I t’s summer, a time when one of the most important decisions any of us makes is … what paperback to take on vacation. In Washington, one of the hottest new books just hit the press, and while you won’t see it reviewed in the New York Times, it’s a must-read. We’re referring, of course, to the Fiscal Year (FY) 1997 appropriations report for the National Institutes of Health (NIH) issued by the House of Representatives. (See report excerpts on opposite page.)
What it lacks in plot, it more than makes up for in intrigue and drama, as in: we’re very intrigued by the fact that the House Appropriations Committee has provided a 6.5-percent increase in the NIH budget, and there are some dramatic statements about the value of behavioral research and research training at NIH.
The passage of the NIH budget and the release of the appropriations report is the first major step in the FY97 appropriations process for NIH, and it has set a positive tone for the rest of the process. The 6.5-percent increase for NIH is a sign of strong support for science, not only because of the amount of money it represents (NIH is at $11 .9 billion in FY96) but also because it is happening at a time when some government agencies are facing deep cuts and uncertain futures. If the House numbers hold, this will be the second year in a row that NIH gets a substantial increase in its budget.
The appropriations report, which is about the size of a paperback book, amplifies Congress’s views on how NIH should be spending its budget. This year’s report addresses a number of issues that reflect APS’s priorities at NIH, particularly with regard to research training, which we conveyed in our NIH testimony (as reported in the May 1996 Observer).
In any year, this kind of recognition is no small feat, given the enormous competition for attention in the selective House committee report. But this year, it may be even more important than in previous years because it is occurring against the ongoing budget deficit debate, which at least publicly has been dominated by a cadre of legislators focused on very near-term budget cutting that is being driven either by fiscal or ideological causes.
Miles to Go
“While the House Committee’s budget and report language are both very good news, I caution everyone against becoming complacent,” notes Alan Kraut, Executive Director of APS. “We still have miles to go. The full House must approve the committee’s version of the NIH budget and the Senate will be developing its own version. Then the two need to be reconciled.”
“My view is that the House report represents a very good base, but we will continue working to preserve and even broaden Congress’s support for behavioral research as the budget moves through the ensuing steps of the appropriations process,” said Kraut. “I’m optimistic that the results will be a strong series of messages to NIH concerning new directions for expanding and strengthening its behavioral science portfolio.”
The House Appropriations Committee endorsed research training for behavioral science at several institutes as wel1 as at the overall NIH level. In their report, they strongly encouraged the use of B/START (Behavioral Science Track Awards for Rapid Transition) grants to ensure a supply of young behavioral science investigators at the National Institute on Child Health and Human Development (NICHD), the National Institute on Aging (NIA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). In addition, they asked the NIH Office of Behavioral and Social Sciences Research (OBSSR) to work with all institutes to develop small grants programs for young behavioral science investigators.
[B/START, you may recall, grew out of concerns about the “greying” of the field, as indicated by the decline in support for young investigators at the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), and elsewhere. APS worked on this with both Congress and NIMH, which launched the first B/START program in 1994. More recently, NIDA announced its own B/START program (see May/June 1996 Observer).]
The House Committee also has asked the NIH director to implement the recommendations of the National Academy of Sciences to increase the number of National Research Service Awards in behavioral sciences (as well as nursing, health services, and oral health research) while keeping level the number of biomedical science awards. To date, NIH has not implemented the NAS recommendations, and APS is concerned that this is a sign of their continued resistance to behavioral science.
Drug Abuse and Mental Health
The lawmakers underscored the importance of basic and clinical behavioral research in a number of areas, including drug abuse and mental health. In their report, they highlighted the importance of behavioral research in understanding and treating drug addiction, strongly commending NIDA’s expanding efforts in these areas. They also expressed support for NIDA’s research in HIV/AIDS, noting the role of drug use and related behaviors in the spread of HIV.
In the area of mental health, the House Committee said it was pleased to learn about the Human Capital Initiative (HCI) report on psychopathology research and added that in next year’s appropriations committee hearings, NIMH should discuss how it might use the report, Reducing Mental Disorders: A Behavioral Science Research Plan for Psychopathology. The committee also addressed the need to link basic and clinical research by encouraging NIMH to build a generation of basic behavioral researchers who are sensitive to clinical issues. (Copies of the HCI report are available from APS.)
Treatment Matching at NIAAA
NIAAA has undertaken a large patient-treatment initiative, Project MATCH, which has enormous implications for the effectiveness of behavioral therapies aimed at alcohol abuse. The House committee expressed interest in this project and requested a report on the results, which are expected out shortly.
On the heels of our May/June Observer featuring behavioral research at the National Institute on Neurological Disorders and Stroke (NINDS), the House Committee encouraged NINDS to better understand the role of behavior in diseases and injuries of the brain.
The House Committee also noted the importance of behavioral science at the Centers for Disease Control and Prevention (CDC), which has been increasingly interested in psychology and other areas of behavioral and social science research. Specifically, the committee commended CDC’s expanded efforts in behavioral and social sciences research, and expressed the view that these are important parts of the CDC mission. A status report on CDC’s efforts in these areas was also requested.
The excerpts from the report accompany this article. Don’t wait for the movie-read them now.
It’s not your typical summer fare (unless you’re a die-hard wonk), but we guarantee it will leave you anxiously awaiting the sequel, due out in the Senate this fall.