Support System Data Knowledge DocumentsCommunication Models “Knowledge-based management of science”

31 The bird has landed. Thank you for your patience. What is the NIH? How does the NIH work? What are the Key challenges? Addressing our challenges.

32 Grant Terminology Competing New - Research grant application requiring peer review; has not previously received funding; also referred to as a Type 1. Competing Renewal - Grant application requiring peer review to continue beyond its current funding segment; also known as Type 2. Noncompeting Renewal - Grant expected to receive continued support through the term of the grant award; has already gone through the peer review process; receives continuation costs based on IC staff review and commitments; also known as Type 5. Commitments- Administrative reservation of specific amount of available funds for a future obligation; subject to availability of appropriations. One-Time Costs- Nonrecurring cost associated with the start of a new activity. Grant Cohort- Group of individual grants that have a common fiscal start year. Modular Grant- A type of grant that budgets by modules $25K, in which direct costs can total $250,000 per year. Accounts for about half of R01 funds.