GOOD MORNING
EVERYONE.
AND I CAN'T THANK YOU ALL ENOUGH
FOR BEING HERE ESPECIALLY OUR
VISITORS FROM -- VISITORS -- OUR
PARTNERS FROM OUTSIDE NIH AND
FOR TAKING YOUR TIME.
WE KNOW HOW PRECIOUS YOUR TIME
IS, WE ARE SO GRATEFUL FOR YOUR
PARTICIPATION IN THIS VERY
IMPORTANT COMMITTEE FOR US AT
NIH.
WELCOME TO THIS CONVENING OF THE
SCIENTIFIC MANAGEMENT REVIEW
BOARD.
CONGRESS AUTHORIZED THE CREATION
OF THIS BOARD IN 2006 WITH THE
NIH REFORM ACT.
WITH THE GOAL OF ADVISING BOTH
NIH, AND HEALTH AND HUMAN
SERVICES OFFICIALS ON THE
ORGANIZATION OF OUR INSTITUTES
AND CENTERS AND OFFICES WITHIN
THE OFFICE OF THE DIRECTOR.
SO TODAY, NEXT SLIDE.
GOT THEM UP?
OKAY.
WE CAN JUST GO TO THE SECOND 1.
OKAY, SO TODAY I WILL SET THE
STAGE BY GIVING A BIG PICTURE
DESCRIPTION OF THE NIERK H
MISSION, HOW WE ARE CURRENTLY
ORGANIZED AND WHAT WE DO.
I WILL ADDRESS THE CONTEXT IN
WHICH WE'RE WORKING AND THE NEW
INITIATIVES THAT I THINK WE NEED
TO IMPROVE THE HEALTH OF THE
NATION AND I'LL CONCLUDE BY
PRESENTING THE CHARGE TO THIS
BOARD.
NEXT SLIDE.
AT NIH, WE'RE ACCOUNTABLE TO THE
AMERICAN PEOPLE.
OUR MISSION IS TO SEEK
FUNDAMENTAL KNOWLEDGE ABOUT
LIVING SYSTEMS AND TO APPLY THAT
KNOWLEDGE TO IMPROVE HEALTH FOR
EVERYONE.
WE FULFILL OUR MISSION BY
SUPPORTING THE FULL SPECTRUM OF
BIOMEDICAL RESEARCH FROM THE
MOST FUNDAMENTAL LEVEL TO BETTER
UNDERSTAND HOW MOLECULES AND
CELLS WORK, TO CLINICAL TESTING
OF DRUGS AND TECHNOLOGY, AND WE
ALSO SUPPORT RESEARCH BY
TRAINING AND FUNDING A CREATIVE
AND DIVERSE SCIENTIFIC
WORKFORCE.
THE BASIS OF OUR PROGRESS IS
CURIOSITY-DRIVEN SCIENCE AND WE
KNOW THIS FROM LOOKING AT THE
HISTORY OF HOW NEWLY APPROVED
DRUGS WERE DEVELOPED.
IT CAN BE MANY YEARS BEFORE A
STRAND OF FUNDAMENTAL KNOWLEDGE
WHICH MIGHT AT FIRST BE OF
INTEREST TO ONLY A VERY SMALL
NUMBER OF EXPERTS BECOMES
CRITICAL FOR DEVELOPING A NEW
DRUG OR OTHER TREATMENT THAT IS
INCREDIBLY VALUABLE TO THE
PEOPLE WE SERVE.
ONE THING WE KNOW, WE'VE TRIED,
IT IS IMPOSSIBLE TO PREDICT
ACCURATELY, WHICH DISCOVERIES
WILL BE THE REALLY IMPORTANT 1S.
SO, SUPPORTING A VERY BROAD
SCIENTIFIC PORTFOLIO WITH THE
CREATIVITY OF OUR ENTIRE NATION
AND INCREASINGLY THE WORLD IS
WHAT WE MUST DO TO MAXIMIZE THE
CHANCES FOR THE BREAKTHROUGHS
THAT WE NEED.
NEXT SLIDE.
PROBABLY I THINK MY HIGHEST
GUIDING PRINCIPLE IS THAT OUR
WORK IS NOT FINISHED WHEN WE
DELIVER SCIENTIFIC DISCOVERIES,
WE MUST HAVE THE VIEW THAT OUR
WORK IS FINISHED ONLY WHEN ALL
PEOPLE ARE LIVING LONG AND
HEALTHY LIVES.
NIH MUST SUPPORT SERVICES THAT
SUPPORT LABORATORY AND CLINIC
BUT WE KNOW THAT HEALTH IS NOT
JUST THE GENES WE INHERIT, NOT
JUST THE BIOLOGY WE ARE BORN
WITH.
IT INVOLVES DEEP -- IT GOES
DEEPLY INTO THE COMMUNITIES
WHERE WE LIVE, WHERE WE LIVE,
WHAT OUR ENVIRONMENT IS LIKE,
WHAT WE EAT, WHAT OUR
EDUCATIONAL ATTAINMENT, SO MANY
THINGS THAT ARE REALLY ABOUT OUR
COMMUNITIES AND THEREFORE, IT IS
VERY IMPORTANT THAT NIH RESEARCH
DOES NOT STOP AT THE DOOR TO THE
CLINIC BUT EXTENDS DEEPLY INTO
THE COMMUNITIES THAT WE SERVE.
NEXT SLIDE.
NIH IS THE LARGEST FUNDER OF THE
BIOMEDICAL RESEARCH IN THE WORLD
WITH A TOTAL BUDGET OF 47.4
BILLION DOLLARS IN FISCAL YEAR
2024.
THE VAST MAJORITY OF OUR
RESEARCH, OF OUR BUDGETS
SUPPORTS RESEARCH CONDUCTED
AROUND THE COUNTRY OUTSIDE OF
NIH, IN UNIVERSITIES, MEDICAL
SCHOOLS, RESEARCH CENTERS, SMALL
BUSINESSES, AND ALSO SUPPORTS
TRAINING OF THE NEXT GENERATION
OF BIOMEDICAL RESEARCHERS.
APPROXIMATELY 1 FIFTH OF THE
OVERALL BUDGET GOES TO SPENDING
AT NIH WITH ABOUT 11% GOING TO
SUPPORT RESEARCH BY NIH
INTRAMURAL SCIENTISTS.
NIH CONSISTS OF 27 CONGRESSALLY
MANDATED INSTITUTES AND CENTERS.
EACH HAS ITS OWN MISSION,
BUDGET, PRIORITIES, LEADERSHIP,
AND FUNDING STRATEGY.
HERE THEY'RE SHOWN AS CIRCLES,
SIZED IN PROPORTION TO THEIR
BUDGETS.
MOST INSTITUTES AND CENTERS
SUPPORT BOTH EXTRAMURAL RESEARCH
AND THEIR OWN RESEARCH
LABORATORIES ON NIH CAMPUSES.
NIH RESEARCH RANGES FROM THE
HIGHLY TECHNICAL, FOR EXAMPLE,
EXCITING NEW METHODS USING
CRYOELECTRON TOMOGRAPHY TO LOOK
AT COMPLETE INTACT TISSUES AT A
NANO GRAM LEVEL AND ALSO LOOK,
ALLOW, OBSERVATION OF PROTEIN
DYNAMICS IN REALTIME.
TOO, ON THE OTHER END OF THE
SPECTRUM, WE'RE CONDUCKED WITH
NATIVE AMERICAN COMMUNITIES
COMBINING TRADITIONAL HEALING
CEREMONIES WITH DRUG THERAPIES
AND COUNSELING FOR DEPRESSION,
CHRONIC PAIN, AND SUBSTANCE USE
DISORDER.
WE HAVE A VERY, VERY LARGE JOB
TO COVER THAT ENTIRE SPECTRUM.
NEXT SLIDE.
THE OFFICE OF THE DIRECTOR IS
THE CENTRAL OFFICE AT NIH
RESPONSIBLE FOR SETTING POLICY
FOR NIH AND FOR PLANNING,
MANAGING AND COORDINATING THE
PROGRAMS AND ACTIVITIES OF ALL
THE NIH COMPONENTS.
THIS INCLUDES THE OFFICE OF
EXTRAMURAL RESEARCH WHICH
PROVIDES THE CORPORATE FRAMEWORK
FOR NIH EXTRAMURAL RESEARCH
ADMINISTRATION, THE OFFICE OF
INTRAMURAL RESEARCH WHICH SERVES
A SIMILAR ROLE OF OVERSIGHT AND
POLICY DEVELOPMENT FOR
INTRAMURAL RESEARCH.
PART OF MY ROLE AS NIH DIRECTOR
IS TO PREVENT SILOS AND TO
INSURE EFFECTIVE CROSS AGENCY
COLLABORATIONS TO ACHIEVE COMMON
GOALS.
AND IMPORTANTLY, TO ACHIEVE
GOALS THAT CANNOT OTHERWISE BE
ACHIEVED WITHOUT COORDINATION
ACROSS THE ENTIRE ENTERPRISE.
SOME OF OUR MOST IMPORTANT
ACCOMPLISHMENTS COME FROM
EFFORTS THAT SPAN MANY DIFFERENT
INSTITUTES AND CENTERS BUT ALSO
INCREASINGLY, OTHER U.S.
AGENCIES AND ACROSS DISCIPLINES,
EFFORTS LIKE PUBLIC PRIVATE
PARTNERSHIPS, AND EFFORTS THAT
BRIDGE THE GAP BETWEEN BENCH AND
COMMUNITY.
ONE OF OUR KEY OFFICES IN THE
OFFICE OF THE DIRECTOR IS THE
DIVISION OF PROGRAM
COORDINATION, PLANNING AND
STRATEGIC INITIATIVES, OTHERWISE
KNOWN AS DPC PSI, NEXT SLIDE.
THIS OFFICE OF HELPED TO
IMPLEMENT THE RENIH REFORM ACT
OF 2006 ALONG WITH THIS BOARD
THE SMRB, THE DPC PSI PLANS,
COORDINATES TRANSNIH INITTIAIVE
ITS AND RESEARCH SUPPORTED BY
THE NIH COMMON FUND AND DEVELOPS
RESOURCES THAT SUPPORT OUR
CRITICAL PORTFOLIO ANALYSIS.
IT ALSO HAS THE ROLE OF
IDENTIFYING EMERGING SCIENTIFIC
OPPORTUNITIES, PUBLIC HEALTH
CHALLENGES AND KNOWLEDGE GAPS
THAT WARRANT FURTHER RESEARCH.
THE OFFICE OF STRATEGIC
COORDINATION SHOWN HERE IN THE
BOTTOM ROW IS RESPONSIBLE FOR
MANAGING THE CRITICAL COMMON
FUND PROGRAMS.
NEXT SLIDE.
SO NOW A LITTLE BIT ABOUT THE
COMMON FUND.
THIS ESTABLISHED IN 2006
PROMOTES INTERDISCIPLINARY
RESEARCH WITH A FOCUS ON
BUILDING SCIENTIFIC
INFRASTRUCTURE.
IT ALLOWS THE NIH DIRECTOR TO
DIRECT FUNDING TO IMPORTANT
MATTERS THAT HAVE NOT OTHERWISE
RECEIVED SIGNIFICANT FUNDING AND
TO MOVE VERY QUICKLY ON RESEARCH
OPPORTUNITIES OF HIGH PRIORITY.
TO LAWRCH A COMMON FUND PROGRAM,
THE OFFICE OF STRATEGIC
COORDINATION IDENTIFIES A HIGH
PRIORITY CHALLENGE FOR THE
SCIENTIFIC COMMUNITY AND THEN
MULTIPLE INSTITUTES AND CENTERS
MUST COME TOGETHER TO
COLLABORATE ON THE ISSUE.
SOME EXAMPLES OF COMMON FUND
PROJECTS ALONG WITH THE
INSTITUTES PARTICIPATING ARE
LISTED HERE.
THE FOCUS FOR THIS WORK IS
DEVELOPING TOOLS AND APPROACHES
THAT WE THEN MAKE WIDELY
AVAILABLE TO THE ENTIRE
SCIENTIFIC COMMUNITY.
ONE OF THE MOST IMPORTANT
ACCOMPLISHMENTS OF THE COMMON
FUND, I HAVE TO SAY, NOW BEING
PRESENT FOR ALMOST 20 YEARS HAS
BEEN TO PROMOTE A CULTURE OF
COLLABORATION ACROSS ALL THE
DIFFERENT NIH INSTITUTES AND
CENTERS AND I AM VERY PROUD TO
SAY THAT THIS CROSS CENTER
COLLABORATION AND CULTURE IS NOW
COMMON PRACTICE.
NEXT SLIDE.
MANY COLLABORATIONS ACROSS
INSTITUTES AND CENTERS ARE NOT
LED BY ACTUALLY, 2 MY POINT, NOT
LED BY THE OFFICE OF THE
DIRECTOR BUT HAVE COME FROM THE
DIFFERENT INSTITUTES AND CENTERS
WHO HAVE DECIDED TO WORK
TOGETHER ON MULTIFACTORIAL
PROBLEMS SUCH AS THE OPIOID
CRISIS.
THE NIH HEAL INITIATIVE IS IN
COLLABORATION ACROSS 18
DIFFERENT NIH INSTITUTES AND
CENTERS.
IT IS SUPPORTED MORE THAN 1800
PRONG ECTOMYOSINS IN ALL 50
STATES INCLUDING MORE THAN 300
CLINICAL TRIALS TO TEST
INTERVENTIONS FOR OPIOID USE
DISORDER AND OVERDOSE AND ALSO
CRITICALLY IMPORTANT TO TACKLE
THE ROUTE CAUSES OF OPIOID USE
DISORDER WHICH IS CHRONIC PAIN
AND OTHER MENTAL HEALTH ISSUES.
NEXT SLIDE.
ANOTHER 1 WAS LAUNCHED WITH
CONGRESSIONAL SUPPORT IN 2018,
THE INCLUDE PROJECT WHICH STANDS
FOR INVESTIGATING CO OCCURRING
CONDITIONS ACROSS THE LIFE SPAN
TO UNDERSTAND DOWNS SYNDROME.
THIS IS AN OFTEN OVERLOOKED
POPULATION.
PEOPLE WITH DOWNS SYNDROME, THE
PROJECT INVOLVES 14 DIFFERENT
NIH INSTITUTES AND CENTERS.
DOWN SYNDROME CONCISIONS TO MANY
CONDITIONS ACROSS THE LIFE SPAN
AND ACROSS ICs, INCLUDING
ALZHEIMER'S DISEASE, DISEEP
DEFICITS, HEARING DEFICITS AND
SLEEP APNEA, SO IT'S IMPORTANT
TO BRING ALL THESE INSTITUTE
TOGETHER THAT FOCUS ON ALL THESE
DISPARATE CONDITIONS.
ONE OF THE WONDERFUL THINGS
THAT'S BEEN ACCOMPLISHED FOR
PEOPLE WITH DOWN SYNDROME IS
THAT THEIR LIFE SPAN HAS
INCREASED DRAMATICALLY AND ALSO
NOW, THOUGH, WE ARE ALSO
UNCOVERING A NEED TO CONQUER
SOME OF THE OTHER EFFECTS WHICH
SHOW SOME ACCELERATION IN PEOPLE
WITH DOWNS SYNDROME.
NEXT SLIDE.
SO THE EXTRAMURAL PROGRAM, JUST
A BRIEF SNAPSHOT HERE, 80% OF
THE NIH BUDGET GOES TO FUNDING
EXTRAMURAL PROJECTS.
GRANTS AND PROJECTS IN ALL 50
STATES AS WELL AS WASHINGTON D.
C.
EVERY YEAR APPROXIMATELY 80,000
APPLICATIONS ARE REVIEWED BY
29,000 REVIEWERS AND
APPROXIMATELY 350,000
INVESTIGATORS ARE FUNDED ACROSS
MORE THAN 2700 DISTINCT
INSTITUTIONS.
THESE ARE RESEARCH PROJECT
GRANTS, SMALL BUSINESS
APPLICATIONS, AND TRAINEE
AWARDS, NEXT SLIDE.
SO HOW DO WE KEEP TRACK, HOW DO
WE KNOW WHAT WE'RE FUNDING IN
THIS GINORMOUS ENTERPRISE.
WELL, MONITORING THE NIH
PORTFOLIO OVERALL AND WITHIN AN
INSTITUTE OR CENTER, OR THE
OFFICE OF THE DIRECTOR OVERALL
IS A VERY IMPORTANT ACTIVITY.
SO THIS IS HOW THIS FIGURE WAS
DEVELOPED.
IT WAS CREATED USING WORD
EMBEDDING DESCRIPTIONIVE AI THAT
CAN EXTRACT SEMANTIC MEANING
FROM WHAT, WENT INTO THIS, THE
GRANT TITLES, THE GRANT
ABSTRACTS, BUT EVEN MORE
IMPORTANT, ALL THE PUBLICATION
TITLES AND PUBLICATION ABSTRACTS
THAT RESULTED FROM THOSE AWARDS.
SO BOTH THE FUNDING AND THE
PRODUCTIVITY THAT CAME OUT OF
THE FUNDING.
THE SIZES OF THE NOTES OR THE
CIRCLES SHOW THE RELATIVE
PERCENTAGE OF ALL NIH FUNDED
RESEARCH THAT WENT TO THESE
SELECTED AREAS.
THERE'S 28 TOPICS SHOWN HERE.
OBVIOUSLY THIS CAN BE EXPANDED
AND CONTRACTED IN MANY WAYS.
THIS IS I THINK 1 OF THE BEST
GLOBAL VIEWS OF EVERYTHING WE
DO.
THE LINES BETWEEN THE NODES ARE
ALSO REALLY VALUABLE, THEY
REPRESENT THE CONNECTIONS
BETWEEN THESE DIFFERENT TOPICS,
AGAIN, ILLUSTRATED BY LOOKING AT
THE REAL FUNDED PROJECT AND
THEIR PRODUCTIVITY.
THICKER LINES INDICATE GREATER
CONTENT SIMILARITY BETWEEN THE
TOPICS AND THEN, THIS WAS ME
TAKING A SHOT AT BEING ABLE TO
HAVE A VISUAL REPRESENTATION.
THE BLUE ROUGHLY CORRESPONDS TO
MORE BASIC SCIENCE RESEARCH.
THE YELLOW MORE TRANSLATIONAL
RESEARCH AND THE GREEN MORE
CLINICAL RESEARCH ALTHOUGH
THAT'S A VERY, VERY LOOSE
DISTINCTION BUT IT DOES KIND OF
GIVE YOU AN EYE ABOUT 50% IN THE
BLUE AND THE REST SPREAD AMONG
TRANSLATIONAL AND CLINICAL.
NEXT SLIDE.
SO NIH'S CLINICAL CENTER HERE ON
THE MAIN CAMPUS IN BETHESDA
MARYLAND IS THE LARGEST CLINICAL
RESEARCH CENTER IN THE WORLD,
THE ONLY HOSPITAL IN THE COUNTRY
DEVOTED ENTIRELY TO BIOMEDICAL
RESEARCH.
HERE INTRAMURAL CLINICIAN
SCIENTISTS PARTNER WITH PATIENTS
AND HEALTHY VOLUNTEERS TO STUDY
THE NATURAL HISTORY OF DECS AND
TO EVALUATE NOVEL INTERVENTIONS
AND CLINICAL TRIALS AND THE GOAL
OF THE CLINICAL CENTER IS TO DO
THE WORK THAT EITHER CANNOT BE
DONE BY ANYONE ELSE BECAUSE IT
REQUIRES TRULY UNIQUE RESOURCES
AT NIH, OR NEEDS TO HAVE A FOCUS
THAT THE NIH INTRAMURAL GROUP
CAN BEST PROVIDE, BUT STILL IS
DONE IN THE COLLABORATION WITH
EXTRAMURAL PARTNERS, AND I WILL
SAY, MANY, MANY PEOPLE WITH RARE
DISEASES RECEIVE THEIR CARE AT
THE CLINICAL CENTER.
NEXT SLIDE.
THE INTRAMURAL RESEARCH PROGRAM
ALSO SUPPORTS LABORATORIES LED
BY MORE THAN A THOUSAND
PRINCIPAL INVESTIGATORS THAT
CONDITION DUCT MORE THAN 3000
PROJECTS AND ALSO SERVES IN A
CRITICAL ROLE TRAINING MORE THAN
2000 POST DOCS AND MORE THAN
2000 PREDOCS AND POST BACKS IN
ANY GIVEN YEAR.
I THINK THIS IS REALLY AN
UNDERAPPRECIATED, AND INCREDIBLE
CONTRIBUTION TO THE BIOMEDICAL
RESEARCH WORKFORCE WHEN YOU
THINK THAT THIS IS THE LARGEST
AGENCY DEVOTED ENTIRELY TO
RESEARCH.
SO THINK ABOUT THE EXPERIENCE
THAT THESE TRAINEES GET
PARTICULARLY THOSE I WILL CALL
OUT WHO ARE CLINICIAN-SCIENTISTS
WHICH AS WE KNOW IS GETTING
INCREASINGLY DIFFICULT DESPITE
OUR BEST EFFORTS TO SUPPORT.
OKAY, SOME THINGS I THINK ARE
CRITICALLY IMPORTANT THAT WE
NEED TO PAY ATTENTION TO AT NIH.
WE KNOW OUR PURPOSE WITH ALL
THIS RESEARCH IS 1 THING, ALL
PEOPLE LIVING LONG AND HEALTHY
LIVES BUT I AM TRULY CONCERNED
THAT WE'RE LOSING GROUND.
THE OVERALL HEALTH OF THE U.S.
POPULATION IS NOT WHERE IT
SHOULD BE.
OUR HEALTHCARE SYSTEM, UNDER
PERFORMS THOSE OF OTHER RICH
NATIONS.
COMMONWEALTH REPORT THIS YEAR,
WE WERE 10 OUT OF 10 AND WE GOT
A 10 IN ALL THE SUBCATEGORIES,
WE GOT A 10, LAST PLACE IN
HEALTH OUTCOMES DESPITE THE FACT
THAT WE SPEND SIGNIFICANTLY MORE
MONEY THAN THE OTHER COMPARITTOR
COUNTRIES.
NEXT SLIDE, AND THIS SLIDE IS
ALSO DEEPLY TROUBLING.
YOU CAN SEE A FEW GREEN POCKETS
WHICH IS HIGH LIFE EXPECTANCY
AROUND THE COUNTRY WHERE
DIFFERENT GROUPS OF PEOPLE ARE
DOING FAIRLY WELL, BUT FOR SOME
DEMOGRAPHICS, PARTICULARLY,
BLACK AMERICANS, NATIVE
AMERICANS, AMERICAN INDIANS AND
ALASKA NATIVES, PEOPLE WHO LIVE
IN RURAL AREAS, LIFE EXPECTANCY
IS PARTICULARLY LOW AND WE AT
NIH TAKE THIS CREDIBLY SERIOUSLY
AND REALLY NEED TO DIRECT
PROGRAMS TO OVERCOMING IN ISSUE.
NEXT SLIDE.
WHAT CAN WE DO?
WELL, HERE'S THE FIRST LARGE
LANDMARK PROGRAM TO ATTACK THIS
DIRECTLY.
WE HAVE TO DO A BETTER JOB OF
CONNECTING THE LABORATORY, AND
THE COMMUNITY CAN TO THIS END WE
RECENTLY LAUNCHED A NEW COMMON
FUND BECAUSE WE COULD GET IT UP
AND RUNNING VERY QUICKLY,
RESPONDING TO THIS WITH URGENCY,
A COMMON FUND PROGRAM CALLED
CARE FOR HEALTH.
IN SEPTEMBER WE ANNOUNCED THE
FIRST 3 PILOT AWARDS FOR WHAT IS
A NEW PRIMARY CARE CLINICAL
RESEARCH NETWORK, PRIMARY CARE
BECAUSE IT'S THOSE ON THE FRONT
LINES OF HEALTH THAT WE NEED TO
ENGAGE IN RESEARCH TO TACKLE
THOSE PROBLEMS THAT WE SEE SO
PROMINENTLY DISPLAYED IN
COMMUNITIES THAT HAVE
TRADITIONALLY BEEN LEFT OUT OF
BIOMEDICAL RESEARCH.
WE'RE STARTING SMALL.
OUR GOAL IS TO BUILD -- IS TO
LEARN HOW TO BRING SUSTAINABLE
HIGH QUALITY RESEARCH TO THESE
CHALLENGING COMMUNITIES AND
TRULY ENGAGE THE COMMUNITIES
THEMSELVES IN THE CLINICAL
RESEARCH.
I THINK THAT THIS IS ALSO A
CRITICAL PROGRAM FOR US TO
ENGENDER TRUST IN SCIENCE BY
BEING DEEPLY INVOLVED IN
COMMUNITIES, ADDRESSING RESEARCH
QUESTIONS, THAT MATTER TO THEM.
NOT ONLY WILL WE BE COLLECTING
INFORMATION FOR RESEARCH, THIS
NEW NETWORK, AS WE KNOW FROM
RESEARCH SUCCESSES ELSEWHERE,
WILL BE HELPING TO DELIVER
EVIDENCE BASED CARE TO
PARTICIPANTS.
THE INITIATIVE WAS INSPIRED BY
MY OWN EXPERIENCE BEFORE I CAME
TO NIH.
I PARTICIPATED IN NCI SPONSORED
RESEARCH ON THE PINE RIDGE
INDIAN RESERVATION.
A PLACE WITH THE LOWEST LIFE
EXPECTANCY OF ANY PLACE IN THE
UNITED STATES, ONLY 49 YEARS FOR
MEN AND 31 YEARS FOR WOMEN.
WE WERE ABLE TO -- AND WHEN NCI
INCREASED RATES OF FUNDING
SCREENINGS, REDUCE TOBACCO
RESEARCH AND USE OF RESEARCH
DOLLARS DEFINITELY DELIVERED
CARE TO PIN RIDGE, HOWEVER,
THERE WERE 2 BIG PROBLEMS WITH
THIS PROGRAM.
FIRST, WE HAD ONLY FUNDING TO
STUDY CANCER AND YOU CANNOT GO
INTO AN ENVIRONMENT LIKE PINE
RIDGE OR SO MANY OF THESE OTHER
PLACES WE NEED TO SERVE AND SAY,
HEY, I'M ONLY HERE FOR CANCER.
WE HAVE TO TAKE CARE OF ALL OF
THEIR HEALTH RESEARCH ISSUES.
AND THEN SECOND, WHEN THE GRANT
WAS ENDED, WE WERE GONE.
WE NEED SUSTAINABILITY IN THESE
COMMUNITIES, THAT'S CRITICAL.
SO CARE FOR HEALTH IS AN
NIH-WIDE PROGRAM, THE RESEARCH
COVERED WITH THE PARTICIPATION
OF WITH ALL OF OUR INSTITUTES
AND CENTERS WILL ENCOMPASS THE
RANGE OF URGENT HEALTH ISSUES,
DIABETES, OBESITY, MATERNAL
HEALTH, SUBSTANCE ABUSE, CANCER
SCREENING, MENTAL HEALTH,
DEMENTIAS AND SO ON AND ALSO
WILL BE DONE BY GIVING
COMMUNITIES WHAT THEY NEED
RATHER THAN ASSUMING THAT 1
RESEARCH PROGRAM IS GOING TO FIT
ALL BECAUSE WE ALREADY KNOW
THAT'S NOT GOING TO WORK.
NEXT SLIDE.
MY SECOND PRIORITY AS DIRECTOR
IS TO HARNESS RESEARCH AND
HEALTH DATA.
WE'VE BEEN TALKING ABOUT OPENING
UP ACCESS TO BIOMEDICAL RESEARCH
DATA FUNDED BY NIH FOR DECADES.
TWO YEARS AGO, THIS JANUARY, WE
MADE IT A REQUIREMENT FOR EVERY
GRANTEE, EVERY NEW GRANTEE TO
MAKE THEIR DATA AVAILABLE FOR
SHARING.
BUT WHAT WE HAVEN'T DONE IS MADE
IT POSSIBLE TO HAVE DATA
ACCESSIBLE TO EVERYONE WHO CAN
-- EVERY RESEARCHER WHO NEEDS IT
TO DO THEIR WORK.
WE NEED TO DRAMATICALLY EXPAND
OUR ABILITY TO MANAGE AND USE
DATA FOR HEALTH RESEARCH.
I THINK WE -- I WOULD LIKE US TO
REIMAGINE THE ROLE OF NLM, BUILD
AN OPEN SCALABLE FEDERATED
DIGITAL ECOSYSTEM FOR ACCESS TO
BIOMEDICAL DATA AND ANALYTICS.
WE NEED AN NLM THAT CAN
INTEGRATE DAT FROM ACROSS THE
FULL SPECTRUM OF WHAT NIH DOES
FROM BASIC AND SOCIAL SCIENCE
RESEARCH PUBLIC HEALTH AND
CLINICAL CARE AND SERVE AS AN
EPICENTER FOR THE ANALYSIS OF
THESE DATA, A FOCUS WITHIN NIH
FOR DATA SCIENCE.
NIH CAN ALSO BE A FRONT DOOR
WHERE BIOMEDICAL AND CLINICAL
RESEARCH, DOMAIN EXPERTS,
TRAINEES, PATIENTS, ADVOCATES
AND ANYONE ELSE SEEKING ANSWERS
TO RESEARCH CAN GET ACCESS TO
THE DATA AND ANALYTIC TOOLS AND
TO ALSO SUPPORT EDUCATION ASK
WORKFORCE DEVELOPMENT AS PART OF
THIS EFFORT.
I WILL TELL YOU MY VISION, WE
WOULD LIKE THE NOBEL LAUREATE
WHO WANTS TO STUDY SOME EXCITING
FANTASTIC QUESTION AND REQUIRES
REQUIRES
DATA FROM EVERYTHING THAT NIH
HAS GENERATED TO BE ABLE TO GO
TO NLM AND BE OFFERED
INTRODUCTION TO AND ACCESS TO
THOSE DATA AND I ALSO WANT A
HIGH SCHOOL SCIENCE FAIR STUDENT
TO BE ABLE TO COME TO NLM AND
SAY, I'M INTERESTED IN SOME
SCIENCE QUESTION THAT'S
INTERESTING TO ME AND IT'S ALSO
TO BE ABLE TO HELP THEM USE THE
DATA THAT WE HAVE FOR PUBLIC
USE.
SO, THAT'S HOW SERIOUSLY WE ARE
TAKING THE SCOPE OF WHAT NLM WE
BELIEVE NEEDS TO DELIVER FOR THE
WORLD.
WE'RE CURRENTLY RECRUITING A NEW
DIRECTOR FOR NLM WHO WILL JOIN
OUR ESTABLISHED LEADERS IN DATA
TECHNOLOGY, DATA SENTENCE AND
PUBLIC POLICY.
OKAY, NOW TO END.
NEXT SLIDE.
THE MSMRB RESTART, NIH CAN DO
WHAT NO OTHER ENTITY CAN
FRANKLY, PROVIDE CONSIST AND
THEN THE WIDE RANGING SUPPORT
FROM THE SPECTRUM FROM
FUNDMENTAL RESEARCH TO BRINGING
A PROBLEM-SOLVING RESEARCH
APPROACH TO ADDRESSING HEALTH
DISPARITIES, TO PARTNERING WITH
ACADEMIC INSTITUTIONS TO TRAIN
BIOMEDICAL RESEARCHERS, AND TO
MAKE BIOMEDICAL RESEARCH DATA
FROM EVERYWHERE AS WELL AS THE
ANALYTIC TOOLS REQUIRED
AVAILABLE TO THE BROADEST
POSSIBLE RESEARCH COMMUNITY.
SO YOUR CHARGE, AS THE SMRB IS
TO HELP US EVALUATE THE CURRENT
STRUCTURE OF NIH.
LET US KNOW HOW WE CAN CHANGE
OUR ORGANIZATION TO HELP US
BETTER FULFILL OUR MISSION,
CHANGE IS ALWAYS IMPORTANT.
WE CAN ALWAYS DO BETTER.
WE'RE ASKING YOU TO REEXAMINE
THE 2010 SMRB REPORT
DELIBERATING ORGANIZATIONAL
CHANGE AND EFFECTIVENESS, SHOULD
WE UPDATE THE CRITERIA FOR
DETERMINING WHEN ORGANIZATIONAL
CHANGE SHOULD BE CONSIDERED,
WE'RE ASKING YOU TO CONSIDER
RECENT PROPOSALS FROM CONGRESS
FOR REORGANIZING NIH, AND TO RE,
VALENTINEDUATE THE EXISTING
GUIDANCE FOR DELIBERATING
PROPOSED ORGANIZATIONAL CHANGES.
ULTIMATELY, BASED UPON UPDATED
CRITERIA AND PRINCIPLES, WE
WOULD LIKE YOUR RECOMMENDATIONS
FOR ANY CHANGES THAT WILL
ENHANCE THE ABILITY OF OUR
AGENCY TO FULFILL ITS
EXCEEDINGLY IMPORTANT MISSION.
SO NEXT SLIDE.
THANK YOU SO MUCH AGAIN FOR
BEING HERE TO DELIBERATE YOUR
EXPERT HELP.
WE NEED YOU AND I WOULD BE HAPPY
TO TAKE ANY QUESTIONS.
>> OKAY, MONICA.
THANK YOU.
WE HAVE PLENTY OF TIME FOR
QUESTIONS WHILE WE HAVE MONICA
HERE, SO IF ANYBODY WOULD LIKE
TO START?
PLEASE, JOSH.
>> THANK YOU.
JOHN AND I WERE TALKING ABOUT
THIS A LITTLE BIT, SO, ON A
BROADER SCALE IMIVEN -- GIVEN
THE LACK OF TRUST IN MANY
COMMUNITIES IN SCIENCE,
SCIENTIFIC METHOD AND SO FORTH,
WHAT DO YOU THINK THE NIH CAN DO
OR SHOULD DO TO TRY TO BETTER
EDUCATE THE PUBLIC AT LARGE,
CONGRESS AND SO FORTH?
THIS ISN'T A POLITICAL QUESTION,
THIS IS A QUESTION RELATED TO
TRUST AND I JUST WONDERED WHAT
YOUR THOUGHTS ARE MADAM
DIRECTOR.
>> TRUST HAS TO BE EARNED AND IT
HAS TO BE EARNED EVERY SINGLE
DAY, YOU KNOW ANYTHING CAN
DAMAGE TRUST AND SO IT'S
SOMETHING THAT WE NEED TO PAY
ATTENTION TO ALWAYS.
AND THE WAYS YOU ENTRUST ARE
FIRST AND FOREMOST DELIVERING
WHAT PEOPLE NEED, PRODUCING,
REALLY, MOVING THE NEEDLE ON THE
HEALTH PROBLEMS THAT ARE
PLAGUING PEOPLE AND MAKING IT
VERY CLEAR AND BEING VERY CLEAR
AND TRANSPARENT AS TO WHY AND
HOW THE -- ALL OF THE RESULTS
THAT COME OUT OF NIH HELP TO
ACHIEVE THAT.
THE OTHER 1 THOUGH, AND YOU CAN
SEE IN THE DESIGN FOR CARE FOR
HEALTH, I THINK THIS IS ALSO
CRITICALLY IMPORTANT IS TO BRING
OUR RESEARCH TO COMMUNITIES THAT
ARE EXPERIENCING THE HIGHEST
LEVEL OF DISTRUST AND NOT TO
WALK IN THERE AND SAY, HEY,
WE'RE IN THE NIH, WE KNOW WHAT
YOU NEED, WE'RE HERE TO TELL YOU
WHAT TO DO, BUT TO WALK IN AND
SAY WHAT DO YOU NEED?
WHAT ARE YOUR MOST CONCERNING
QUESTIONS IN AND THEN DELIVER
FOR THEM WHAT THEY'RE ASKING, SO
THAT'S -- THAT'S THE PLAN, AND
I'M REALLY -- IT WILL ALSO SAY
THAT MY INTERACTIONS WITH
MEMBERS OF CONGRESS HAVE BEEN
VERY FAVORABLE IN THIS REGARD
BECAUSE I THINK THIS IS A
POLITICAL ISSUE, BUT WE'RE
REALLY ALLOT SAME PAGE IN TRYING
TO MAKE THIS HAPPEN.
>> OTHER COMMENTS OR QUESTIONS?
>> THANK YOU FOR THAT EXCELLENT
OVERVIEW, I THINK WE'RE ALL FROM
DIFFERENT VERY DIVERSE
SCIENTIFIC BACKGROUNDS AND THE
PROGRAMS THAT YOU HIGHLIGHTED
ARE OUTSTANDING BUT WE ALSO KNOW
THAT WE LIVE IN A CONSTRAINED
MONETARY ENVIRONMENT AND
ALTHOUGH IT'S NOT OUR JOB ON
THIS COMMITTEE TO LOOK AT THE
FINANCIAL ASPECTS OF IT, IT
WOULD BE HELPFUL TO HEAR YOUR
OPINION AS TO HOW THE DECISION'S
MADE TO GET TO THESE OUTSTANDING
PROGRAMS CAN BE AFFECTED BY THE
FUNDING SO THAT WE CAN
INCORPORATE THAT INTO OUR
CONVERSATIONS.
>> YEAH, SO REALLY CRITICAL
QUESTION.
SO A COUPLE THINGS ABOUT THESE
NEW, THESE LARGE PROGRAMS.
I'M SURE IT'S NO SURPRISE THAT,
I MEAN I THINK THESE ARE
CRITICALLY, CRITICALLY IMPORTANT
PROGRAMS THAT ARE GOING TO HELP
LEVERAGE AND AMPLIFY ALL THE
WORK THAT'S DONE ACROSS NIH
ALREADY.
SO THE VALUE ADDED TO A DOLLAR
SPENT ON A BASE -- THESE BASE
FUNDAMENTAL PROJECT PROGRAMS FOR
WHICH EVERY INSTITUTE AND CENTER
CAN THEN DOCK-IN AND USE IS
TREMENDOUS.
SO IN TERMS OF I THINK OF WISE
USE OF THE DOLLARS TO GET THE
VERY MOST WE CAN OUT OF THOSE
INVESTMENTS TO DRIVE SCIENCE
FORWARD IS WHY THESE PARTICULAR
PROJECTS -- BESIDES THAT THEY
ARE RELATED TO CRITICAL NEED
SYSTEM WHY I THINK THESE
PARTICULAR PROJECTS ARE THE
RIGHT WAY TO GO.
NOW, THE OTHER THING IS THAT OUR
INSTITUTES AND CENTERS NEED TO
MAKE VERY DIFFICULT DECISIONS
ALL THE TIME BUT IT IS EASIER TO
MAKE SOME OF THOSE DIFFICULT
DECISIONS IF THERE'S A
COLLABORATIVE ENVIRONMENT AND
AGAIN, LEVERAGING TRADE-OFFS,
WORKING TOGETHER, REALLY GOES A
LONG WAY WHEN YOU GET TO DOLLAR
CONSTRAINTS.
THE LAST THING I WILL SAY IS
THAT, WE ALSO UNDERSTAND THAT
THERE'S A VERY LARGE BIOMEDICAL
RESEARCH COMMUNITY IN OUR
EXTERNAL COMMUNITY THAT REALLY
COUNTS ON THE FUNDING THAT COMES
FROM NIH, AND MAXIMIZING OUR
INVESTMENT IN INVESTIGATOR
INITIATIVE SCIENCE IS ALSO A
CORE FEATURE OF EVERYTHING WE
DO.
>> THANK YOU.
THANK YOU FOR THAT.
>> OTHER COMMENTS?
>> THANK YOU VERY MUCH.
VERY EXCITING.
AI IS CHANGING EVERYTHING WE DO
AND HOW IS THE NIH GOING TO
INCORPORATE THIS RAPIDLY
EXPLODING TECHNOLOGY AND ALSO
PLAN FOR THE NEXT GENERATION OF
INVESTIGATORS?
>> SO, NOW MACHINE LEARNING
METHODS ARE EVERYWHERE NOW BUT
THEY'RE NOT NEW TO NIH.
AS YOU KNOW WE'VE BEEN USING
THESE METHODS FOR DECADES
FRANKLY, RIGHT NOW, SO THEY'RE
NOT UNFAMILIAR TO US.
THEY ARE UNFAMILIAR TO EVERYONE
ELSE OUT THERE AND THERE IS ALSO
AN EXPLOSION OF USE.
SO WE HAVE A COUPLE CRITICAL
THINGS THAT ARE CORE TO OUR
STRATEGY ABOUT NEW MACHINE
LEARNING METHODS, NUMBER 1,
PROVIDE A FOCUS FOR THE
BIOMEDICAL RESEARCH COMMUNITY
FOR EDUCATION AND WORKFORCE
SUPPORT OF THESE NEW
TECHNOLOGIES, WHAT THEY MEAN,
WHEN THEY SHOULD BE USED AND
THAT WORKFORCE DEVELOPMENT HAND
IN HAND WITH REALLY SOUND
ETHICAL POLICY.
SO, YOU KNOW THIS IS A GREAT
EXAMPLE OF THE STRENGTH OF THE
PROGRAMS WE HAVE HERE AT NIH,
RIGHT?
BECAUSE WE HAVE WITHIN THE
OFFICE OF THE DIRECTOR AN
OUTSTANDING, ALL THE PARTS AND
PIECES WE NEED TO MAKE THAT
HAPPEN.
SO THAT'S THE WORKFORCE.
NUMBER 2, THE DATA.
THESE METHODS DON'T HAPPEN
WITHOUT DATA TO TRAIN THEM AND
INFORM THEM AND THAT DATA ISN'T
1 AND DONE,, IT'S A CONTINUAL
STREAM OF REALLY IMPORTANT,
DIVERSE DATA THAT NEEDS TO
INFORM THESE METHODS.
THAT'S ANOTHER REASON WHY I
BELIEVE WE NEED A TREMENDOUS
UPGRADE OF OUR ACTIVITIES IN THE
NATIONAL LIBRARY OF MEDICINE FOR
DATA SHARING AND ALSO TO BE ABLE
TO ACQUIRE DATA FROM PEOPLE
ACROSS THE FULL SPECTRUM OF
THOSE WHO LIVE IN THE UNITED
STATES AND THOSE ARE -- THOSE
ARE BIG EFFORTS THAT WE'LL TAKE
-- THAT WILL BE A SIGNIFICANT
LIFT, BUT THOSE ARE OUR HIGHEST
PRIORITIES AS WELL.
>> THAT WAS A GREAT
PRESENTATION, SOMETHING TO HEAR,
I GUESS MY QUESTION KIND OF
RELATES TO SOME OF THE POTENTIAL
ORGANIZATIONAL CHANGES AND
THINGS THAT THIS COMMITTEE WOULD
WORK ON, WHERE IT'S OBVIOUSLY SO
LABOR INTENSIVE TO IMPLEMENT
THOSE CHANGES, BUT MY QUESTION
IS MORE ARK ASSESSESMENT OF HOW
THOSE CHANGES WILL IMPACT THOSE
OUTCOMES THAT YOU SO ELOQUENTLY
SPOKE TO WHICH IS ALSO JUST AS
IMPORTANT I THINK, DOWN THE ROAD
FOR THOSE CHANGES.
YEAH, AND TO REALLY ANSWER YOUR
QUESTION, YOU KNOW, WE WOULD
HAVE TO DEAL WITH THE SPECIFICS,
RIGHT BECAUSE, YOU KNOW, ANY
CHANGE CAN CREATE BENEFIT AND
UNINTENDED CONSEQUENCES AND I
THINK THE SPECIFICS REALLY,
REALLY MATTER.
I CAN SAY THAT AGAIN, IN THIS
TIME WHEN WE HAVE TO BE -- WE
HAVE TO USE EVERY DOLLAR WE GET
FROM THE PUBLIC IN THE VERY BEST
POSSIBLE WAY TO PRODUCE THE VERY
BEST POSSIBLE RESEARCH.
AND THERE ARE ALWAYS DISCUSSIONS
OUT THERE AS TO WHAT THE
STRATEGIES AND THE APPROACHES TO
ACHIEVE THAT.
SO, REALLY ANYTHING CAN BE ON
THE TABLE WHEN IT COMES TO HOW
WE CAN DELIVER BETTER RESEARCH
RESULTS AND RESEARCH RESULTS
THAT THE AMERICAN PEOPLE NEED.
SO I GUESS WHAT I'M SAYING IS
THAT WE NEED TO BE ABSOLUTELY
OPEN TO THINKING ABOUT WHAT CAN
MOVE US FORWARD BUT ALSO VERY
MINDFUL OF THE FACT THAT WHAT
WE'RE DOING IS WITH PRECIOUS
DOLLARS AND WE CAN'T JUST, YOU
KNOW, WE HAVE TO BE VERY CAREFUL
IN MAKING ANY CHANGES TO MAKE
SURE THAT WE DON'T DO MORE HARM
THAN GOOD, FRANKLY.
I GUESS THE LAST THING I WILL
SAY VERY QUICKLY IS THAT WE HAVE
HEARD A CALL FOR, YOU KNOW
COLLAPSE THE INSTITUTES AND
CENTERS, YOU KNOW, HAVE FEWER --
I WILL JUST GIVE YOU MY PERSONAL
IMPRESSION OF THAT.
BEFORE I CAME TO NIH, I KIND OF
BOUGHT INTO OH IT'S A WHOLE
BUNCH OF SILOS AND NOBODY'S
WORKING TOGETHER AND YOU KNOW
WOULDN'T IT BE GREAT IF YOU
ROLLED A FEW MORE TOGETHER
BECAUSE OF COLLABORATION,
ABSOLUTELY THE OPPOSITE.
AND I THINK WHEN YOU ARE ABLE TO
DIVE, I GAVE YOU 2 EXAMPLES BUT
THERE ARE SO MANY AND LOOK AT
THE CULTURE HERE, YOU WILL SEE
THAT THAT IS NOT AN ISSUE, SO
THAT'S NOT A REASON FOR
CONSOLIDATING.
OTHER REASONS MIGHT BE CAN YOU
SAVE MORE RESOURCES WITH
ADMINISTRATION, THIS KIND OF
THING, YOU WILL DELIBERATE THAT
AND LOOK AT THAT WITH THE PROPER
DATA GIVEN TO YOU.
THAT WILL BE 1 OF THE THINGS YOU
WILL DO BUT THEN LAST OF ALL, I
DO SUPPORT OUR CURRENT
STRUCTURE, OUR CURRENT STRUCTURE
OF INSTITUTES AND CENTERS
BECAUSE WE ALSO NEED TO HAVE
PEOPLE IN OUR -- PEOPLE IN THE
COMMUNITIES, PEOPLE WE SERVE BE
OUR PARTNERS IN THIS RESEARCH.
WE TAKE THAT VERY SERIOUSLY.
AND I JUST THINK IT REALLY DOES
HELP FOR PEOPLE WHO HAVE CANCER
TO HAVE A CANCER INSTITUTE OR
PEOPLE WHO WORRY ABOUT KIDNEY
DISEASE HAVE NIDDK.
YOU SEE WHAT I MEAN AND WE
ALREADY KIND OF SEE THIS BECAUSE
I'LL GIVE YOU AN EXAMPLE,
INCLUDE IS THE EXAMPLE OF A
PROGRAM FOR PEOPLE WITH DOWNS
SYNDROME THAT NEEDS, YOU KNOW
THE HEART INSTITUTE, IT NEEDS
NIDDK, IT NEEDS OUR INSTITUTE OF
DEAFNESS AND COMMUNICATIVE
DISORDERS, IT NEEDS ALL THOSE
DIFFERENT ICs BUT THEIR FOCUS
IS THE EUNICE KENNEDY SHRIVER
INSTITUTE FOR CHILDHOOD
DEVELOPMENTAL -- SORRY, MY
APOLOGIES FOR FLUBBING THAT,
IT'S NICHD, BUT THAT'S THEIR
CENTER AND HOME AND THAT
INSTITUTE TAKES THAT VERY
SIRESLY AND HELPS DO ALL THE
COORDINATION, DO YOU SEE WHAT I
MEAN?
SO IF WE WERE TO COLLAPSE, WE
WOULD DEFINITELY LOSE SOMETHING
IN TERMS OF OUR ENGAGEMENT WITH
THE PUBLIC AND I THINK THAT'S
REALLY CRITICAL.
>> ANOTHER QUESTION FOR YOU IS,
WHEN YOU LOOK AT THROUGHOUT ALL
THE 26 CENTERS THAT DOING
INCREDIBLE THINGS, HOW IMPORTANT
OR HOW PREVALENT IS THEIR FOCUS
ON HEALTHCARE DISPARITIES OR IS
THAT SOMETHING YOU'VE HEARD IN
YOUR TENURE HERE AND HOW SHOULD
WE CONSIDER THAT?
>> SO I THINK I CAN HONESTLY
SAY, YOU KNOW, WE NEED FOR 2
HOURS EVERY SINGLE WEEK, ALL THE
DIRECTORS OF ALL THE INSTITUTES
AND CENTERS, AND I THINK I CAN
HONESTLY SAY I DON'T THINK
THERE'S BEEN A SINGLE MEETING
WHEN 2 THINGS, 2 TOPICS DON'T
COME UP, OUR YOUNG TRAINEES, THE
YOUNG GENERATION, WHO'S COMING
NEXT AND HEALTH DISPARITIES.
I MEAN IT IS JUST SO -- EVERYONE
UNDERSTANDS THE DEPTH OF THIS
ISSUE AND HOW CRITICAL NIH IS TO
SOLVING IT AND THOSE 2 ISSUES
ARE ALWAYS TOP OF MIND.
>> MARK?
>> THANKS FOR A VERY INTERESTING
PRESENTATION AND I'M VERY
INTERESTED IN THE TARGETED
OUTREACH PARTICULARLY FOR
CLINICALLY RELEVANT GROUPS THAT
DEVELOP, BUT FOLLOWING UP ON
DR. WIN'S COMMENT ABOUT TRUST,
I'M WONDERING WHAT WE CAN DO
THAT WOULD IMPROVE TRUST ACROSS
THE POPULATION?
IF THE TAX HOLDER VIEWS
THEMSELVES AS SHAREHOLDERS IN
THEIR ORGANIZATION BECAUSE
THEY'RE FUNDING IT, WHAT DO WE
GIVE THEM IN RETURN, THE AVERAGE
PERSON WHO THINKS THEY'RE GOING
TO LIVE FOREVER, THEY DON'T NEED
VACCINES, THEY DON'T NEED
FLUORIDE, HOW DO WE EDUCATE
THEM?
CONVINCE THEM OF THE WOW OF THE
SCIENCE THAT'S DONE AT THE
INSTITUTE AND MAKE THEM MORE
SCIENCE LITERATE SO THAT THEY
WERE APPRECIATE THE MISSION OF
NIH.
YOU KNOW WHERE I SIT IN THE
HINTA LANDS AND WE'RE RELATIVELY
[INDISCERNIBLE] BUT NOT COMHOO
PLETELY, I DON'T THINK THIS IS
AN ISSUE, I DON'T THINK ANY OF
MY NEIGHBORS UNDERSTAND WHAT
GOES ON AT THE NIH BUT THEY MAY
KNOW THAT THEIR TAX DOLLARS COME
HERE, SO HOW DO WE BRIDGE THAT
GAP AND IMPROVE TRUST THROUGH
EDUCATION AND THE WOW OF SCIENCE
WHICH HAS TO ACCOMPANY IT?
>> SO I THINK -- I DO THINK WE
COULD DO MORE TO MAKE THE
AMERICAN PEOPLE AWARE OF THE
FACT THAT NOT ONLY DOES 11% OF
OUR PORTFOLIO FUND THE AMAZING
WORK DONE HERE ON THIS CAMPUS AT
NIH THAT'S TAKING CARE OF THE
RAREST OF THE RARE, REALLY
THINGS THAT CANNOT DO ANY PLACE
ELSE THAT ALSO OUR WORK FUNDS
RESEARCH THAT'S DONE ACROSS THE
ENTIRE UNITED STATES, ALL 50
STATES IN AND THE DISTRICT OF
COLUMBIA AND THAT THAT
UNIVERSITY THAT USUALLY PEOPLE
ARE VERY PROUD OF, IN THEIR
STATE OR THEIR HOME TOWN IS
FUNDED BY THE NIH TO DO A VAST
AMOUNT OF ITS RESEARCH.
I WON'T SAY MAJORITY BECAUSE
ALSO THERE'S -- THERE ARE MANY
FACTORS THAT GO INTO OUR COMPLEX
ECOSYSTEM BUT THAT'S 1 THING,
MAYBE WE COULD DO BETTER.
AND IS TO TIE THIS -- I COME
BACK TO TIE TO WHAT MATTERS TO
THEM AND WHAT MATTERS TO THEM IS
LOCAL, MORE THAN IT IS NATIONAL.
AND SO THE LOCAL UNIVERSITIES,
THE LOCAL THINGS LIKE HEALTH
NETWORK, THINGS LIKE MANY
OUTREACH PROGRAMS, YOU KNOW,
THAT'S NOT THE ONLY 1, YOU KNOW
THE HEAL INITIATIVE, MANY OF
THESE THINGS ARE OUT IN VERY
DIVERSE COMMUNITIES, MAKE IT
VERY CLEAR, THAT'S TAXPAYER
DOLLARS THAT ARE BRINGING THAT
WORK TO THEM.
IT'S ANOTHER THOUGHT.
AND I WOULD BE VERY HAPPY --
VERY, VERY OPEN TO SUGGESTIONS.
I WOULD SAY THAT WE ALSO TAKE
VERY SERIOUSLY OUR MANDATE TO BE
VERY ACCOUNTABLE AND VERY
TRANSPARENT IN WHAT WE DO AS
WELL AND I THINK THAT'S ANOTHER
IMPORTANT PART OF TRUST.
>> SO MONICA, MAYBE YOU CAN
SHARE WITH THE GROUP YOUR RECENT
EXPERIENCE TALKING TO A HIGH
SCHOOL?
>> YES, I DID.
I WAS VISITING ARKANSAS,
NORTHWEST ARKANSAS WITH CONGRESS
WOMACK AND SENATOR BOZMAN A
COUPLE WEEKS AGO AND I HAD AN
OPPORTUNITY TO GO TO A BIG
ASSEMBLY WITH 3 DIFFERENT HIGH
SCHOOLS AND GOT TO TAKE
QUESTIONS.
IT WAS VERY BRIEF LITTLE 2
MINUTE TALK ABOUT MOSTLY ABOUT
CAN I ANSWER YOUR QUESTIONS?
AND IT WAS ABSOLUTELY THRILLING.
I DON'T KNOW -- ANYTIME YOU GET
DOWN ABOUT ANYTHING IN OUR WORLD
IN BIOMEDICAL RESEARCH AND
SCIENCE, AND HEALTHCARE, JUST
SPENDING A LITTLE BIT OF TIME
WITH THE YOUNG PEOPLE WHO ARE
REALLY GOING TO BE THE UP AND
COMING, IS JUST ABSOLUTELY
REJUVENATING AND THRILLING.
I MEAN THEY ASK ME BETTER
QUESTIONS THAT I'VE GOTTEN OUT
OF ANY AUDIENCE, THEY WERE
INCREDIBLY WELL INFORMED AND
THEY NEW EXACTLY WHAT THE
IMPORTANCE OF RESEARCH AND
CAREER DEVELOPMENT AND WHAT WE
DO AT NIH AND IT WAS JUST
DELIGHTFUL.
SO THANK YOU FOR BRINGING THAT
UP LARRY.
IT WAS DEFINITELY THE HIGHLIGHT
OF PROBABLY EVERYTHING I'VE DONE
LAST YEAR SITTING DOWN, BEING
ABLE TO HAVE THAT TIME WITH
THOSE YOUNG PEOPLE.
>> NORA?
>> HI, MONICA THANKS A LOT, YOU
STARTED THE PRESENTATION SHOWING
US A SLIDE WHICH INDICATES THAT
THE UNITED STATES ACTUAL LOW HAS
SOME OF THE HIGHEST INVESTMENTS
ON HEALTHCARE, AND WE KNOW THAT
AND YET WE'RE RANKING # 10,
WE'RE ALSO 1 OF THE COUNTRIES
THAT INVESTS THE MOST MONEY IN
SCIENCE AND HEALTH AND WE ARE
SEEING A DISCONNECT IN WHY WE
SEE IT.
THAT IS A MAJOR GAP, AND AS
WE'RE DISCUSSING THE WHOLE ISSUE
OF TRUST, IT ACTUALLY LED ME
INTO THE SCIENTIFIC QUESTION OF
ALSO AS NIH, AND AS SORT OF
DIRECTORS OF VARIOUS INSTITUTES,
HOW SHOULD WE BE TACKLING
SCIENCE TO ADDRESS WHAT APPEARS
TO BE THAT DISCREPANCIES IN OUR
ADVANCES AND OUR ABILITY OF WHAT
YOU SAID AT THE END HERE WHICH
IS THE COMMUNITY?
>> YEAH, THIS IS WHY I DO KNOW
THAT IT IS CRITICAL FOR US TO
CONTINUE OUR VERY, VERY SOLID
CERTAINTY OF FUNDAMENTAL
SCIENCE.
THERE'S NO QUESTION.
THAT'S WHERE THE NEW MIRACLE --
TRULY AND SOME OF THEM TRULY
MIRACULOUS.
YOU KNOW WE'VE SEEN EVEN
RECENTLY, SOME BREAKTHROUGHS IN
TREATMENT OF AUTOIMMUNE DEC, IN
TREATMENT OF ALS, IN TREATMENT
OF DIABETES, I MEAN I COULD GO
ON AND ON, THAT COMES FROM
FUNDAMENTAL SCIENCE SO WE CANNOT
LET UP ON THAT, BUT WHAT I'M
TRYING TO EMPHASIZE, BY SHOWING
THAT SLIDE AND ALSO BY PUTTING
OUT PROGRAMS LIKE CARE FOR
HEALTH AND LIKE HEAL AND LIKE
SEAL, SOME OF OUR OTHER OUTREACH
PROGRAMS IS THAT WE CANNOT
IGNORE HEALTH DELIVERY EITHER.
AND THAT IS AN AREA OF RESEARCH,
WE'RE FOCUS ON THE HEALTHCARE
DELIVERY SYSTEM, BUT WE NEED TO
UNDERSTAND WHY PEOPLE'S HEALTH
IS WORSE.
THE COMPONENTS OF IT I BELIEVE
ARE DELIVERY SYSTEM, TO A
CERTAIN DEGREE ACCESS TO CARE.
I GREW UP IN A RURAL LOCATION, I
GREW UP 98-MILES FROM THE
DOCTORS OFFICE.
I KNOW HOW CHALLENGING IT IS FOR
RURAL COMMUNITIES TO HAVE ACCESS
TO CARE AND I KNOW THAT HURTS
THEIR HEALTH OUTCOMES.
SO IT'S ACCESS TO CARE, BUT IT'S
ALSO, ALL SO MANY SOCIAL AND
ENVIRONMENTAL THINGS THAT ARE
DIFFERENT IN EVERY COMMUNITY,
YOU KNOW, WHAT THE DIET IS, WHAT
THE -- YOU KNOW EFFECTS OF
CLIMATE CHANGE.
YOU CAN THINK OF MANY OTHER
SOCIETAL AND SOCIAL FACTORS AND
THAT'S GOT TO BE SOMETHING WE
PAY ATTENTION TO AND THAT MEANS
AND THAT'S REALLY IMPORTANT
RESEARCH IN THOSE AREAS.
ANY ADDITIONAL COMMENTS OR
QUESTION?
MIKE?
>> MONICA, THANK YOU.
I WAS WONDERING IF YOU COULD
SPEAK TO WHAT WILL HAPPEN TO THE
SMRB REPORT.
LIKE FOR EXAMPLE, I'M REALLY
WONDERING WHO THE AUDIENCE FOR
THE REPORT WILL BE AND HOW WILL
THE REPORT TIE INTO EVERYTHING
ELSE THAT WE'RE HEARING IN THE
NEWS ABOUT?
>> SO THIS IS OUR -- THIS IS A
FACA COMMITTEE, CORRECT?
THIS IS A FACA COMMITTEE WHICH
IS WONDERFUL BECAUSE THIS -- THE
PRODUCTIVITY OF THIS COMMITTEE
WILL BE AVAILABLE TO THE PUBLIC,
IT WILL BE TRANSPARENT, IT WILL
BE -- AS WELL AS OUR
DELIBERATIONS AND RESPONSES AND
SO, I PERSONALLY VIEW EVERY
SINGLE 1 OF THESE COMMITTEES AS
OUR OPPORTUNITY TO REALLY ENGAGE
THOUGHTFULLY, WITH
REPRESENTATIVES OF THE PEOPLE WE
SERVE TO MAKE SURE THAT YOU KNOW
WE GET THE VERY BEST ADVICE THAT
WE CAN HAVE TO DO OUR WORK
BETTER.
SO I THINK THESE -- THAT'S WHY
THIS IS CRITICAL AND YOU ALL,
AGAIN, I THANK YOU SO MUCH
BECAUSE YOU ARE OUR
REPRESENTATIVES OF THE PEOPLE WE
SERVE.
NOKAY, ANY FINAL QUESTIONS?
YES, PLEASE?
>> SO THAT REPORT THAT YOU
QUOTED, AND SHOWED US, WAS NOT
THE FIRST ITERATION OF IT I
REMEMBER IT WAS 5 PRIOR OR
SOMETHING LIKE THAT AND THINGS
HAVEN'T CHANGED.
>> THEY'VE GOTTEN WORSE.
>> YEAH.
SO WHATEVER WE'RE DOING DOESN'T
-- WE COLLECTIVELY DOESN'T SEEM
TO BE GETTING THE DESIRED
OUTCOME, HOW DO WE CHANGE THAT?
>> WELL, SO I THINK CARE FOR
HEGHT IS A BIG PART OF IT.
WE NEED TO BRING IN THESE
COMMUNITIES.
WE NEED TO BRING RESEARCH, IT
WILL IMPROVE THEIR CARE AND WE
WILL START TO ADDRESS SOME OF
THE CORE PROBLEMS BEHIND THIS
ISSUE.
I WILL GIVE YOU ANOTHER 1 THEY
REALLY CARE ABOUT A LOT, OUR
DATA AREN'T AS GOOD AS THEY NEED
TO BE.
AND WHAT I'M TALKING ABOUT ARE
DATA FROM THE CLINICAL CARE
ENVIRONMENT.
ONE OF THE THINGS I DEARLY WANT
TO FIX IS A CHALLENGE WITH DATA
FROM THESE ENVIRONMENTS.
OKAY, SO I WILL GIVE YOU A VERY
CONCRETE EXAMPLE.
THE SEER REGISTRY, THE RECARD WE
GET EVERY YEAR ABOUT HOW ARE WE
DOING FOR OUTCOMES IN CANCER,
BECAUSE OF THE DATA SYSTEMS WE
HAVE TO RELY ON RIGHT NOW, THAT
DAT IS 3 YEARS OLD BEFORE WE
EVER EACH GET TO SEE IT.
NOW I KNOW THAT THERE ARE SOME
THINGS, I THINK DR. VOLKOW CAN
GIVE YOU EXAMPLES LATER ABOUT
HOW WE KNOW THAT SOME OF THE
THINGS SEEM TO BE -- WE SEEM TO
BE MAKING SOME HEAD WAY IN SOME
AREAS BUT WE DO HAVE THIS REALLY
LONG DATA LAG, AND IT WOULD BE
REALLY NICE TO BE ABLE TO
RESPOND TO THINGS IN A MORE
TIMELY MANNER, THAT'S GOING TO
TAKE A REALLY BROAD ALL OF
GOVERNMENT APPROACH TO BEING
ABLE TO ACHIEVE BETTER
UNDERSTANDING JUST OF WHAT'S
GOING OUT THERE IN MORE
REALTIME.
>> GREAT.
JUST MAKING SURE THAT ALBERT,
JAMES OR LINDE DON'T HAVE ANY
COMMENTS BECAUSE SOMETIMES WHEN
THEY'RE NOT IN THE ROOM -- YES,
JAMES, PLEASE.
NSO THANK YOU LARRY AND THANK
YOU DR. BERTAGNOLLI FOR A GREAT
PRESENTATION EMPLOY I JUST WANT
TO INCREASE THE NUMBER OF EXAMS
OUT THAT IF WE'RE TALKING ABOUT
HEALTH, ONLY ABOUT 10-15% OF 1'S
HEALTH IS ATTRIBUTABLE TO ACCESS
TO HEALTHCARE WHICH TRANSLATES
TO ACCESS TO DRUGS.
THE REST OF IT IS SOCIAL
DETERMINANTS OF HEALTH WHICH
MONICA'S ALREADY MENTIONED AND
IF YOU LOOK AT THE FUNDING OF
THE INSTITUTES AND CENTERS AT
THE NIH, THOSE THAT ARE FOCUSED
ON SOCIAL DETERMINANTS OF HEALTH
ARE THE SMALLEST BUBBLES OR
LEAST AMOUNT OF FUNDING AND
THOSE DOING THE FUNDAMENTAL
RESEARCH AT LEAST TO DRUGS GET
MOST OF THE FUNDING SO IF YOU'RE
GOING TO ADDRESS HEALTH AS AN
INSTITUTION, THE FUNDING
DISTRIBUTION TO THOSE CENTERS,
FOCUS ON SERM DETERMINANTS OF
HEALTH SHOULD BE A LOT MORE THAN
IT IS NOW.
LET ME ALSO POINT OUT THAT OUR
HELT CARE SYSTEM IS A SICK CARE
SYSTEM.
WE'RE NOT DOING ANYTHING TO
PROMOTE HEALTH, WE'RE JUST
TREATING PEOPLE WHO ARE SICK AND
THOSE ARE 2 VERY DIFFERENT
THINGS AND MY SERVICE ON
PRESIDENT BIDEN'S HEALTH EQUITY
TASK FORCE TAUGHT ME THAT WE'RE
THE ONLY COUNTRY THAT SPENDS
TRILLIONS OF DOLLARS ON HELT
CARE WHERE PUBLIC HEALTH AND
HEALTHCARE ARE THOUGHT OF AS 2
SEPARATE THINGS.
IN ORDER TO FOR US TO ACHIEVE
THE BEST HEALTH OF ALL OF OUR
CITIZEN, THOSE 2 THINGS HAVE TO
BE BROUGHT BACK TOGETHER AND
MAYBE THAT'S 1 THING WE CAN
THINK ABOUT AS WE TALK THROUGH
THESE ISSUES SURROUNDING NIH AND
FUNDING FOR HEALTH.
THANK YOU, LARRY NSO, THANK YOU.
I REALLY APPRECIATE YOUR
COMMENTS ISSUES THE ONLY THING I
WOULD ASK YOU TO CONSIDER, AND I
BELIEVE YOU WILL PROBABLY GET
BETTER INFORMATION ON THIS AS
THIS BOARD GOES ON IS THAT IT IS
NOT THE CASE THAT ALL OF THE
FUNDING THAT GOES TO ADDRESSING
SOCIAL DETERMINANTS OF HEALTH IS
JUST IN THOSE INSTITUTES AND
CENTERS SEEM TO HAVE IT ON THEIR
MAST HEAD, YOU KNOW, FAR FROM
IT.
I, YOU KNOW PARTICULARLY -- AND
THAT'S NOT JUST IN TERMS OF THE
CLINICAL SCIENCES AND
TRANSLATIONAL SCIENCES, IT ALSO
IMPACTS OUR FUNDAMENTAL RESEARCH
AS WELL.
HAVING FUNDAMENTAL DATA SETS
INSURING IF WE HAVE A GENOMIC
CATASET AND UNDERSTANDING THE
AMERICAN PEOPLE, IT HAS TO
INCLUDE ALL THE PEOPLE, WHO FOR
RECENTS OF SOCIAL DETERMINANTS
OF HEALTH HAVE BEEN LEFT OUT.
IT'S AN ENORMOUS CONTRIBUTION OF
THE ALL OF US PROGRAM THAT IS
BEING BUILT ON BY OTHER THINGS
-- BUILT ON TODAY.
BUT THE OTHER 1 EVERY SINGLE
INSTITUTE AND CENTER IN SOME WAY
CONTRIBUTES IN THEIR CLINICAL
ACTIVITY TO ADDRESSING ISSUES OF
NOT JUST ACCESS, ALSO, THE TYPE
OF CARE, BUT ALSO ALL OF THE
SOCIETAL FACTORS, SOCIAL
DETERMINANTS OF HEALTH THAT ARE
SOABT WIDE POOR OUTCOMES, SO
IT'S ANOTHER EXAMPLE, DON'T LOOK
AT THESE PLACES AS SILOS BECAUSE
WHEN YOU START DRILLING DOWN AND
LOOK WHAT THEY'RE REALLY DOING,
THEY ARE MOST CERTAINLY NOT.
>> WELL, I RESPECT WHAT YOU'RE
SAYING, MONICA BUT THE
FUNDAMENTAL TRUTH IS THAT WHEN
YOU LOOK AT THE SPENDING OR
FUNDING OF SOCIAL DETERMINANTS
OF HEALTH AT NIH, IT IS NOT WHAT
IT NEEDS TO BE.
AND 1 THING WE WERE LEARN ABOUT
TRUST, 1 LESSON WE LEARNED IN
THE PANDEMIC, IF YOU DON'T HAVE
PEOPLE WHO COME FROM THE
COMMUNITIES YOU WANT TO HELP,
THEY'RE GOING TO BE DISTRUSTING
BECAUSE WE NOW KNOW FOR SURE
THAT WHEN PHYSICIANS WHO TAKE
CARE OF COMMUNITIES ARE
CULTURALLY, RACIALLY AND
OTHERWISE CONNECTED TO THOSE
COMMUNITIES, OUTCOMES ARE BETTER
AND WE DID NOT TURN THINGS
AROUND IN THE PANDEMIC IN TERMS
OF MINORITY COMMUNITIES UNTIL
MINORITY INVESTIGATORS, MINORITY
LEADERS GOT INVOLVED.
SO TRUST HAS TO BE EARNED OR IT
CAN BE CHANNELED THROUGH THOSE
WHO CAN BE TRUSTED, THE LAST
THINK THIS I WILL SAY AND THEN I
WILL SHUT UP, THE ORGANIZATIONS
WHO GET FUNDING TO DO THE SOCIAL
DETERMINANTS OF HEALTH ARE THE
USUAL PLAYER WHO IS QUITE
HONESTLY IF YOU LOOK AT THEIR
RECORD OF DIVERSITY AND WHAT
THEY DO IN COMMUNITIES IS NOT
VERY GOOD.
SO 1 THAT CAN BE DONE WOULD BE
TO FUND THOSE ORGANIZATIONS BEST
ABLE TO DO THE WORK BECAUSE
THEY'RE A PART OF THOSE
COMMUNITIES AND YOU KNOW THAT'S
JUST A FACT WE HAVE TO DEAL
WITH.
>> WELL, THE LAST THINK THIS I
WILL SAY TO ADDRESS YOUR
CONCERNS IS, I URGE YOU TO TAKE
A REALLY DEEP LOOK INTO THE CARE
FOR HEALTH INITIATIVE AND GIVE
US YOUR OPINION ON THE -- YOU
KNOW I DIDN'T HAVE TIME TO
REALLY GO INTO THE VERY DEEP
DETAILS OF THAT AND I URGE YOU
TO TAKE A LOOK AT THAT
INITIATIVE AND GIVE US FEEDBACK
ON WHETHER YOU THINK THAT MIGHT
HIT IN OF THE THINGS THAT YOU'VE
BROUGHT UP HERE.
>> OKAY, WE O WILL HAVE DEBAND
THEN ELBA, WE WILL LET YOU HAVE
THE LAST WORD ON THIS TOPIC.
SO DEB?
>> THANK YOU, YOU MAY BE GETTING
INTO THIS LATE BUTIME JUST
WONDERING PROCEDURALLY, HOW THIS
BOARD WILL DECIDE WHAT QUESTIONS
TO ADDRESS BECAUSE A HUGE NUMBER
OF QUESTIONS HAVE BEEN RAISED
THAT ARE SO IMPORTANT AND TO
WHAT EXTENT WILL WE BE
SPECIFICALLY ADDRESSING FOR
EXAMPLE, THE CONGRESSIONAL
RECOMMENDATIONS AND I THINK THIS
PLAYS INTO MIKE'S QUESTION ABOUT
WHO THE AUDIENCE IS?
>> I THINK IF WE COULD PUT A PIN
ON THAT AND REVISIT THAT TOWARDS
THE END OF THE DAY, I THINK WE
ARE GOING TO SPEND ALET TIME
TALKING ABOUT THOSE ELEMENTS
ISSUES OBVIOUSLY VERY CRITICAL.
OKAY, ELBA, LAST WORD?
>> MY COMMENT IS RELATED TO THE
PREVIOUS 1 AND FIRST OF ALL
THANK YOU FOR THIS PRESENTATION,
IT'S VERY EXCITING AND
INFORMATIVE.
I GUESS MY QUESTION TO YOU IS
WHEN YOU LOOK AT THE PORTFOLIO
OF NIH EXTRAMURAL FUNDING, IS IT
AS REPRESENTATIVE AND DIVERSE AS
IT COULD BE WITH REGARD NOT JUST
TO REGIONAL REPRESENTATION, BUT
ALSO TO THE TYPES OF ENTITIES,
NOT FOR PROVEIS, PRIVATE SECTOR
AND SO ON, WHEN THE MAP OF WHERE
WE SEE THE SHORTER LIFE SPAN IS
POSSIBLY, POSSIBLY CORRELATED
WITH THE PRESENCE OF NIH FUNDING
AND PROJECTS GOING DIRECTLY TO
THOSE COMMUNITIES.
CURIOUS YOUR HOW THES ON THAT.
>> NO, WE'RE NOT WHERE WE WANT
TO BE, THAT BEING SAID, THERE
ARE DEDICATED EFFORTS TO ACHIEVE
THAT.
I CAN -- THE IDEA STATES
PROGRAM, FOR 1, EXPANDING
NETWORK OUTREACHES OF THE
CTSAs, LET'S SEE I CAN KEEP
GOING.
THROUGHOUT ALL OF NIH, THERE ARE
QUITE -- A LARGE NUMBER OF
PROJECTS THAT SEEK TO DO EXACTLY
THAT EMPLOY ARE WE MAKING
PROGRESS?
YES.
IS IT TOO SLOW?
YES.
BUT SOME OF THAT AN
INFRASTRUCTURE ISSUE IS SOME OF
IT FRANKLY IS A FUNDING ISSUE AS
WELL.
WE'VE BEEN IN A PRETTY TIGHT
FUNDING ENVIRONMENT OVER THE
LAST YEAR AND HAVE -- I HAVE TO
HONESTLY SAY MADE A LITTLE BIT
LESS PROGRESS THAN WE HAVE LIKED
TO ON SOME OF OUR NEW OUTREACH
EFFORTS.
>> OKAY ACCIDENT BEFORE YOU GIVE
YOUR -- THANK YOU SO MUCH.
>> FEEL FREE TO GIVE YOUR
REMARKS, I'VE BEEN TAKING NOTES
AND THROUGHOUT THE AFTERNOON,
WHEN WE GET TO THE END OF THE
DAY, AS HOW WE MOVE FORWARD,
WHAT KIND OF SUBCOMMITTEES WE
WANT AND WE WANT TO ADDRESS HOW
MANY MEETINGS WE WANT TO HAVE,
THE LENGTH OF THE MEETINGS, ET
CETERA, SO, AND HOPEFULLY I WILL
BE ABLE TO SUMMARIZE AT THE END
TO REMIND YOU WHAT WE TALKED
ABOUT AT 12:00 WHEN WE GET TO 4
OR 5:00.
>> OKAY, SO IF WE CAN PULL UP MY
-- THANKS.
IF YOU GO TO THE NEXT SLIDE,
PLEASE.
SO WHAT I WOULD LIKE TO DO IS
JUST TALK A LITTLE BIT ABOUT THE
RESTART, WHAT LED TO IT, GO
THROUGH THE CHARTER IN SOME
DETAIL BECAUSE WITHIN THAT ARE
SOME OF THE ANSWERS TO SOME OF
THE QUESTIONS THAT YOU HAVE
RAISED, AT LEAST THE FRAMEWORK
TO HELP GUIDE US, TALK A LITTLE
BIT ABOUT SUBCOMMITTEES AND THEN
THE REPORTS.
SO IN 2024 WE RECEIVED
APPROPRIATIONS REPORT LANGUAGE
DIRECTING NIH TO RECONVENE THIS
BODY WITHIN 1 YEAR OF ENACTMENT.
AND WE HAVE DONE THAT.
WE HAVE MET THAT DEDICATED TO
LINE AND AGAIN I WANT TO THANK
ALL MEMBERS OF THE BOARD FOR
AGREEING SO QUICKLY TO
PARTICIPATE AND FOR FILLING OUT
ALL THE RELEVANT PAPERWORK SO
THAT WE COULD ENGAGE WITH YOU AS
FULL MEMBERS OF THIS BOARD.
AS YOU KNOW SEE BEFORE YOU, THIS
IS A GROUP COMPOSED ATYPICALLY
OF NIH STAFF, DIRECTORS OF NIH
INSTITUTE ANDS CENTERS AS WELL
AS THOSE OF YOU, ARE PARTNERS
FROM OUTSIDE ORGANIZATIONS, AND
THIS BOARD WILL PROVIDE ITS
ADVISE AND RECOMMENDATIONS TO
THE REPORTS TO THE NIH DIRECTOR
WHO IN TURN WILL PROVIDE THAT TO
THE SECRETARY OF HHS, BUT
EVERYBODY'S WATCHING AND SO,
THIS INFORMATION NO DOUBT WILL
ALSO FIND ITS WAY OUT TO THE
GENERAL PUBLIC, LEGISLATORS AND
SO FORTH FELT SO WHAT YOU DO AND
SAY WILL BE WIDELY AND BROADLY
DISSEMINATED, AND THAT WAS THE
WHOLE POINT, THAT'S WHAT FACA'S
ALL ABOUT QUITE FRANKLY.
THE AUTHORITY IS LISTED HERE AND
AS YOU HEARD THIS MORNING DURING
OUR SORT OF ORIENTATION SESSION,
THIS IS GOVERNED BY THE FEDERAL
ADVISORY COMMITTEE ACT.
SO, AGAIN, JUST A FOCUS IN ON
WHAT THIS IS SUPPOSED TO BE
LOOKING AT, THE USE OF AGENCY
ORGANIZATIONAL AUTHORITIES TO
ESTABLISH OR ABOLISH INSTITUTES
AND CENTERS, THE REORGANIZATION
OF OFFICES WITHIN THE OFFICE OF
THE DIRECTOR, AND MONICA, YOU
KNOW SHOWED YOU A SERIES OF
SLIDES DISPLAYING THAT, AND THEN
FINALLY TO REORGANIZE WITHIN AND
ACROSS INSTITUTES AND CENTERS.
IT'S A VERY BROAD MANDATE AND
OBVIOUSLY WOULD REQUIRE MANY,
MANY YEARS TO DO ALL, EACH AND
ALL OF THESE JUSTICE BUT THAT
WILL BE THE ART OF THIS IS TO
FOCUS IN ON THE SEMINOLE
QUESTIONS.
SO WE HAVE SPECIFIC DUTIES,
CONVEYED THROUGH REPORTS OUR
ADVICE WILL BE MADE TO THE NIH
DIRECTOR AND THE HHS SECRETARY
AND NOT LESS THAN ONCE EVERY 7
YEARS THE BOARD WILL ISSUE A
REPORT TO THE NIH DIRECTOR
ET AL, TO DETERMINE WHETHER AND
TO WHAT EXTENT ORGANIZATIONAL
AUTHORITY SHOULD BE USED AND
PROVIDE REGARDING USE OF THOSE
ORGANIZATIONAL AUTHORITIES AND
THEN THE RATIONAL BEHIND
WHATEVER RECOMMENDATIONS ARE
MADE BY THIS GROUP.
THE ACTIVITIES OF THE BOARD WITH
RESPECT TO A SPECIFIC REPORT
WILL REQUIRE A REVIEW OF THE
RESEARCH PORTFOLIO OF THE NIH
DETERMINE THE PROGRESS AND
EFFECTIVENESS OF THE VALUE OF
THE PORTFOLIO AND THE ALLOCATION
AMONG THE PORTFOLIO ACTIVITIES
OF THE RESOURCES OF NIH.
SO THE PRECEDING DISCUSSION THAT
YOU HAD WITH MONICA WAS SPOT ON.
IT'S EXACTLY THIS SORT OF THING
THAT WILL ULTIMATELY LEAD YOU TO
THAT PARTICULAR EFFORT YOU KNOW
LOOKING AT THAT PORTFOLIO,
DEEPLY, UNDERSTANDING HOW AND
WHERE IT IS SUPPORTED AND
ORGANIZATIONALLY ARE THERE WAYS
OF SUPPORTING IT BETTER.
SO THIS IS NOT ABOUT MORE MONEY,
IT'S ABOUT HOW DO YOU MOVE THE
RESOURCES AROUND IN THE MOST
EFFECTIVE WAY POSSIBLE.
AND THEN FINALLY TO DETERMINE
THE PENDING SCIENTIFIC
OPPORTUNITIES AND PUBLIC HEALTH
NEEDS, SO, THIS ALL ANTICIPATED
THIS MARRIAGE THAT SEVERAL
SPEAKERS REFERRED TO, YOU KNOW,
SCIENCE AND PUBLIC HEALTH NEEDS,
MARRYING THOSE TOGETHER PERHAPS,
YOU KNOW A BIT MORE STRONGLY
THAN IS TYPICALLY THOUGHT OF.
AND AGAIN, CONTINUING ON WHAT
NEEDS TO BE WITH THESE SPECIFIC
REPORTS FOR ANY PROPOSAL FOR
ORGANIZATIONAL CHANGES TO WHICH
THE BOARD GIVES SIGNIFICANT
CONSIDERATION, THE BOARD HAS TO
ANALYZE THE BUDGETAR EXPE
OPERATIONAL CONSEQUENCES OF THE
PROPOSED CHANGE.
NOT NECESSARILY FOR THIS MOMENT
BUT WE DO HAVE HISTORY WHERE WE
HAVE ATTEMPTED TO MERGE
INSTITUTES.
ONE OF US SPENT A LOT OF TIME
TRYING TO MANAGE THAT EFFORT AND
IT IS -- FOR THOSE OF YOU IN
ACADEMIC HEALTH CENTERS, THINK
ABOUT A MERGER OF 2 OF YOUR
HOSPITALS, GOES VERY WELL, VERY
QUICKLY AND THEN THAT'S SORT OF
THE SCALE OF THE SORTS OF THING
THAT YOU'RE LOOKING AT HERE BUT
IT CAN BE DONE IF IT'S
APPROPRIATE.
RIGHT SO YOU SHOULD BE DISSUADED
BY THE MAGNITUDE OF THE EFFORT
THAT'S REQUIRED BECAUSE AT THE
END YOU MAY COME UP WITH
SOMETHING THAT'S BETTER.
AND THEN OF COURSE, TO TAKE INTO
ACCOUNT THE HISTORICAL FUNDING
AND SUPPORT FOR THE RESEARCH
ACTIVITIES, THE SLIDE THAT
MONICA SHOWED YOU WITH THE
BUBBLES, ACTUALLY, YOU KNOW IN
ADDITION TO SHOWING YOU THE
AMOUNT OF FUNDING, IT ALSO
SHOWED YOU WHEN EACH INSTITUTE
AND CENTER WAS CREATED.
SO FROM THE LEFT TO THE RIGHT,
YOU KNOW NCI WAS THE FIRST AND
THEN IF YOU GO INTO THE INNER
CIRCLE, NCATS WAS THE LAST
CREATED AND SO IT DOES GIVE YOU
A SENSE OF WHAT DOES THE VALUE
OF TIME HAVE VIS A VIS THE
ALLOCATION OF RESOURCES.
YOU HAVE TO ESTIMATE THE LEVEL
OF RESOURCES THAT WILL BE NEEDED
TO LIMP EMENT THE PROPOSED
CHANGES AND WE HAVE DATA NOW
THAT WE CAN DRAW UPON BECAUSE WE
HAVE GONE THROUGH THIS EXERCISE
BEFORE YOU HAVE ASSUME THE
PROPOSED CHANGES WILL BE MADE
AND MAKE A RECOMMENDATION FOR
THE ALLOCATION OF THE RESOURCES
GOING FORWARD AND THEN ANALYZE
THE CONSEQUENCES FOR THE
PROGRESS OF RESEARCH IN THE
AREAS AFFECTED BY THE PROPOSED
CHANGES AND THOSE CONSEQUENCES
CAN BE FAVORABLE OR THEY CAN BE
DISFAVORRABLE AND AGAIN THE
BOARD WILL HAVE TO CONSIDER
WHICH, AND THE LIKELY ANSWER IS
BOTH.
BECAUSE IT'S RARELY ALL OR NONE.
THE LIKELY ANSWER IS BOTH AND
THEN IT'S A BALANCE TO WHICH
MAKES THE MOST SENSE.
WHEN YOU'RE ISSUING A REPORT
WITH 1 OR MORE CONTEMPLATED
ORGANIZATIONAL ISSUES, WE NEED
TO CONSULT WITH INSTITUTE AND
CENTER DIRECTORS WHO ARE NOT
MEMBERS OF THE BOARD, OTHER
SCIENTIFIC LEADERS, WHO ARE AT
NIH AND ARE NOT MEMBERS OF THE
BOARD.
WE HAVE TO CONSULT WITH ALL THE
ADVISORY COUNCILS OF THE
INSTITUTES AND CENTERS, WE HAVE
TO CONSULT WITH ORGANIZATIONS
REPRESENTING THE SCIENTIFIC
COMMUNITY AND THEN FINALLY WE
HAVE TO CONSULT WITH
ORGANIZATIONS REPRESENTING
PATIENTS.
SO THE GOOD NEWS IS THAT THERE'S
GOING TO BE BROAD OUTREACH AND A
VERY DEEP AND THOROUGH ANALYSIS
OF THE FEEDBACK THAT WE RECEIVE
FROM ALL OF THESE DIFFERENT
STAKEHOLDER GROUPS.
BUT THAT WILL TAKE TIME AND
ENERGY, HENS THE BRIEF
CONVERSATION QUEE HAD ABOUT
WORKING GROUPS BECAUSE IF WE
ENABLED AND INSISTED THAT ALL OF
THIS WORK BE JUST DONE BY THIS
GROUP, IT WILL BE A VERY LONG
TIME BEFORE WE ARE ABLE TO COME
UP WITH FINAL ANYTHING IN THE
WAY OF RECOMMENDATIONS BUT IF
WE'RE ABLE TO JUDICIOUSLY
EMPOWER CERTAIN WORKING GROUPS,
ET CETERA, THAT WILL ALLOW US TO
LEVERAGE THE EXPERTISE OF THIS
GROUP WITH OTHER INDIVIDUALS WHO
CAN AT LEAST HELP AS LONG AS IT
IS BROUGHT BACK TO THIS GROUP
AND DISCUSSED IN DETAIL IN AWE
PUBLIC SESSION, SO THAT THE
PUBLIC CAN HEAR WHAT WE HAVE
LEARNED AND WHAT WE ARE THINKING
ABOUT.
YOU'VE HEARD ABOUT THE NUMBER OF
VOTING MEMBERS.
WE STILL HAVE A FEW MEMBERS TO
GO.
WE ARE NOT COMPLETELY AT FULL
NUMBER YET ALTHOUGH WE DO HAVE A
QUORUM AND THE MEMBERS OF COURSE
ARE SELECTED, RECOMMENDED BY THE
DIRECTOR OF NIH, AND ULTIMATELY,
YOU KNOW THE SECRETARY OF HHS
HAS FINAL SAY.
SO HERE IS THE VOTING MEMBERSHIP
RULES AND SO FORTH.
THE IC DIRECTORS WERE PICKED IN
ORDER TO FULFILL THE OBLIGATIONS
THAT ARE LISTED HERE.
IT'S PRETTY PRESCRIPTIVE.
SO BUDGETS ARE SUBSTANTIAL
RELATIVE TO A MAJORITY OF THE
OTHER INSTITUTES, INSTITUTES
WHO'S BUDGETS ARE SMALL,
RELATIVE AND SO FORTH, AND YOU
ALL KNOW WHO YOU ARE AND WE
DON'T HAVE TO GO THROUGH THAT,
THOSE INTUITIES THAT HAVE BEEN
AROUND FOR A WHILE CAN WITHOUT
SUBSTANTIVE CHANGE AND FOR MORE,
AND THERE'S A REASON WHY YOU
WERE SELECTED IN CASE YOU WERE
WONDERING.
IT WASN'T THAT YOU DID SOMETHING
WE DIDN'T LIKE AND YOU KNOW WE
PUT YOU HERE, IT WAS TO FILL THE
NEEDS THAT ARE OUTLINED HERE.
AND THEN THE NONFEDERAL MEMBERS
OF THE BOARD, YOU KNOW WHY YOU
ARE HERE, YOU'RE ALL SGEs,
WE'VE APPOINTED YOU TO SERVE,
OVERLAPPING TERMS SO THAT WE
DON'T LOSE THE CONTINUITY BUT
DON'T SENTENCE YOU FOREVER AND
AS YOU KNOW, WE DO HAVE TO HAVE
A QUORUM BEFORE WE CAN PUT
ANYTHING TO A VOTE ALTHOUGH MUCH
OF OUR WORK WILL LIKELY BE WITH
THE SENSE OF THE BUT THERE WILL
BE CERTAIN THINGS THAT I'M SURE
THE CHAIR WILL WANT A SPECIFIC
VOTE ON.
AS POINTED OUT EARLIER, WE CAN
USE SUBCOMMITTEE, THESE CAN BE
EXTREMELY IMPORTANT.
THIS IS HOW WE CAN REACH OUT TO
VERY, VERY BUSY PEOPLE IN
INDUSTRY, WHO PROBABLY WOULDN'T
WANT TO SERVE ON A COMMITTEE AS
DEDICATED AS ALL OF YOU ARE
BECAUSE OF THEIR OTHER
COMMITMENTS WHICH IS AND WHERE
WE CAN GET THAT EXPERTISE, THOSE
FROM THE NOT FOR PROVEIS SECTOR
AND AS WELL AS OTHER AREAS OF
EXPERTISE AND MANAGEMENT
ORGANIZATIONAL SPECIALIST,
ECONOMICS, FOLKS AND SO FORTH,
ALL OF THIS IS FAIR GAME AND WE
WILL BE ABLE TO DRAW UPON ANY
AND ALL OF THESE FOLKS IN
PARTICULARLY THROUGH THE USE OF
SUBCOMMITTEES ANYTHING THAT'S
DONE TO THE SUBCOMMITTEE COMES
BA BEING TO THE COMMITTEE AS A
WHOLE, FULL PRESENTATION AND
DISCUSSIONS, COMMITTEE ON THE
ENERGY AND COMMERCE AND
COMMITTEE ON APPROPRIATIONS OF
THE HOUSE OF REPRESENTATIVES,
AND COMMITTEE OF HEALTH,
EDUCATION, LABOR, PENS PENSIONS
AND COMMITTEE ON PROARPGS OF THE
SENATE, THE SECRETARY, AND
OFFICIALS WITH ORGANIZATIONAL
AUTHENTICS OTHER THAN ANY
OFFICIAL ON THE BOARD.
AGAIN, OKAY, SO I THINK I MADE
BACK THE TIME.
I WANTED YOU ALL TO HAVE
COMPLETE AVAILABILITY FOR MONICA
TO ANSWER YOUR QUESTIONS BUT AT
THAT -- LET'S OPEN THIS 1 UP IF
THERE'S ANY QUESTIONS ON THIS
TOPIC.
>> THANK YOU LARRY.
BEFORE WE TART INTO THE
QUESTIONS, THESE SLIDES WILL BE
MADE AVAILABLE TO ALL OF US?
>> YES.
THE SLIDES SHOULD BE ON THE
WEBSITE, POSTED AFTER THE
MEETING AND WE CAN ALSO SEND
THEM TYRONE, DIRECTLY TO ALL THE
MEMBERS SO THAT THEY HAVE THEM.
>> YES, BECAUSE I THINK WE WILL
NEED TO REFER TO THEM FROM TIME
TO TIME.
>> YES OF COURSE.
ANY COMMENTS OR QUESTIONS.
I KNOW I'M THE ONLY THING
STANDING BETWEEN YOU AND LUNCH.
YEAH, JOANY GO AHEAD.
>> THERE'S' QUESTION ONLINE!
>> LINDE IS IT?
>> YES, THANK YOU.
THANK YOU MONICA AND LARRY, THAT
WAS SUPER HELPFUL.
I AM WONDERING IF YOU CAN
CLARIFY A BIT MORE ABOUT THE
REPORTS.
I HEARD FOR EXAMPLE THAT THIS
BODY HAS TO PRODUCE A REPORT AT
LEAST EVERY, I THINK IT'S 7 YEAR
ANDS THAT THERE HAS TO BE 5
MEETINGS IN RELATION TO ANY
REPORT BUT SINCE THERE'S BEEN
SOME GAP IN TERMS OF WHEN THIS
GROUP HAS WEIGHED IN ON SOME OF
THESE ISSUES AND WE HAVE AT
LEAST 2 REPORTS WITH
CONGRESSIONAL BODIES TO TAKE A
LOOK AT.
WHEN ARE YOU FIRST REPAIRING TO
DO THE FIRST REPORT?
>> WELL, AGAIN, THIS WILL DEPEND
PART ON THE CADENCE OF MEETINGS
THAT THIS GROUP AGREES TO AND WE
HAVE TALKED ABOUT THIS A BIT AND
WE WOULD LIKE TO BE ABLE TO MEET
A TOTAL OF 5 TIMES THIS YEAR,
BUT THE EXPECTATION WOULD BE
THAT --
>> NEXT CALENDAR --
>> NEXT CALENDAR -- NI DIDN'T
WANT TO SCARE ANYBODY SINCE
WE'RE NEAR DECEMBER NWE THINK IN
TERMS OF FEDERAL CALENDAR, BUT
YEAH, 25 CALENDAR YEAR, BUT, WE
WOULD NOT HAVE ALL OF THESE
MEETINGS IN PERSON.
WE WOULD LIKELY HAVE EITHER 2 OR
3 MEETINGS IN PERSON AND THE
REST WOULD BE VIRTUAL.
AND THAT WILL BE OF COURSE
SUPPLEMENTED BY WORKING GROUPS,
SO HOPEFULLY BY THIS TIME NEXT
YEAR, THE GROUP WOULD BE ABLE TO
PRODUCE ITS -- IF NOT FIRST
REPORT, AT LEAST A GOOD WORKING
DRAFT SO THAT PEOPLE CAN
UNDERSTAND WHAT IS COMING.
THE ACTUAL WRITING SOMETIMES
TAKES A LITTLE TIME TO POLISH.
>> YEAH, SEXER SENTIA WILY A
YEAR AND -- YEAH, ESSENTIALLY A
YEAR AND BEEN THE T MEETINGS WE
SHOULD ANTICIPATE A SIGNIFICANT
AMOUNT OF HOME WORK SO TO SPEAK.
THERE WILL BE A LOT OF
ASSIMILATING INFORMATION WE'VE
SEEN, ASSIMILATING DATA, COMING
UP WITH PROPOSALS SO THAT WHEN
WE UTILIZE THE TIME WE HAVE AT
THE MEETINGS IN A WAY THAT IS
VERY, VERY PRODUCTIVE AND WE CAN
HEAR EVERYONE'S THOUGHTS SO EVEN
THOUGH IT'S ONLY 5 MEETINGS IN A
CALENDAR YEAR, BY NOVEMBER OF
NEXT YEAR, WE HOPE TO HAVE A
PRODUCT THAT WE CAN AT LEAST A
DRAFT OF THE PRODUCT THAT WE CAN
BE EXCITED ABOUT.
>> I'VE GOT NORA AND THEN JA,
NNE.
>> YEAH, LARRY, THANKS, MY
QUESTION TO YOU IS BECAUSE WE
BOTH WENT THROUGH THAT PROCESS
OF THE REORGANIZATION, THAT WHEN
THE MSRB CAME UP WITH THE
RECOMMENDATION THAT NIDPRKSA AND
THE NDAA, SHOULD BE BROUGHT
TOGETHER BECAUSE SIGNIFICANTLY
BOTH ORGANIZATIONS ARE
ADDRESSING SCIENCE, BECAUSE WE
-- SO THE QUESTION IS IF YOU
WERE TO LOOK AT IT
RETROSPECTIVELY, HOW ARE THINGS
DIFFERENT NOW THAN THEY WERE 14
YEARS AGO WHERE WE ARE NOW AGAIN
RECONSIDERING ARE THERE
REORGANIZATION OF THE INSTITUTES
AND HOW DO WE INSURE, WHAT ARE
THE OUTLOOKS TO OUR
RECOMMENDATION THAT WILL BE
HAVING AN IMPACT AS OPPOSED TO
ENDING AT JUST LIKE A
RECOMMENDATION?
>> WELL, I THINK WITH THE
BENEFIT OF THAT EXPERIENCE, WE
WILL HAVE TO DO A BETTER JOB IN
DESCRIBING THE RATIONAL BEHIND
WHAT IT IS THAT THE GROUP
ULTIMATELY PROPOSES AND WILL
HAVE TO PAY A BIT MORE ATTENTION
TO SOME OF THE REALITIES BY
CONSULTING WITH A BROADER RANGE
OF GROUPS TO INSURE THAT
WHATEVER IT IS THAT THE GROUP
COMES UP WITH, DOESN'T FAIL
BECAUSE OF SOMETHING THAT WE
TALKED ABOUT, BUT PERHAPS DIDN'T
CONSIDER AS CAREFULLY AS WE
SHOULD HAVE THE LAST TIME.
AND SO I THINK IT MEANS A BIT
MORE OUTREACH TO DIFFERENT
STAKEHOLDER GROUPS AND I
CERTAINLY, WE DON'T WANT TO FAIL
OPPORTUNITY OR EFFORT DEPENDING
ON HOW YOU LOOK AT IT BUT WE
SHOULD BE MINDFUL OF ENGAGING
MORE BROADLY WITH THE DIFFERENT
STAKEHOLDER GROUPS, SO THAT AT
THE END BEFORE WE MAKE THAT
FINAL DECISION, FOR THE CHAIR
SIGNS HER NAME ON THE REPORT, WE
HAVE A MORE REALISTIC ASSESSMENT
OF THE LIKELIHOOD OF IT, YOU
KNOW BEING SUSTAINED OR NOT.
>> I AGREE LARRY BECAUSE WHEN
THE SMRB WAS RECOMMENDING THIS
IN 2010, OF COURSE EVERYBODY WAS
COMING FROM THE PERSPECTIVE, IT
MAKES SCIENTIFIC SCIENCE IS NOW
WE'RE IN 2024 AND WE FIND
OURSELVES IT DIDN'T HAPPEN AND
YET THE ALLOT OF VERY POSITIVE
THINGS HAVE HAPPENED BY KEEPING
THE INNSITUTES SEPARATED SO,
UNDERSTANDING THE LESSONS
LEARNED FROM IT IS ALSO
VALUABLE, SO, A PRIORITY WOULD
HAVE SAID IT MAKES A LOT OF
SCIENCE, BUT GENERATE AND MODEL
ORGANIZATION MAKE ITS VISIBLE
WHAT THE GOAL WAS.
>> AND AGAIN, AND WE'VE DONE AN
EXPERIMENT AND WE MAKE THE
OBSERVATIONS FROM THAT
EXPERIENCE AND YOU HAVE TO TAKE
TAKE PROS AND CONS BASED UPON
THE OBSERVATIONS THAT YOU MAKE.
AND THAT WILL REQUIRE SOME
ADDITIONAL THOUGHT AND NOT THAT
ANYBODY'S ON THIS COMMITTEE WILL
BE BASHFUL BUT EVERYBODY'S GOING
TO HAVE TO SPEAK THEIR MIND
EMPLOY THE GROUPS WE ENGAGE
WITH, AS PART OF WORKING GROUPS
THEY WILL HAVE TO SPEAK THEIR
MINDS AND SO FORTH, BECAUSE,
I'VE NEVER SEEN AN ORGANIZATION
THAT CAN'T BE ENHANCED SOMEHOW,
BUT OF COURSE, THE QUESTION IS,
YOU KNOW HOW BEST TO DO IT,
OKAY, LET'S GO TO JEANNE AND
THEN MIKE.
>> THANKS LARRY AND MONICA FOR
THOSE HELPFUL PRESENTATIONS,
JUST A QUESTION ABOUT THE
FEEDBACK FROM THE COMMUNITIES,
SO THE LAST 2 BULLETS YOU HAVE,
ORGANIZATIONS REPRESENTING THE
SCIENTIFIC COMMITTEE AND
ORGANIZATIONS REPRESENTING
PATIENTS, THERE ARE SO MANY.
SO IS THERE ANY GUIDANCE ABOUT
HOW WE DO ENGAGE WITH THE GROUPS
THAT ARE GOING TO BE MOST
IMPORTANT?
>> FORTUNATELY WE ARE NOW MORE
COMFORTABLE FOR THINGS LIKE
WEBINARS WHICH ALLOW FOR VERY,
VERY BROAD ENGAGEMENT AND YOU
PUT A FEDERAL REGISTER NOTICE
OUT, WE WILL HOLD THE WEBINAR ON
SUCH AND SUCH ABOUT THUS AND
THUS AND AS YOU ALL KNOW BECAUSE
EVERY INSTITUTE AND CENTER HAS
DONE THIS, YOU GET INCREDIBLY
BROAD PARTICIPATION AND ROBUST
PARTICIPATION.
SO I DON'T ENVISION US GOING TO
EACH AND EVERY OFFICE OF EACH
AND EVERY, YOU KNOW SOCIETY ET
CETERA BUT I CAN ENVISION A
NUMBER OF WEBINARS, WHERE YOU
CAN REACH, YOU KNOW LITERALLY
THOUSANDS OF PEOPLE AND WE'VE
DONE IT, WE'VE ALL HAD THAT
EXPERIENCE, I THINK THAT WILL
BEENTIOUS FICIENT, AND I THINK
-- WILL BE EFFICIENT AND I THINK
WE WILL LEARN A GREAT DEAL IN
THAT WAY.
MIKE?
>> LARRY, I JUST HAVE 2
QUESTIONS THAT ARE RELATED.
THE FIRST 1 IS THAT EVERY DAY I
FEEL LIKE WE'RE HEARING REPORTS
ABOUT YOU KNOW WANTING TO REFORM
THE HEALTHCARE AND THE RESEARCH
ECOSYSTEM, AND I'M JUST
WONDERING WHAT IS YOUR ADVICE
ABOUT THE TIMING OF THIS REPORT
ALONG THOSE LINES OF, I THINK
IT'LL BE GOOD TO NOT SUBMIT A
REPORT THAT'S TOO LATE TO HAVE
IMPACT, AND THE SECOND QUESTION
IS THAT IF YOU HAVE ADVICE ABOUT
STRATEGIZING ABOUT THIS REPORT,
ARE WE BETTER OFF ORGANIZING IT
IN RESPONSE TO THESE 2
CONGRESSIONAL REPORTS VERSUS
ANYTHING BACK TO FIRST
PRINCIPLES AND STARTING FROM
GOALS AND SO, IF YOU COULD JUST
ADVISE ABOUT THAT?
>> MY OPINION, OKAY, IS THAT WE
SHOULD AT LEAST TAKE SOME TIME
TO LOOK AT THE PREVIOUS REPORTS
BECAUSE IT COULD VERY WELL BE
THAT SOME OF THE PRINCIPLES THAT
ARE ARTICULATED STILL HOLD TRUE.
I THINK THAT IT WILL BE EASIER
AND MORE EFFICIENT TO REVISE AND
IN PARTICULAR THE REPORT THAT
I'LL DESCRIBE THIS AFTERNOON,
THEN TARTING DE NOVO.
THE TIMING, YOU HAVE TO MEET 5
TIMES, EMPLOY THAT'S -- TIMES.
THAT'S WILL RULES THAT GOVERN
THIS COMMITTEE BUT THE
DELIBERATIONS ARE ALL PUBLIC.
AND SO WHILST THIS MEETING IS IN
PART SORT OF GETTING TO KNOW YOU
AND SETTING THE LANDSCAPE,
EVERYTHING THAT IS SAID IS
PUBLIC AND PRESUMABLY, THE
DISCUSSION EVEN DURING ITS
INTERIM OR ITERATIVE FORM, CAN
BE HOPEFULLY BENEFICIAL TO
WHOMEVER IS INTERESTED IN THESE
ISSUES, SO, THE FACT THAT THE
FINAL REPORT, YOU KNOW MAY NOT
BE DONE BECAUSE OF ALL THE
FRANKLY CONSTRAINTS THAT WE HAVE
AND BECAUSE OF THE COMPLEXITY OF
THE ISSUES THAT WE'RE DEALING
WITH, THAT DOESN'T MEAN THAT ALL
OF THE INTERIM EFFORT WILL GO
UNNOTICED AND MY HOPE IS THAT WE
WILL HAVE VERY SUBSTANTIVE
DISCUSSIONS INFORMED BY DATA AND
ANALYSIS, AND THAT THAT WILL
HELP DURING THIS INTERIM TIME
BEFORE A REPORT EVEN IN DRAFT IS
AVAILABLE.
>> I AND THINK ALSO, MIKE, WE'RE
ALL GOING TO READ THE PREVIOUS
REPORT.
THAT WAS 1 THING I WAS GOING TO
REMIND US BEFORE THE END OF THE
MEETING IS THAT WE SHOULD ALL BE
FAMILIAR WITH THE PREVIOUS
REPORT NOT JUST THE CONTENT BUT
THE STRUCTURE AND HOW THEY HAVE
UNDERLYING PRINCIPLES AND THEN
THEY HAVE BUILT ON THAT, OKAY,
EVERYTHING HAS TO BE IN LINE
WITH THE MISSION, ET CETERA, ET
CETERA SO MAYBE NOT SO MUCH FOR
THE CONTENT BECAUSE YOU DON'T --
WE MAY NOT WANT TO REPEAT THE
CONTENT, OR WE MAY, IF WE SEE
SOMETHING IN THERE THAT IS STILL
AN ISSUE BUT THE STRUCTURE
WILLIVE US A GUIDE AS TO HOW TO
GET THAT FORMED IN AN EFFICIENT
WAY.
>> OKAY, ANY OTHER COMMENTS OR
CONCERNS, QUESTIONS, THAT PEOPLE
HAVE?
I KNOW THE BLOOD SUGAR LEVELS
ARE DROPPING, BUT IT'S -- BUT
IT'S GOING TO BE OKAY.
YEAH.
OKAY, SO I THINK WE'VE LANDED
THE PLANE ON TIME SO BACK TO THE
CHAIR.
>> OKAY, SO WE HAVE A BREAK NOW,
WE HAVE LUNCH NOW, AT 12:45.
WE SHOULD BE BACK HERE BY ABOUT 1:40.
SO MY NAME'S NEAL SHAPIRO, I'VE
BEEN THE BUDGET DIRECTOR HERE AT
NIH SINCE 2010 AND I WILL GIVE A
CAVEAT THAT THIS OVERVIEW WILL
NOAOF THELY BE DIRECTED TOWARDS
THE NONNIH MEMBERS OF THE SMRB,
BUT PERHAPS WE WILL SEE MAYBE
THERE WILL BE SOMETHING OF
INTEREST TO OUR DIRECTORS AS
WELL.
NEXT.
SO THIS SLIDE SHOWS SORT OF THE
VISUAL DEPICTION OF THE NIH
BUDGET BY INSTITUTE AND CENTER,
SO, THE LARGER CIRCLES HAVE
LARGER BUDGETS AND YOU CAN SEE
THE LARGEST OF THESE IS NCI.
ON THE OPPOSITE END OF THE AGING
INSTITUTE HAS BEEN GROWING
RAPIDLY IN RECENT YEARS, THAT'S
NOW 1 OF THE LARGEST AS WELL,
AND WE HAVE QUITE A RANGE OF
SIZES AND THEN IN THE LIGHTER
BLUE RIGHT BELOW THE OFFICE OF
THE DIRECTOR, WE HAVE THE
CENTERS THAT DON'T HAVE DIRECT
APPROPRIATIONS, THEY RECEIVE
THEIR FUNDING THE INSTITUTE ANDS
CENTERS THAT DO HAVE DIRECT
APPROPRIATIONS.
SO, YOUR INTEGRATED POLICIES AND
INFRASTRUCTURE, SO WE'RE
INTEGRATED IN THAT FINANCIAL
SENSE THAT THOSE SENATORS ARE
FUNDED INTERNALLY AND WE ALSO
HAVE CENTRAL SERVICES THAT ARE
PROVIDED LARGELY BY THE OFFICE
OF THE DIRECTOR THAT ALSO GET
FUNDED COOPERATIVELY, SO SORT OF
THE SERVICES THAT ARE BEING
PROVIDED TO THE INSTITUTES AND
CENTERS CAN BE FUNDED FROM THEM,
THROUGH A CENTRAL SERVICES
PROCESS, WHICH DR. ROGERS CO
CHAIRS AND THAT'S ALSO PART OF
HOW WE IMPLEMENT OUR
APPROPRIATIONS.
THE 47.4 BILLION FIGURE, THAT'S
A TOTAL AND I WILL SHOW IN A
MOMENT HOW WE ADD UP TO THAT
THAT DOES NOT INCLUDE ARP A-H
WHICH IS PART OF NIH BUT
INDEPENDENT AND REPORTING
DIRECTLY TO THE SECRETARY SO
THEY HAVE THEIR OWN BUDGET AS
WELL.
GO TO THE NEXT SLIDE.
SO THIS IS SORT OF A HIGH LEVEL
LOOK AT WHAT COMPOSES THE NIH
BUDGET, IT AM CANS FROM A COUPLE
DIFFERENT SOURCES THAT ADD UP TO
THAT TOTAL.
THE LARGEST 1 HERE IN THE FIRST
LINE LABOR/HHS BUDGET AUTHORITY,
THAT IS THE FUNDING FROM OUR
APPROPRIATIONS SUBCOMMITTEE, SO
THERE'S MULTIPLE SUBCOMMITTEES
THAT HANDLE CONGRESSIONAL
APPROPRIATIONS, WE'RE PART OF A
GROUP THAT ALSO INCLUDES THE
LABOR DEPARTMENT, THE EDUCATION
DEPARTMENT, AS WELL AS HHS AND
OTHER INDEPENDENT SMALLER
AGENCIES AS WELL, SO THAT'S HOW
WE GET THE BULK OF OUR FUNDING
THROUGH THE ANNUAL
APPROPRIATIONS PROCESS, THAT IS
CALLED ON THE RIGHT SIDE, YOU
SEE DISCRETIONARY FUNDING WHICH
MEANS, IT'S IN AN APPROPRIATIONS
BILL AS OPPOSE TO AN
AUTHORIZATION BILL, DIFFERENT
KIND OF BILL, DIFFERENT
COMMITTEE THAT ORIGINATES THAT
LEGISLATION AND SO IN SOME
CASES, WHICH SUBCOMMITTEE THE
AGENCY IS IN CAN HAVE AN IMPACT
IN TERMS OF HOW FUNDS ARE
DIVIDED BY CONGRESS.
SO IF THE APPROPRIATIONS
COMMITTEE ALLOCATES A CERTAIN
AMOUNT TO EACH SUBCOMMITTEE, AND
THEN OUR PARTICULAR SUBCOMMITTEE
IN THIS CASE WOULD BE DIVIDING
FUNDS BETWEEN HHS, LABOR
DEPARTMENT, EDUCATION
DEPARTMENT, AND THEN WITHIN HHS,
SO, SOMETIMES WHICH SUBCOMMITTEE
IS HANDLING YOUR BUDGET CAN HAVE
AN IMPACT IN TERMS OF SOME
COMPETITION AMONGST AGENCIES FOR
FUNDING, TYPICALLY, YOU SEE MORE
MOVEMENT WITHIN A SUBCOMMITTEE
THAN ACROSS SUBCOMMITTEES WHEN
CONGRESS MAKES ITS ALLOCATIONS,
BUT IT ALL DEPENDS ON THE
SPECIFICS OF ANY INDIVIDUAL
YEAR.
THE SECOND LINE THERE INTERIOR
BUDGET AUTHORITY, SO THAT IS
COMING FROM A DIFFERENT
SUBCOMMITTEE, THE INTERIOR
SUBCOMMITTEE.
IT ONLY INCLUDES THE NIEHS
SUPERFUND PROGRAM.
THE REASON IT'S COMING FROM THE
INTERIOR SUBCOMMITTEE IS THAT
THEY HANDLE THE EPA BUDGET,
THAT'S PART OF THE INTERIOR BILL
AND THIS PARTICULAR PROGRAM AT
NIEHS ORIGINATED IN SUPERFUND
LEGISLATION, WHICH IS BROADLY
MOST OF IT MANAGED BY EPA, SO
THE FUNDING FOR THAT COMES FROM
THE SAME BILL THAT DOES THE EPA
BUDGET.
SO SMALL AMOUNT, BUT IT REQUIRES
THAT WE TRACK THAT BILL AS WELL
AS THE LABOR HHS BILL.
THEN THE NEXT ITEM, TIME 1
DIABETES, THIS IS MANDATORY
FUNDING SO IT'S CONSIDERED
AUGUST RISING LEGISLATION, NOT
PART OF THE ANNUAL APPROPRIATION
BILL, ALTHOUGH SOMETIMES THE 2
CAN GET COMBINED IN SOME
RESPECTS BUT WHEN THEY DO GET
COMBINED, THIS FUNDING WOULD BE
IN A SET PROVISION OR AN
AUTHORIZATION, AN AMENDMENT TO
THE BILL TO EXTEND THE FUNDING.
THIS WAS INCREASED IN THE PAST
YEAR, IT HAD BEEN AT 150 MILLION
FOR A LONG TIME.
IT WAS BUMPED UP THIS PAST YEAR
TO 195, PART OF THAT WAS
INTENDED TO COVER THE BEGINNING
OF 2025, SO IT'S MORE LIKE
160 MILLION SORT OF ON
ANNUALIZED BASIS BUT THAT IS
COMING FROM THIS DIFFERENT POT
CONSIDERED MANDATORY SEPARATE
FROM DIGS CRETIONARY FUNDING --
DISCRETIONARY FUNDING AND
SOMETIMES BECAUSE IT'S SEPARATE
IT CAN BE SUBJECT TO SEQUESTER.
THERE ARE PROVISIONS, THE MOST
COMMON SEQUESTER YOU MAY HAVE
HEARD OF HAPPENED UNDER FORMER
DISCRETIONARY CAPS, THOSE NO
LONGER HANDLE SEQUESTRATION, BUT
ON THE MANDATORY SIDE WHICH
SOMETIMES INCLUDES THIS TYPE 1
DIABETES FUNDS, THERE CAN STILL
BE A SEQUESTER SO IN SOME YEARS
WE'VE HAD TO GIVE UP A SMALL
PORTION OF THOSE FUNDS AND IT
USUALLY DEPENDS ON THE TIMING OF
WHEN THE LEGISLATION PASSES AS
TO WHETHER OR NOT THAT HAPPENS.
THEN THE NEXT ITEM, PROGRAM
EVALUATION FINANCING, THIS IS
GOING ENTIRELY TO NIGMS, JUST AS
THE TYPE 1 DIABETES IS ALL IN
NIDDK, AND THESE FUNDS ARE
COMING FROM ALL OF THE DIFFERENT
PARTS OF HHS THAT ARE UNDER THE
PUBLIC HEALTH SERVICE.
CONGRESS PASSES A PROVISION
TYPICALLY THAT WILL ESTABLISH A
PERCENTAGE OF THE AMOUNTS TAKEN
FROM THOSE APPROPRIATIONS FOR
THIS PURPOSE IN RECENT YEARS,
IT'S BEEN 2 AND HALF%, AND SO
THAT GETS SPREAD ACROSS THE
BOARD THROUGHOUT HHS FOR THOSE
PARTICULAR AGENCIES.
AND THEN, INCLUDING NIH AND THEN
IT GOES TO NIGMS.
SO OF THAT 1.4 BILLION DOLLARS,
THE MAIORITY OF THAT IS COMING
FROM WITHIN NIH, SO OTHER
INSTITUTES INCLUDING NIGMS, ARE
CONTRIBUTING TO THAT AMOUNT BUT
A PORTION OF THAT IS ALSO COMING
INTO NIH FROM OTHER PARTS OF
HHS, SO, IT'S A WAY THAT
CONGRESS CAN DECIDE TO SORT OF
REALLOCATE FUNDS WITHIN THEIR
BILL.
TYPICALLY THE AMOUNT THAT IS
GOING INTO AN AGENCY LIKE NIGMS,
WHICH IS THE LARGEST RECIPIENT,
IS DETERMINED BY CONGRESS, WHERE
THE FUNDS COME FROM, TYPICALLY
HAS TO BE CALCULATED THROUGHOUT
HHS IN EACH YEAR AND UNDER A C.
R. TO DETERMINE HOW MUCH IS
GOING AT ANY PARTICULAR TIME.
SO THAT'S A MORE COMPLICATED
FORM OF FUNDING THAT WE HAVE AND
THOSE LINES ADD UP TO WHAT WE
CALL THE PROGRAM LEVEL WHICH
INCLUDES ALL THE VARIOUS
MANDATORY AND FUNDING MECHANISMS
AND THEN AS I MENTIONED, HERE IS
ARP A-H HAS 1.5 BILLION DOLLARS.
WE CAN GO TO THE NEXT SLIDE
EMPLOY I WANTED TO EXPLAIN THE
OPERATING PLAN.
THIS IS SOMETHING CONGRESS
REQUIRES WE PROVIDE TO THEM
EVERY YEAR AND WE UPDATE DURING
THE YEAR AS NECESSARY AND IT
BREAKS DOWN THE BUDGET BY
INDIVIDUAL APPROPRIATIONS AS
WELL AS PROGRAM PROJECT OR
ACTIVITY OFTEN CALLED PPA AS THE
ABBREVIATION.
AND AT NIH, A LOT OF THE
INSTITUTES AND CENTERS HAVE A
SINGLE LINE IN THE OPERATING
PLAN OF THE INSTITUTES AND
CENTERS, NONE HAVE MORE THAN 5
LINES, THE OFFICE OF THE
DIRECTOR HAS A LOT MORE BECAUSE
OF SPECIFIC PROGRAMS AND OTHER
THINGS THAT CONGRESS WANTS TO
SPECIFY, SO THE OPERATING PLAN
IS BASICALLY THE WAY THAT
CONGRESS CAN LAY OUT THEIR
INTENTIONS FOR THE
APPROPRIATIONS AT A HIGHER LEVEL
OF DETAIL THAN JUST THE
APPROPRIATION BY APPROPRIATION.
THEY'RE DETERMINED IN BOTH BILL
AND REPORT LANGUAGE, THEY APPLY
TO SPECIFIC PROGRAMS, SO I GAVE
AN EXAMPLE HERE FOR NCI, THIS IS
1 WHERE THERE ARE 3 SPECIFIC
LINES AND THEN AN ALL OTHER
WHICH IS A REMINDER OF THE NCI
TOTAL.
I CHOSE THIS 1 BECAUSE THE LAST
LINE REPAIRS IMPROVEMENT AND
THAT COMES FROM BILLING AND THE
OTHER 2 LINES ABOVE IT THE
CHILDHOOD CANCER DATA INITIATIVE
AND THE STAR ACT, THOSE ARE BOTH
IN REPORT LANGUAGE.
SO ALL OF THOSE BOTH THE BILL
AND REPORT LANGUAGE PP As GET
INCLUDED IN THE ANNUAL OPERATING
PLAN, NOW THE MEETING OF ALL
THIS, THERE ARE A NUMBER OF
THINGS THAT IT CAN DETERMINE.
ONE THING YOU CAN SEE, THE ALL
OTHER NCI LINE IS OVER 7 BILLION
DOLLARS.
SO IN THAT RESPECT NIH HAS A
GREAT DOLE OF FLEXIBILITY IN
TERMS OF HOW WE SPEND THE ANNUAL
BUDGET.
IN MANY AGENCIES, YOU WON'T SEE
LINES THAT LARGE, 7 BILLION
DOLLARS, IS BIGGER THAN WHOLE
AGENCIES IN MANY CASES.
SO HAVING LARGE LINES LIKE THAT
GIVE US A LOT OF FLEXIBILITY, OF
COURSE IN RETURN, WE HAVE A LOT
OF TRANSPARENCY IN TERMS OF HOW
WE SPEND THAT MONEY, SO WE'RE
REPORTING AT VERY DETAILED
LEVELS ON INDIVIDUAL GRANTS, ALL
SORTS OF THINGS WE MAKE PUBLIC,
WE POST ON OUR WEBSITE, SO WE'RE
VERY TRANSPARENT IN TERMS OF
WHERE THE MONEY IS GOING, BUT WE
DO HAVE THE BENEFIT OF SOME OF
THESE LARGE LINES THAT GIVE US
SOME FLEXIBILITY IN TERMS OF HOW
WE SPEND THOSE FUNDS IN THE
SENSE THAT CONGRESS IS NOT
EXPLICITLY TELLING US WHAT TO DO
WITHIN THOSE INDIVIDUAL LINES.
NOW THERE IS SOME FLEXIBILITY
BETWEEN LINES IN SOME CASES AND
THAT CAN DEPEND ON WHETHER
THEY'RE IN REPORT LANGUAGE OR
BILL LANGUAGE.
IN REPORT LANGUAGE, IF FOR
EXAMPLE, WE WERE TRYING TO
REALLOCATE FUNDS BETWEEN SOME OF
THESE LINES, WE WOULD NEED TO
HAVE THE SUPPORT OF HHS, AND
OMB, WE WOULD NEED TO REPORT TO
THE APPROPRIATIONS COMMITTEE IN
ADVANCE BEFORE WE MAKE CHANGES
LAKE THAT AND THAT CAN HAPPEN ON
OCCASION.
TYPICALLY BECAUSE EVEN IF IT'S
COMING FROM REPORT LANGUAGE,
NIH'S GOAL IS ALWAYS TO
IMPLEMENT THE CONGRESSIONAL
INTENT TO THE GREATEST EXTENT
POSSIBLE, BUT SOMETIMES IT MIGHT
NOT BE POSSIBLE, FOR EXAMPLE, IF
CONGRESS TOLD US TO START A NEW
PROGRAM AND WE FOUND OUT ABOUT
THAT LATE IN THE YEAR AND THERE
WASN'T ENOUGH TIME TO SPEND ALL
THE FUNDS CONGRESS INTENDED THAT
PARTICULAR YEAR, WE WOULD BE
ABLE TO REPORT TO THEM, IN TERMS
OF WHAT ADJUSTMENTS WE MIGHT
NEED TO MAKE THAT YEAR IN ORDER
TO DEAL WITH THE TIMING ISSUES.
SO THERE ARE PROVISIONS IN THE
STATUTE WHICH GIVE US
FLEXIBILITY IN TAKEN--THEY
RESPECT WHETHER IT'S BETWEEN
REPORT LANGUAGE LINES OR BETWEEN
BILL LANGUAGE LINES OR BETWEEN
PROARPGS, THERE IS A MUCH MORE
LIMITED ABILITY IF WE ACTUALLY
HAVE TO MAKE SOME CHANGES
BETWEEN APPROPRIATION LINES, THE
BILL LANGUAGE, BUT IT'S MUCH
MORE LIMITED THAN IF IT'S NOT,
IF IT'S ONLY IN REPORT LANGUAGE.
NOW AS I SAID, WE WOULD STILL
TRY TO IMPLEMENT IT TO THE
GREATEST EXTENT POSSIBLE.
AND THE NEXT SLIDE.
SO, AT THE RISK OF GETTING A
LITTLE CONFUSING, THIS IS
ANOTHER WAY OF LOOKING AT THE
OVERALL NIH BUNLET, AGAIN THAT
WE CALCULATE, REPORT PUBLICLY
AND UPDATE THROUGHOUT THE YEAR,
THIS IS WHAT WE CALL THE BUDGET
MECHANISMS, AND THIS IS LOOKING
AT THAT SAME 47 BILLION DOLLARS
BUT IN TERMS OF BROADLY
SPEAKING, WHERE THE MONEY IS
GOING.
SO THESE LINES, THE FIRST
SEVERAL LINES, ARE EXTRAMURAL
SPENDING, STARTING WITH THE
LARGEST CATEGORY, THE RESEARCH
PROJECTS, RESEARCH PROJECT
GRANTS, THEN SBIR/STTR, SMALL
BUSINESS, THESE ARE AGAIN
RESEARCH GRANTS, RESEARCH
CENTERS, TYPICALLY LARGER GRANTS
TO INDIVIDUAL CENTERS THAT SOME
INSTITUTES HAVE, OTHER EFFORTS
FOR ADDITIONAL EXTRAMURAL AWARDS
AND THE TRAINING GRANTS THAT WE
MAKE TO OTHER OR INSTITUTIONAL
AWARDS FOR TRAINING SCIENTISTS,
RESEARCH SCIENTISTS.
THEN THE NEXT LINE, THE R&D
CONTRACTS STILL EXTRAMURAL BUT
THESE ARE CONTRACTS AS OPPOSED
TO GRANTS.
OUR OWN RESEARCH PROGRAM, OUR
OWN CLINICAL LABORATORIES, ET
CETERA, ET CETERA AND FINALLY
THE RESEARCH MANAGEMENT AND
SUPPORT WHICH COVERS BOTH
LEADERSHIP AND ADMINISTRATIVE
TYPICALLY FOR THE EXTRAMURAL
PROGRAM BUT AT HIGH LEVELS
COVERS SOME INTRAMURAL AS L. NOW
IF YOU ARE DOING MATH, YOU WOULD
SEE THESE NUMBERS DON'T ADD UP
TO THE WHOLE 47 BILLION AND THE
REASON FOR THAT IS THAT WE HAVE
THE OFFICE OF THE DIRECTOR
BUDGET AS WELL AS THE BUILDINGS
AND FACILITIES BUDGET.
FOR THE OFFICE OF THE DIRECTOR
THERE ARE SOME PORTIONS OF THE
OFFICE THAT WE DO SPREAD OUT
AMONG THESE MECHANISMS, BECAUSE
THEY RESEMBLE THE INSTITUTE AND
CENTER SPENDING MORE, THE COMMON
FUND FOR EXAMPLE, THAT WOULD BE
BROKEN OUT AND INCLUDED IN THESE
MECHANISM LINES.
THE OFFICE OF INFRASTRUCTURE
RESEARCH PROGRAMS IS THE RPGHT 1
BUT THEN FOR THE MOST LEADERSHIP
AND OTHER PROGRAMS WITHIN THE
OFFICE OF THE DIRECTOR THAT
DON'T LEND THEMSELVES AS WELL TO
BREAK OUT INTO THESE MECHANISMS,
THOSE ARE SEPARATE THERE.
SO CAN YOU SEE AGAIN, THE RPGs
BY FAR THE LARGEST CATEGORY
REFLECTING WITH THE OTHER LINES
THAT EXTRAMURAL SPENDING IS THE
BULK TYPICALLY, 80% OR MORE OF
NIH SPENDING, AND THEN THE
REMAINING FUNDS, I'VE GIVEN THE
PERCENTAGES AS WELL, SO YOU CAN
SORT OF SEE, THE BREAK OUT THERE
IN TERMS OF HOW THE FUNDS ARE
ALLOCATED SORT OF MORE IN TERMS
OF WHERE THEY'RE GOING, AS
OPPOSE TO WHERE THEY CAME FROM
AND IN A PRIOR SLIDE .
THE REPORTING WE MENTIONED
TYPICALLY WE DO THAT ON A
QUARTERLY BASIS, SO WE WILL TELL
CONGRESS, EARLY IN THE YEAR,
USUALLY IN THE PRESIDENT'S
BUDGET, SUPPOSED TO COMING OUT
BEGINNING OF FEBRUARY, NOT EVERY
YEAR BUT BECAUSE OF THAT, THAT
TYPICALLY IS THE FIRST ESTIMATE
OF HOW WE ALLOCATE FUNDS BY
THESE MECHANISMS AND IT'S BROKEN
OUT AGAIN BY INDIVIDUAL
INSTITUTES AND CENTERS, THIS
SHOWS NIH AS A WHOLE BUT WE
REPORT THIS ON AN INSTITUTE BY
INSTITUTE BASIS AND THEN WOE
UPDATE THAT QUARTERLY, SO AFTER
THE SECOND, THIRD QUARTER, AND
THEN AT THE END OF THE YEAR, WE
PROVIDE, THE ACTUAL RESULTS,
WHAT HAPPENED IN THE PRIOR YEAR,
SO THESE ARE CONTINUOUSLY
UPDATED BUT UNTIL THE EPPED OF
THE YEAR, THESE ARE ESTIMATES,
BUT TEND TO VARY, YOU DON'T
NECESSARILY KNOW EARLY IN THE
YEAR HOW MUCH YOU WOULD SPEND ON
AN INDIVIDUAL MECHANISM, IT ALL
DEPENDS ESPECIALLY WITH THE
EXTRAMURAL PROGRAM, DEPENDS ON
WHAT KIND OF APPLICATIONS COME
IN, WHAT DECISIONS ARE MADE
THROUGH THE COURSE OF THE YEAR,
THROUGH THE GRANT DECISION
MAKING PROCESS AND SO AS A
RESULT, THIS MECHANISMS WE
PROVIDE TO CONGRESS, THE PUBLIC
QUARTERLY ON OUR WEBSITE,
THEY'RE ALL POST UNTIL WE REACH
THE END OF THE YEAR.
NOW I WANT TO TALK A LITTLE BIT
ABOUT HOW THE EXTRAMURAL BUDGET
WORKS TO GIVE AIAN SENSE, THIS
IS OBVIOUSLY THE GREAT BULK OF
THE BUDGET AND MOST OF THE
GRANTS WE MAKE ARE AWARDED FOR A
MULTIPLE YEAR PERIOD BUT FUNDED
INCREMENTALLY.
SO THERE WOULD BE AN AWARD AND
AN EXPECTATION, THIS IS FOR 4
YEARS, FOR EXAMPLE, AND YOU
WOULD RECEIVE X-DOLLARS EACH
YEAR FOR THOSE 4 YEARS.
AND THE WAY THAT WE KIND OF
SEPARATE THE DESCRIPTION OF
WHETHER IT'S A NEW AWARD OR 1
THAT IS COMPETED AT THE
BEGINNING OF THAT PERIOD, VERSUS
NOT, IS COMPETING OR
NONCOMPETING, AND SO THOSE ARE
SORTING SIGNALS OF THE LARGEST
KIND OF SCALE DESCRIPTIONS OF
THE EXTRAMURAL AWARDS.
AS YOU COULD EXPECT BECAUSE OF
THE WAY WE MAKE THESE AWARDS,
THEY'RE ABOUT 3 TIMES AS MANY
NONCOMPETING GRANTS AS COMPETING
GRANTS.
SO NOT EVERY GRANT IS A 4 YEAR
GRANT, SOME ARE SHORTER, SOME
ARE LONGER, BUT ON AVERAGE,
THAT'S ABOUT HOW IT WORKS AND
BECAUSE OF THAT, A GREAT DEAL OF
THE NIH BUDGET, IS GOING TO
THESE NONCOMPETING AWARDS TO
CONTINUE THE 1S MADE IN PRIOR
YEARS, SO, I SOMETIMES DESCRIBE
IT AS SORT OF AS MAKING CHANGES
TO THE NIH BUDGET IS LIKE
TURNING THE BATTLESHIP, YOU HAVE
TO DO IT RATHER SLOWLY BECAUSE
SO MUCH OF WHAT WE SPEND EACH
YEAR, IS PREDETERMINED AND IT'S
REALLY THE COMPETING AWARDS
WHERE WE HAVE THE ABILITY TO
MAKE DECISIONS IN TERMS OF HOW
TO DIRECT NEW FUNDS OR REDIRECT
NEW FUNDS THAT ARE COMING UP
FROM,A WARDS THAT HAVE ENDED,
BUT WE HAVE AS A SAID, THE BULK
IN THIS, THE NONCOMPETING BRANCH
WHERE WHAT WE CAN DO IF WE HAVE
A FLAT BUDGET OR A SMALLER
BUDGET IS LIMITED BY THE NATURE
OF THOSE AWARDS.
AND FINALLY HERE, THE NUMBER OF
COMPETING RPGs, IS A VERY
COMMONLY USED METRIC FOR THE NIH
BUDGET.
SO COMPETING ARE TYPICALLY EVEN
THE NEW AWARDS OR COMPETITIVE
AWARDS, AND EACH YEAR WE REPORT
NOT ONLY HOW MANY DOLLARS WE
SPEND ON ALL THESE DIFFERENT
CATEGORIES BUT THE NUMBER THAT
WOE MAKE AND SO, THE NUMBER OF
THESE COMPETING RPGs IS
COMMONLY CITED.
YOU MAY HAVE HEARD DISCUSSION OF
A SUCCESS RATE, THAT SUCCESS
RATE WOULD BE THE NUMBER OF
COMPETING RPGs DIVIDED BY THE
NUMBER OF APPLICATIONS, THAT'S
ALSO A MEASURE THAT THE PEOPLE
LOOK AT TO SORT OF SEE WHAT'S
GOING ON WITH THE NIH BUDGET AD
THE WHOLE GRANT ECOSYSTEM.
SO THAT'S COMMONLY TRACKED AND
SOMETHING THAT WE TRY TO
INCREASE AS MUCH AS POSSIBLE.
SO IF YOU GO TO THE NEXT SLIDE.
SO THIS KIND OF ILLUSTRATES WHAT
HAPPENS WITH THE GRANTS WHEN
THEY'RE MADE FOR A MULTIYEAR
PERIOD AND HOW THAT IMPACTS OUR
BUDGET, AND THE FIRST BULLET
HERE OVER THE LONG-TERM, IT
TAKES A MULTIPLE OF THE INITIAL
COST TO INCREASE THE NUMBER OF
COMPETING RPGs.
IT DEPENDS ON THE LENGTH OF THE
AWARD, THIS EXAMPLE IS A 4 YEAR
AWARD, AND YOU CAN SEE BY THE
COLOR COATING THAT IF YOU HAD A
NEW AWARD, IF YOUR BUDGET IS IN
A VERY, ITEM BY ITEM SENSE, IF
YOUR BUDGET WENT UP BY HALF A
MILLION DOLLARS, AND YOU WERE
ABLE TO MAKE 1 NEW AWARD, IN THE
FIRST YEAR, COME THE SECOND
YEAR, THE THIRD YEAR, THE FOURTH
YEAR, YOU WOULD NEED THAT HALF
MILLION DOLLARS AGAIN TO HANDLE
THE CONTINUATION, SO IN TERMS OF
THE COUNT, THE NUMBER OF
COMPETING AWARDS, YOU WOULD GO
UP BY 1 AND GO BACK DOWN TO NONE
IN THE NEXT 3 YEARS UNTIL THE
FIFTH YEAR, THOSE FUNDS WOULD
FREE UP AND YOU GO BACK UP TO 1
AGAIN.
SO IF YOU WANT TO INCREASE THE
NUMBER OR SUSTAIN IT OR MAKE IT
LARGER, YOU ACTUALLY NEED A
MULTIPLE OF THAT NEW FUNDING IN
ORDER TO CONTINUE THAT.
SO IN THE SECOND YEAR, YOU WOULD
NEED 2 OF THE HALF MILLION
AMOUNT OR 1 MILLION IN ORDER TO
MAINTAIN THAT NUMBER AT THE
COMPETING RPG LEVEL AND SO ON
UNTIL IT RECYCLES AFTER THE 4
YEAR PERIOD.
AND AS A RESULT OF THAT, WHAT WE
SEE WHEN THE BUDGET IS FLAT, OR
IF IT GOES DOWN, IT -- EVEN A
FLAT BUDGET CAN SORT OF LOOK
LOOK A DECREASE BECAUSE OF THIS
WAY THAT THE GRANTS ARE MADE,
YOU DON'T HAVE THE FUNDS TO DO
THE ADDITIONAL COMPETING AWARDS,
THE FOLLOWING YEAR, SO, YOU GET
IN SOME CASES, IF YOU DON'T HAVE
SORT OF A CONSISTENT BUDGET TO
INCREASE THAT COMPETING LEVEL OR
TO KEEP IT FLAT, EVEN, YOU WOULD
WANT TO GRADUALLY INCREASE IN
BUDGET.
IF YOU DON'T GET THAT WHAT CAN
HAPPEN IS SOMETIMES WHAT WE CALL
A ROLLER COASTER WHERE YOU'RE
COMPETING GRANTS WILL GO UP AND
DOWN AND UP AND DOWN, AND WE DO
WHAT WE CAN TO TRY TO SMOOTH
THAT OUT SO WE DON'T HAVE BIG
CHANGES OR, YOU KNOW WE TRY TO
MINIMIZE SOME OF THOSE CHANGES
BUT THAT CAN HAPPEN BECAUSE TO
SUSTAIN THE DEVELOPMENTS, THE
IMPROVEMENTS, INCREASES IN
GRANTS THAT WE HAVE FROM PRIOR
YEARS, IT REQUIRES THE FUNDING
TO CONTINUE THAT AS WELL AS TO
MAKE IT HAPPEN AGAIN.
SO, YOU SEE AS A RESULT, THAT
SOMETIMES AS I SAID, YOU'LL HEAR
THAT A FLAT BUDGET IS LIKE A
DECREASE IN THIS RESPECT, IT
DOESN'T CHANGE THE TOTAL NUMBER
OF GRANTS BUT IT CHANGES THE
NUMBER OF COMPETING AWARDS, SO
COMPETING AWARDS CAN'T BE
SUSTAINED IF YOU'RE IN THAT
SITUATION, AND YOU'RE HAVING TO
USE THE SAME FUNDS FOR MORE
NONCOMPETING AWARDS THAT WERE
MADE IN PRIOR YEARS.
NEXT SLIDE.
SO SOME OF THE WAYS WE DEAL WITH
THAT ARE INDICATED HERE, THE
COMMITMENT BASE, THAT'S WHAT WE
CALL THE GROUP OF NONCOMPETING
AWARDS, WE'RE CAREFUL UNDER A CR
LIKE WE ARE AT THE MOMENT.
WE REDUCE THE FUNDING OF THOSE
TO 90% OF WHAT WAS PLANNED TO
GIVE US FLEXIBILITY UNTIL WE
KNOW WHAT THE FINAL PROARPGS
ARE, AT THAT POINT, WHERE
POSSIBLE, THOSE WILL BE
INCREASED FROM 90% TO A 100%.
IF IT'S NOT POSSIBLE, IT MIGHT
BE SOMEWHAT LESS THAN A
HUNDRED%, IT ALL DEPENDS ON THE
PARTICULAR CIRCUMSTANCES OF THE
YEAR AND SOMETIMES THE
CIRCUMSTANCES OF INDIVIDUAL
INSTITUTES AND CENTERS.
IT CAN HAPPEN THAT SOME
INSTITUTES HAVE A DIFFERENT
LOOKING GRANT CYCLE THAN OTHERS,
SO IT'S NOT UNIFORM ACROSS NIH,
SOMETIMES IF NECESSARY, WE WILL
HAVE AN NIH WIDE POLICY ON HOW
TO ADDRESS THAT, BUT MORE
FREQUENTLY INDIVIDUAL
INSTITUTES
AND CENTERS CAN SEE WHAT KIND OF
ABILITY THEY HAVE TO CONTINUE
THEIR COMMITMENT BASE AT THE
EXPECTED LEVEL OR NOT.
SO THAT'S THE SECOND BULLET IN
TERMS OF HOW WE DEAL WITH THAT,
TIMES IT'S A POLICY BASIS,
SOMETIMES INDIVIDUAL, BUT THERE
ARE LIMITS IN TERMS OF WHAT WE
CAN DO IN THAT RESPECT.
IF THE FUNDING FOR A
NONCOMPETING GRANT IS DECLINING
BY MORE THAN A CERTAIN AMOUNT,
IT MAY NOT BE POSSIBLE FOR A
GRANTEE TO MEET THE INITIAL AIMS
OF THAT RESEARCH GRANT IN WHICH
CASE IT WOULD REQUIRE
RENEGOTIATION AND WEEZ HAVE 10S
OF THOUSANDS OF GRANTS SO THAT'S
NOT REALLY A POSSIBILITY.
AS A RESULT, WE HAVE TO BE
CAREFUL THAT IF WE ARE TRYING TO
ADJUST THE NONCOMPETING AWARDS,
THAT WE NOT DO IT TO AN EXTENT
WHERE IT'S GOING TO HAVE THAT
KIND OF IMPACT.
SO THERE'S A LIMIT TO WHAT YOU
CAN DO THERE, AND AS A RESULT,
WE HAVE TO TRY TO MAXIMIZE AS WE
CAN THE NEW AWARDS, SPERKLY
BECAUSE THAT WILL HAVE AN IMPACT
ON EARLY STAGE INVESTIGATORS,
OTHER PRIORITIES FOR NIH, BUT WE
DO HAVE THE TOOL THAT WE CAN
MAKE LIMITED ADJUSTMENTS
SOMETIMES TO THAT COMMITMENT
BASE OF NONCOMPETING AWARDS.
AND THEN SOME OTHER TECHNIQUES
THAT ARE OCCASIONALLY USED
ISSUES THE LAST BULLET, UP FRONT
FUNDING.
SO IN THAT CASE IF YOU WERE
MAKING A 4 YEAR AWARD, YOU COULD
IN SOME SITUATIONS PROVIDE THE
ENTIRE AMOUNT TO THE GRANTEE UP
FRONT.
OBVIOUSLY THAT'S GOING TO COST
YOU 4 TIMES AS MUCH IN THE
INITIAL YEAR BUT IT HAS AN
ADVANTAGE THAT THE FOLLOWING
YEAR, YOU ARE GOING TO HAVE
THOSE FUNDS AVAILABLE.
AGAIN, THEY WON'T BE GOING TO A
NONCOMPETING AWARD, SO SOMETIMES
THAT'S USED IN ORDER TO HANDLE
SOME OF THE DYNAMICS OF THE
GRANT FUNDING, ADMINISTRATIVE
SUPPLEMENTS IS ANOTHER TOOL THAT
CAN BE USED AT TIMES THAT IS A 1
YEAR ADDITION TO AN EXISTING
GRANT.
SO IF YOU HAD FUNDS AVAILABLE,
YOU DIDN'T WANT TO COMMIT TO
CONTINUING GRANT WITH THOSE
FUNDS IN THE FOLLOWING YEAR AND
ADMINISTRATIVE SUPPLEMENT WOULD
ALLOW YOU TO GET MORE RESEARCH
FROM AN EXISTING GRANT WITHOUT
MAKING THAT COMMITMENT FOR THE
NEXT YEAR.
THE NEXT SLIDE.
SO JUST A LIST HERE OF SOME OF
THE COMMON TYPES OF GRANTS THAT
WE MAKE, THE RO-1.
THAT IS THE MOST COMMON.
R21, AGAIN SHORTER, R03, LARGER
GRANTS HERE, THE Us, THE Ps,
AND T AND F GRANTS, TRAINING AND
FELLOWSHIP, Ks, SBIR AND OTHER
MECHANISMS, OTHER TRANSACTION, I
WILL MENTION THAT IS AN
AUTHORITY, STATUTORY AUTHORITY
THAT NIH HAS TO MAKE AWARDS THAT
ARE NOT GRANTS OR CONTRACTS
WELL'S MORE FLEXIBILITY THERE IN
TERMS OF WE CAN DESIGN THE
PROVISIONS THAT APPLY TO THOSE
AWARDS.
IT'S SOMETHING THAT HAS BEEN
VERY HELPFUL FOR EXAMPLE, WITH
OUR COVID RESEARCH.
WE'VE BEEN ABLE TO USE OTHER
TRANSACTIONAL AUTHORITY FOR
THAT, TO A GOOD EXTENT AND I
WILL MENTION JUST AS I PROBABLY
SHOULD HAVE EARLIER, THIS BUDGET
THAT I'M TALKING ABOUT, THIS IS
THE ANNUAL NIH BUDGET.
IT DOESN'T INCLUDE SUPLEMMAL
FUNDING THAT WE HAVE SPEBT IN
RECENT YEARS FOR COVID-19
RESEARCH FOR EXAMPLE, THAT IS
ALL, THAT IS SEPARATE FROM THIS,
SOMETIMES, THOSE KIND OF
PROVISIONS WILL GET ADD TO
ANNUAL BUDGET BUT THIS IS
FOCUSED ON HOW WE HANDLE OUR
ONGOING ANNUAL APPROPRIATIONS
AND BUDGET.
AND SO THE WAY WE KNOW WE LET
EVERYBODY KNOW ABOUT THE FUNDING
ANNOUNCE WANTS BUT WE USE THEM
TO AMILLIOORITIZE THE GRANT
OPPORTUNITIES, WE HAVE SOME THAT
ARE ONGOING, LAST A LONG TIME,
SOME THAT ARE DESIGNED FOR
SPECIFIC PROGRAMS, HIGHLIGHT A
SPECIFIC FOCUS AREA, PRIORITY,
BASICALLY TO LET THE RESEARCH
COMMUNITY KNOW WHAT FUNDS ARE
AVAILABLE FOR WHAT, AND LATELY
WE'VE BEEN USING NOSIs TO
HIGHLIGHT THOSE AREAS AND TO
EXPLAIN AREAS TO EXISTING FOAs
FOR APPLICATIONS PLIRICATION --
APPLICATIONS.
SO THIS IS JUST LETTING PEOPLE
KNOW HOW THE FUNDS ARE COVERED
FOR THE PARTICULAR RESEARCH
AREAS.
NEXT.
SO I WANT TO TALK A LITTLE BIT
ABOUT WHAT WE CALL RCDC, THIS IS
FUNDING ESTIMATES FOR RESEARCH
CONDITION DISEASE CATEGORIES.
YOU CAN SEE THEA THE BOTTOM A
COUPLE OF THE 1S BUT WE HAVE
HUNDREDS OF THESE AND
AUTOANOTHER WAY OF LOOKING AT
THE -- IT'S ANOTHER WAY TO LOOK
AT THE NIH BUDGET TO DEEMERGING
IT HOW MUCH WE'RE SPENDING ON
DIFFERENT RESEARCH AREAS,
THERE'S A LOT OF INTEREST IN
THIS, PARTICULARLY NOT ONLY FROM
CONGRESS BUT FROM THE PUBLIC, IF
THEY'RE INTERESTED IN HOW MUCH
EFFORT IS NIH DEVOTING TO A
PARTICULAR CONDITION, A
PARTICULAR RESEARCH AREA, WE
HAVE A SOPHISTICATED WAY WE COME
UP WITH THESE NUMBERS, WE REPORT
BOTH THE ACTUAL AMOUNTS FOR
PRIOR YEARS, RIGHT NOW WE HAVE
POSTED THROUGH 2023, AND THEN WE
ALSO ESTIMATE EITHER BASED ON
CURRENT APPROPRIATION THAT WE
RECENTLY RECEIVED OR PRESIDENT'S
BUDGET, ONCE IT'S RELEASED FOR
COMING YEARS, WHAT WE THINK IS
LIKELY AMOUNT FOR THESE VARIOUS
CATEGORIES.
IT DIFFERS A LITTLE BIT FROM THE
REST OF THE BUDGET IN THE SENSE
THAT FIRST, IT'S MEASURING
OBLIGATIONS SO IF WE RECEIVE
MONEY FOR EXAMPLE THAT IS
AVAILABLE FOR US TO OBLIGATE
OVER A MULTIYEAR PERIOD, AND
TAKEN--THEY CAN BE 2 YEAR MONEY,
3 YEAR, 4, 5, OR NO YEAR,
SOMETIMES, WHEN WE GET MONEY
FROM CONGRESS AND THOSE FORMS,
WE'RE NOT REQUIRED TO MAKE A
GRANT FOR EXAMPLE, A CONTRACT
WHATEVER WITH IT IN THE FIRST
YEAR.
SO IN RCDC, WE'RE REPORTING WHAT
WE ACTUALLY OBLIGATED IN THE
CURRENT YEAR, IT DOESN'T
NECESSARILY COVER EVERYTHING
THAT CONGRESS GAVE US FOR THAT
DISEASE OR CATEGORY IN A
PARTICULAR YEAR IF IT'S FUNDS
THAT ARE AVAILABLE FOR MORE THAN
1 YEAR, SO THAT'S A LITTLE BIT
DIFFERENT THAN THE OTHER BUDGET
NUMBERS THAT I SHOWED YOU
BEFORE.
THE OTHER THING THAT'S A LITTLE
DIFFERENT IS THAT THESE
CATEGORIES ARE NOT EXCLUSIVE.
SO IF YOU HAVE A RESEARCH GRANT
THAT FALLS INTO MORE THAN 1 OF
THESE CATEGORIES, WE WOULD LIST
THE FULL AMOUNT OF THE GRANT FOR
EACH CATEGORIES, SO THERE IS
SOME OVERLAP BETWEEN RELATED
CATEGORIES IN SOME CASES, AND
WHEN REQUESTED, WE CAN -- WE
HAVE THE ABILITY TO REMOVE THE
DOUBLE COUNT TO SAY, OKAY, IF
YOU WANT TO KNOW HOW MUCH WAS
SPENT FOR THESE 2 CATEGORIES
THAT ARE SIMILAR, IT'S POSSIBLE
WE CAN CALCULATE WHAT THE TOTAL
AMOUNT WAS FOR THOSE WITHOUT ANY
DUPLICATION, BUT IN GENERAL, TO
GIVE A BETTER PICTURE OF
EVERYTHING THAT WE'RE DOING IN
THESE DIFFERENT RESEARCH AREAS,
THE CATEGORY NUMBERS ARE NOT
EXCLUSIVE.
SO, IF YOU WERE TO ADD UP THE
ENTIRE RCDC TABLE, IT WOULD BE
MORE THAN THE TOTAL NIH BUDGET
OR MORE THAN TOTAL NIH
OBLIGATIONS IN THIS PARTICULAR
CASE BUT THAT'S HOW WE CALCULATE
IT SO THAT WE DON'T NEED TO SORT
OF FIGURE OUT, WELL, HOW MUCH OF
THIS GRANT IS FOR THIS 1 OR THAT
1.
WE'RE SIGHING TO SHOW OW MUCH IS
GENERATED IN THOSE AREAS.
SO WITH THAT LET ME PAUSE AND
TAKE QUESTIONS.
>> THANKS.
I'VE BEEN REMINDED TO ASK PEOPE
TO STAY CLOSE TO THE MICROPHONE.
PEOPLE HAVE HAD TROUBLE HEARING.
SO WHO HAS QUESTIONS FOR NEIL.
>> JOAN?
>> THANK YOU SO MUCH FOR THE
PRESENTATION, 1 THING WE TALKED
ABOUT IN TERMS OF THE COMMON
TYPES OF GRANTS IS THAT THEY GO
TO INSTITUTIONS AND 1 OF THE
THINGS WE TALK ABOUT TODAY IS
THE IMPORTANCE OF INCLUDING
PATIENT ADVOCACY GROUPS AND
COMMUNITIES IN RESEARCH AND I
WONDERED IF YOU COULD SPEAK TO
ANY FLEXIBILITIES IN THE GRANT
MECHANISMS THAT MAY BE ABLE TO
BE BEST SUITED TO GO TO THOSE
TYPES OF COMMUNITIES, PATIENT
ADVOCACY OR COMMUNITIES IN THAT
REGARD.
>> RIGHT, WELL, AS I WAS SAYING
WE DO HAVE THE FLEXIBILITY FOR
EXAMPLE IF WE DISCOVER DURING
THE COURSE OF THE YEAR, THAT
THERE'S A PARTICULAR MECHANISM
THAT WOULD BE BETTER FOR
PARTICULAR TYPE OF RESEARCH THAN
ANOTHER, IF IT'S A SHIFT BETWEEN
SAY GRANTS AND R&D CONTRACTS IN
A PARTICULAR CASE, WE HAVE THE
FLEXIBILITY TO DO THAT, BECAUSE
WHAT WE'RE REPORTING TO CONGRESS
ARE ESTIMATES WITH THE
UNDERSTANDING THAT THOSE
ESTIMATES CAN VARY, SO THERE CAN
BE CHANGES BETWEEN MECHANISMS,
THOSE ARE NOT LIMITED IN THE
CONGRESSIONAL PROCESS BUT THEY
ARE MONITORED, SO, WE ALWAYS
WANT TO BE PREPARED AND IN MY
OFFICE WHEN WE'RE DOING THE
QUARTERLY ESTIMATES, IF WE SEE A
BIG SHIFT, AND WE HAVE ALL SORTS
OF PARAMETERS, SAY, WELL, WHAT'S
BIG, WHAT'S SMALL, IF WE SEE
SOMETHING LIKE THAT WE MAKE SURE
THE INSTITUTE OR CENTER HAS AN
EXPLANATION FOR THE REASON FOR
THAT, SO WE'RE PREPARED FOR
QUESTIONS FROM CONGRESSIONAL
STAFF, WHICH WE GET ON A DAILY
BASIS SOMETIMES SO THAT WE CAN
EXPLAIN USUALLY IF THERE'S
SOMETHING ON KIND OF A
MACROLEVEL, WE DON'T GET THAT SO
MUCH INSTITUTE BY INSTITUTE, BUT
IF THERE SEEMS TO BE SOME SORT
OF NOTICEABLE SHIFT IN TERMS OF
HOW THE MECHANISMS ARE
DISTRIBUTED, THAT COMMONLY MIGHT
RESULT IN QUESTIONS FROM THE
HILL, OR FROM OTHER
STAKEHOLDERS.
>> OKAY, THANK YOU EMPLOY OTHER
COMMENTS, QUESTIONS?
OKAY, MARK, GO AHEAD.
>> THANK YOU FOR THE GOOD
PRESENTATION.
I'M WONDERING FOR MECHANISMS
WHERE THE DIRECT COSTS ARE
CAPPED LIKE AN R21, IS THERE ANY
EVIDENT THAT THE CAP IS
INSUFFICIENT TO SUPPORT CURRENT
COSTS FOR RESEARCH FOR A LIMITED
PROJECT?
>> I'M NOT SURE I'M THE BEST
PERSON TO ANSWER THAT BUT I KNOW
THERE ARE DISCUSSIONS ON
SUBJECTS LIKE THAT PERIODICALLY.
>> WHO AMONG THE IC DIRECTORS
WANTS TO HANDLE THAT?
IT'S A LOADED QUESTION.
SO IF PEOPLE APPLY FOR THEM,
RIGHT, SO IT'S HARD TO TELL IF
IT TURNED OUT TO BE
INSUFFICIENT, RIGHT, BUT PEOPLE
DO APPLY FOR THOSE MECHANISMS.
SO IF PEOPLE STOPPED APPLYING,
YOU KNOW THEN YOU WOULD SAY,
WAIT A MINUTE, SOMETHING'S AMISS
BUT BECAUSE PEOPLE KEEP APPLYING
WE HAVE TO ASSUME THAT FOLKS
FEEL THEY CAN CONDUCT THE
RESEARCH THEY NEED TO.
NOW, ALONG THE WAY,IME SURE ALL
THE PROGRAM OFFICERS GET
FEEDBACK, WHICH MAY SAY
SOMETHING LIKE I CAN'T DO
SPECIFIC AIM 2 LET'S SAY BECAUSE
I RUN OUT OF FUNDS OCCASIONALLY
AN INSTITUTE WILL SUPPLEMENT
THAT BUT IT'S ONLY ON OCCASION.
BUT ALL THE GRANT NUMBERS AND
ALL THE COSTS OF GRANTS
CONTINUES TO RISE EMPLOY I DON'T
KNOW IF IT'S TIED DIRECTLY TO
INFLATION, IT MAKES A GOOD CHUNK
OF THAT, DOES THAT HELP?
>> I CAN SAY WE CERTAINLY
RECOGNIZE THAT INFLATION AS
LARRY SAID IS A PROBLEM AND
THINGS LIKE THE R15, WHICH HAD A
CAP FOR MANY YEARS DIDN'T
CHANGE, WE JUST INCREASED THAT
CAP FOR THE REASONS YOU'RE
STATING.
R21S HAVE GENERALLY BEEN WHERE
THEY ARE FOR A LONG TIME BUT
IT'S A BALANCE BETWEEN HOW MANY
GRANTS YOU CAN GIVE AND HOW MANY
PEOPLE YOU CAN SUPPORT AND HOW
MUCH YOU GIVE FOR EACH GRANT.
>> I WOULD SAY INUPPORT OF
DR. TABAK'S COMMENT, PEOPLE DO
VOTE WITH THEIR FEET AND SO FOR
EXAMPLE, FOR THE LONGEST TIME
INCLUDING EVEN NOW MODULAR
GRANTS SORT OF LIMITED TO
$250,000, PEOPLE HAD A
PERCEPTION THAT THEIR CHANCE OF
SUCCESS WAS GREATER IF THEY
APPLIED FOR A MODULAR GRANT
VERSUS A NONMODULAR GRANT.
I HAVE TO TELL YOU THAT'S AT
LEAST FOR OUR INSTITUTE
SOMETIMES AROUND 2015, WE
REACHED A POINT IN WHICH THE
NUMBER OF NONMODULAR GRANTS IS
IN THE MINORITY NOW AND THE COST
OF GRANTS CONTINUES TO GO UP
WHICH ADDS TO NEALS POINT.
YOU KNOW IT'S A VERY NICE
PRESENTATION ASSUMING
EVERYTHING'S EQUAL BUT THERE'S
INFLATION IN THE BACKGROUND SO
WHAT YOU CAN -- ASSUMING YOU
HAVE A FLAT BUDGET IT'S EACH
WORSE THAN TAKING INTO ACCOUNT.
SO AGAIN PEOPLE DO SORT OF VOTE
WITH THEIR FEET AND THEY'VE
MOVED TO THESE NONMODULARS,
MULTIPI GRANTS ARE MORE
EXPENSIVE THAN THE NUMBER OF
PIGRANTS AND THE NUMBER OF THOSE
HAVE BEEN INCREASING FOR THE
LAST FEW YEARSER SO.
NI WOULD ADD THAT HISTORICALLY
THE NIH PURCHASING POWER IN
INFLATION ADJUSTED TERMS PEAKED
IN 2003 AND THEN BOTTOMED OUT
AROWNT 2015.
IT LOST ABOUT 22% OF THE
PURCHASING POWER BECAUSE
INFLATION HAD BEEN GREATER THAN
THE INCREASES IN THE
APPROPRIATION LEVEL SINCE 2016,
WE'VE RECOVERED A LOT OF THAT
ALMOST ALL OF THAT INFLATIONARY
REDUCTION, BUT IT HAS A BIG
IMPACT AGAIN IN TERMS BECAUSE OF
THE AVERAGE COST OF GRANTS HAS
GONE UP OVER THE YEARS.
>> ALLYSON.
>> SWITCHING GEARS YOU HAD SOME
PARTICULARLY FOR NCIs LINES
AND THEIR DIRECT -- HOW DOES
THAT COME ABOUT?
WHAT IS THE PROCESS FOR THAT?
>> THAT COMES FROM CONGRESS,
THROUGH BILL AND REPORT
LANGUAGE.
WE SUBMIT THE PRESIDENT'S BUDGET
EVERY YEAR WITH OUR
RECOMMENDATIONS FOR THOSE KINDS
OF ITEMS.
CONGRESS DELIBERATES.
THEY HAVE THE FINAL SAY BUT IT'S
AN INTERACTIVE PROCESS THAT
WE'RE VERY ENGAGED WITH THE
APPROPRIATIONS COMMITTEES AND
OTHERS THIS CONGRESS THROUGHOUT
THE YEAR.
>> THANK YOU THAT WAS HELPFUL.
I KNOW YOU SHOWED THINGS LIKE
SBIRs AND CERTAIN TYPES OF
GRANTS.
DO YOU TRACK THINGS LIKE ACROSS
ALL INSTITUTES HOW MUCH IS USED
TO SUPPORT CLINICAL TRIALS AND
THINGS LIKE THAT?
>> MY OFFICE DOESN'T TRACK THAT
BUT IT CAN BE TRACKED.
OUR EXTRAMURAL RESEARCH OFFICE
DOES TRACT THOSE TYPES OF DATA.
>> WHAT HAPPENS AT THE END OF A
FISCAL REPORTING PERIOD?
CAN YOU CARRY FUNDS FORWARD?
WHAT HAPPENS WITH THAT?
>> TWO THINGS.
TWO THINGS.
I TALKED BEFORE ABOUT
OBLIGATIONS.
SO THE WAI OBLIGATIONS WORK, YOU
MAKE AN AWARD IN 1 YEAR, IF WHAT
WE CALL 1 YEAR MONEY WHICH IS
THE BULK OF OUR BUDGET, YOU HAVR
EXPENDITURES, SO THE GRAPTEE,
THE INSTITUTION THAT RECEIVES
THE GRANT HAS 5 YEARS TO
COMPLETE THE RESEARCH WITH THE
GRANT, SO 5 YEARS AFTER WE MADE
THE GRANT.
IF WE HAVE MORE THAN 1 YEAR TO
ALLOCATE THE FUNDS, THEN IT'S 5
YEARS FROM WHENEVER THAT
OBLIGATION PERIOD ENDS.
IF IT'S CALLED NO YEAR MONEY.
THERE IS NO LIMIT BUT
ESSENTIALLY THE AMOUNT OF TIME
THAT NIH HAS TO GIVE OUT THE
MONEY STARTS THE CLOCK BY A YEAR
IN TERMS OF HOW LONG THE
RESEARCHERS HAVE TO DO THE
RESEARCH.
>> BUT WE CAN CARRY OVER VERY
LITTLE IN THE WAY OF FUNDS?
>> RIGHT, BECAUSE MOST OF OUR
FUNDING IS 1 YEAR.
>> SO IT'S NOT LIKE SAVING FOR A
RAINY DAY, WE CAN'T DO THAT.
>> RIGHT.
>> VIRTUALLY ALL OF OUR FUNDS
HAVE TO BE OBLIGATED IN A FISCAL
YEAR.
>> RIGHT.
THERE ARE A A FEW YEARS LIKE BT
THE BULK OF IT HAS TO BE USED IN
THE YEAR RESILIENCE CEIVE IT,
WHICH MAKE ITS CHALLENGING WHEN
WE HAVE A LENGTHY CONTINUES
RESOLUTION FOR EXAMPLE.
>> MAY I ASK A QUESTION ABOUT
JUST FOR INFORMATION FOR THE
GROUP ABOUT THE FUNDING LINES.
SO WHEN YOU'RE LOOKING, SINCE
MOST OF THE BUDGET IS RPGs AND
THE OBVIOUSLY THE FUNDING LINES
CAN MOVE UP DOWN DEPENDING
ON HOW MUCHS BUDGETED FOR THAT
CENTER, HOW MUCH FLEXIBILITY OR
IS THERE AN EXPECTATION FOR
MOVING FUNDING LINES OR HOW IS
THAT MANAGED CURRENTLY?
>> THAT IS 1 OF THE KEY
BUDGETARY RESPONSIBILITIES --
EXCUSE ME -- OF THE INSTITUTE
AND CENTER OF DIRECTORS TO MAKE
THOSE DETERMINATIONS AND THERE
ARE TIMES WHEN
EN WGIESITUTES WILL DECIDE
THAT THEY WANT TO INCREASE HOW
MUCH OF THEIR FUNDING THEY'RE
DEVOTING TO RPGs, VERSUS OTHER
FUNDING FOR EXAMPLE, AND THOSE
ARE DECISIONS EACH INSTITUTE
MAKES TIMES WITH CONSULTATION
WITH THE OFFICE OF THE DIRECTOR.
>> YEAH, SO, IT'S DISCRETIONARY
BUT IT SOUNDS LIKE THE OFFICE OF
THE DIRECTOR HAS SOME INFLUENCE
OVER WHERE THEY END UP THAT
CORRECT OR NO?
>> SO AGAIN, YOU REFERRING TO
THE ALLOCATION AMONG THE
INSTITUTES AND CENTERS OR THE
ALLOCATIONS WITHIN A SINGLE
INSTITUTE OR CENTER?
>> WITHIN A CENTER.
>> WITHIN A CENTER, INSTITUTE
AND CENTER DIRECTOR MAKES THAT
CALL THERE MAY BE CONSULTATION
BUT WHEN'S THE LAST TIME YOU
EVER LISTENED -- I MEAN -- NO,
I'M --
>> THAT'S WHAT WE WANT TO KNOW
THOUGH.
>> THE INSTITUTE CENTER
DIRECTORS ALMOST INVARIABLY WILL
MAKE THE FINAL CALL.
>> OH OKEAH, BECAUSE THAT'S
SOMETHING THAT IS FLEXIBLE BASED
ON THE DIRECTOR IS WHAT I WAS
TRYING TO GET AT.
>> EXCEPT FOR SOME SUBCATEGORIES
LIKE SBIR FOR EXAMPLE WHICH IS
MANDATED THERE NEEDS TO BE A
CERTAIN PERSPECTIVE NI MEAN
THERE ARE GUARD RAILS AND
GUIDANCE, SO IF WE GO TOO FAR 1
WAY OR THE OTHER, WE GET UP TO
--
>> BROUGHT TO THE PRINCIPAL'S
OFFICE.
>> AND THERE ARE SOMETIMES
OPPORTUNITIES AMONGST THE
INSTITUTES AND CENTERS IN TERMS
OF PARTICULAR ACTIVITIES AND
SBIR, IN SOME CASES WHERE 1
INSTITUTE MAY HAVE MORE HIGH
QUALITY APPLICATIONS THAN OTHER
INSTITUTE AND THEY CAN
COLLABORATE TO COOPERATION IN
TERMS OF THAT TYPE OF ACTIVITY.
>> OKAY.
>> YEAH.
>> JUST TO ADD AND THEN SOME
INTUITYS HAVE SLIGHTLY DIFFERENT
PHILOSOPHY.
SOME INSTITUTES CHOOSE TO PUT
THE BULK OF THEIR FUNDS IN
INVESTIGATOR INITIATED
INCONSTITUTES HAVE TO OR FIND IT
BEST TO USE CONTRACTS TO MANAGE
CLINICAL TRIALS, SO THAT BROAD
PERCENTAGE THAT NEAL SHOWED
EARLY, YOU KNOW 11% INTRAMURAL,
AND 70%, IN CONTRACTS ALIGN,
THAT'S PROBABLY THE BIGGEST
VARIANCE.
>> RIGHT.
THERE CAN BE A LOT OF
VARIABILITY BETWEEN MECHANISMS
DEPENDING ON THE NATURE OF THE
INSTITUTE AND WHAT MAKES THE
MOST SENSE FOR THESE PROGRAMS.
>> ANY FINAL WORD FOR ANYBODY?
>> OKAY, THANKS NEIL.
>> THANKS.
>> WELL, GOOD AFTERNOON.
I'M GRIFFIN ROGERS AS YOU KNOW,
I'M THE DIRECTOR OF NIDECKER DK
AND I THINK I AM 1 OF THE FEW
REMAINING MEMBERS OF THE
ORIGINAL SMRB AND AS I DREW THE
SHORT STRAW, I'M HERE TO TELL
YOU WHAT OUR ORIGINAL
DELIBERATIONS WERE ALL ABOUT TO
GIVE YOU A HISTORICAL
PERSPECTIVE.
SO LET ME TAKE YOU THROUGH IN
THE TIME ALLOTTED AND I WILL TRY
TO GET US BACK ON TIME THROUGH
THE HISTORY, MEMBERSHIP,
PROCESS, REPORTS, ORIGINAL SMRB,
AND THEN, LARRY OR DR. TABAK,
LARRY HAS ALREADY OUTLINED THE
BOARD'S ROLE SO I WILL FOCUS ON
HOW ITS FUNCTION AND KEY
ACTIVITIES.
NEXT SLIDE, PLEASE.
SO TO UNDERSTAND THE ROLES, IT'S
FIRST IMPORTANT TO UNDERSTAND
THE HISTORY OF THE NIH.
NIH ORIGINS TRACE BACK TO SPHENE
98 WHEN THE MARINE HOSPITAL
SERVICES PRECURSOR OF THE UNITED
STATES PUBLIC HEALTH SERVICE WAS
ESTABLISHED TO PROVIDE MEDICAL
CARE FOR THE MERCHANT MARINE SEA
MEN AND THEN 1880S IT EXPANDED
TO ENCLOUD DISEASE SURVEILLANCE
PARTICULARLY INFECTIOUS DECS
LIKE CHOLERA AND YELLOW FEVER.
LEADING TO THE CREATION OF
LABORATORIES AND THEN OVER TIME
THIS MARINE HOSPITAL SERVICES
BEGAN TO FOCUS THEIR EFFORTS ON
A BROADER BIOMEDICAL RESEARCH
WITH MAJOR MILESTONES INCLUDING
THE REDESIGNATION OF THE MARINE
HOSPITAL SERVICE LABS.
BY THEN IT WAS CALLED A HIGENIC
LABORATORIES, TO THE NIH IN 1930
AND THEN THE OPENING OF THE
BETHESDA CAMPUS YOU'RE ON NOW
AND THEN THE CREATION OF THE
NATIONAL CANCER INSTITUTE AND
OTHER INSTITUTES AND CENTERS.
IN 2006, CONGRESS ESTABLISHED
THE SMRB AS YOU HEARD ALREADY,
WHICH WAS TASKED WITH ADVISING
NIH'S LEADERSHIP, ON STRUCTURAL
AND PROGRAMMATIC CHANGES,
NOTABLY THIS LED TO THE CREATION
OF THE NATIONAL CENTER FOR
TRANSLATIONAL SCIENCES OR NCATS
THAT DR. RUDDER IS THE DIRECTOR
IN 2011 AND MORE ON THAT LATER,
NEXT SLIDE, PLEASE.
THE SMRB AS YOU HEARD ALREADY
WAS CREATED IN THE 2006 AS PART
OF THE NIH REFORM ACT, THE ROLE
WAS TO ADVISE THE DIRECTOR OF
NIH, HHS SECRETARY AND OTHER NIH
LEADERSHIP ON THE USE OF NIH
ORGANIZATIONAL AUTHORITIES, THIS
INCLUDED THE DECISIONS TO
ESTABLISH OR ABOLISH INSTITUTES,
REORGANIZE OFFICES AND PROGRAMS
BUT THIS WAS JUST SOME OF WHAT
THE ORIGINAL SMRB TOOK ON.
THE PURPOSE WAS TO ADVISE THE
DIRECTOR AND OTHER APPROPRIATE
AGENCIES THROUGH REPORTS OF THE
NIH DIRECTOR, ON THE USE OF
THESE ORGANIZATIONAL AUTHORITIES
TO IDENTIFY THE RATIONAL AS
YOU'VE HEARD UNDERLYING THE
RECOMMENDATIONS THAT ULTIMATELY
WERE EMBEDDED IN THESE REPORTS.
YOU HEARD THAT NOT LESS THAN
ONCE EVERY 7 YEARS, THE BOARD
WILL BE PROVIDING THIS ADVICE TO
THE DIRECTOR, AND OTHER
APPROPRIATE AGENCIES REGARDING
THE USE OF THE AUTHORITIES,
REFORMED IN THIS REFORM ACT.
NEXT SLIDE, PLEASE.
THE ORIGINAL SMRB INCLUDED A
DISTINGUISHED GROUP OF LEADERS
FROM GOVERNMENT AND ACADEMIA AND
INDUSTRY WITH DEEP EXPERTISE AND
BIOMEDICAL RESEARCH AND BEYOND
AND WHAT SETS THE SMRB APART AND
IT IS UNIQUE FEDERAL AND
NONFEDERAL COMPOSITION, WHICH
WAS MANDATED BY LAW THAT YOU
HEARD ABOUT, SHOWN ON THIS SLIDE
IS NOT THE ORIGINAL MEMBERS, BUT
ON THE RIGHT YOU'LL ACTUALLY SEE
THE LISTENING OF THOSE ORIGINAL
MEMBERS.
THE ORIGINAL SMRB WAS CHAIRED BY
NORM AUGUSTINE WHO IS A FORMER
PRESIDENT AND CEO OF LOCKHEED.
IT HAD NOT ONLY MEMBERS FROM
ACADEMIA AS YOU WILL SEE THERE,
THERE WAS A NONFEDERAL MEMBERS
THAT ARE ALSO AT LEAST 3 MEMBERS
OF GOVERNMENT OR RATHER OUTSIDE
AGENCIES WITH AN INTEREST IN
SCIENCE, AND YOU CAN SEE THE
FEDERAL MEMBERS, THE NIH
INSTITUTES LISTED ON THE RIGHT.
THE PICTURE ON THE RIGHT WAS
TAKEN IN 2015 AT THE BACK OF
THIS ROOM BEFORE IT WAS
RECONSTRUCTED AND IT WAS
INCLUDES SOME OF THOSE MEMBERS
THAT WERE PRESENT AT THE MEETING
BUT NOT THE FULL GROUP.
NEXT SLIDE, PLEASE.
SO HOW DO WE GET OUR WORK
ACCOMPLISHED?
LARRY TOUCHED ON THE STATUTORY
FRAMEWORK, I WILL NOW FOCUS ON
HOW WE OPERATIONALIZE THAT.
THE WORKING GROUPS AND
SUBCOMMITTEES WERE REALLY
CRUCIAL TO THIS PROCESS, THESE
GROUPS ALLOWED US TO FOCUS ON
SPECIFIC TOPICS THAT WERE
COLLECTIVELY PRIORITIZED BY THE
BOARD, THE FULL SMRB INCLUDING
THE NIH DIRECTOR, AS AN
EXOFFICIO MEMBER ADENTIFIED KEY
AREAS FOR DEEPER EXPLORATION OF
THE WORKING GROUPS, THE CHAIR BY
THE SMRB, IT WAS EITHER CHAIRED
OR CO CHAIRED, THAT WAS AN
ANSWER TO A QUESTION THAT CAME
UP THAL MORN BEING BUT ALSO
INCLUDED SUBJECT MATTER EXPERTS
THAT WERE FORMED TO DIVE INTO
THESE AREAS, THESE GROUPS MET
INDEPENDENTLY, SO THIS WASN'T A
PART OF THE 5 TIME A YEAR
WORKING ON DETAILED RESEARCH AND
ANALYSIS.
THE WORKING GROUPS, WELL, LET ME
JUST FINISH ON THAT THOUGHT, THE
WORKING GROUPS REALLY DID CARRY
OUT THE HEAVY LIFTING, THEY
STUDIED THE ISSUES, THEY HOSTED
WORKSHOPS, AND PANEL
DISCUSSIONS, THEY INVITED
EXPERTS TO SHARE INSIGHTS, THEY
ALSO SOLICITED INFORMATION AND
INPUT FROM THE PUBLIC FROM
PAICIALT ADVOCACY GROUPS OTHERS
OTHER ORGANIZATIONS AND
STAKEHOLDERS AND BASED UPON
THESE EFFORTS THE WORK GROUPS
DEVELOPED THE FINDINGS AND
RECOMMENDATIONS THAT WERE
PRESENTED TO THE FULL SMRB FOR
REVIEW AND APPROVAL AFTERWARDS
THE ECMENDATIONS WERE FORMALLY
TRANSMITTED TO THE NIH DIRECTOR,
AND THE HHS IN THE FORMAL
REPORT.
NOW BETWEEN 2000, CAN YOU KEEP
IT ON THAT.
BETWEEN 2009 AND 2015, THE SMRB
ISSUED 8 REPORTS ON AS YOU CAN
SEE HERE A WIDE RANGE OF TOPICS,
CRITICAL TO NIH AND BIOMEDICAL
RESEARCH COMMUNITY THE FIRST
REPORT WAS FELT AT THE ORIGINAL
MEETING, THE FIRST MEETING BEING
IN APRIL 2009 WAS CONSIDERED
DELIBERATING ORGANIZATIONAL
CHANGE AND EFFECTIVENESS.
BUT THIS FIRST REPORT SET REALLY
THE TONE FOR MOST OF THE BOARD'S
WORK SUBSEQUENTLY AND RIGHT
AFTER MY TALK DR. TABAK WILL
GIVE AN INDEPTH LOOK AT THIS
REPORT OF COURSE, YOU CAN ACCESS
ALL THESE REPORTS LISTED
CHRONOLOGICALLY, ON THE ARCHIVE
SMRB WEBSITE AND THE LINK WILL
BE ROUGH ATOM VIEDED ON --
PROVIDED ON THE FINAL SLIDE.
NEXT SLIDE, PLEASE.
AS I SAID, THE FIRST REPORT
ENTITLED THE DELIBERATING
ORGANIZATIONAL CHANGE AND
EFFECTIVENESS WAS ISSUED IN MAY
OF 2010, SO TO GIVE YOU A SENSE
OF A TIMELINE, THE FIRST MEETING
WAS IN APRIL OF 2009 AND THE
VERY FIRST REPORT CAME OUT IN
MAY OF 2010.
SO THAT'S VERY MUCH IN LINE WITH
WHAT THE BOARD IS CONSIDERING
FOR OUR FIRST REPORT.
IT REALLY WAS FOUNDATIONAL TO
MANY OF THE OTHER REPORTS THAT
EMERGED FROM THE SMRB.
WHAT I WANT TO DO IN THE TIME
ALLOTTED AND I SHOULD SAY WE
DISCUSSED A LITTLE BIT WHEN
DR. ROLKOW MENTIONED IT, IS THE
SUBSTANCE ABUSE AND ADDICTION AT
NIH WHICH WAS ALSO DELIBERATED
BY THIS GROUP.
WHAT I WOULD LIKE TO DO IN THE
TIME ALLOTTED IS HIGHLIGHT THE 4
REPORTS THAT ARE SHOWN IN RED,
THE NIH CLINICAL CENTER,
TRANSLATIONAL MEDICINE AND
THERAPEUTICS, APPROACHES TO
ASSESS THE VALUE OF BIOMEDICAL
RESEARCH, A TOPIC THAT WAS --
CAME UP IN 1 OF THE QUESTIONS
TODAY AND THEN FINALLY,
PRECOLLEGE ENGAGEMENT IN THE
BIOMEDICAL SCIENCES.
I WANTED TO SORT OF GIVE YOU A
FLAVOR OF THE ACTIVITIES
CONSIDERED AND REALLY THE
IMPETUS OF THE WHY, WHY IS IT WE
CHOSE THESE TOPICS OVER MANY
OTHER TOPICS THAT COULD HAVE
BEEN CONSIDERED AND WHY THESE
WERE SELECTED, THE IMPETUS
BEHIND IT AND SOME OF THE
RECOMMENDATIONS THAT FOLLOWED
THOSE DELIBERATIONS.
OKAY, NEXT SLIDE, PLEASE.
ONE OF THE EARLY REPORTS FOCUSED
ON THE NIH CLINICAL CENTER,
INITIALLY PART OF A BROADER
REVIEW OF THE NIH INTRAMURAL
RESEARCH PROGRAM, OR THE IRP, IT
BECAME CLER THAT THE CLINICAL
CENTER ITSELF REQUIRED URGENT
ATTENTION.
THERE WAS INCREASING FISCAL
CONSTRAINTS, INCLUDING THE
INABILITY TO KEEP PACE WITH
INFLATION, SOMETHING THAT WE
JUST MENTIONED.
THE COST OF BIOMEDICAL RESEARCH
IS AT A LEVEL BUT THE COST AND
THE INFLATION RATE FOR DOING
CLINICAL RESEARCH EXCEEDS THAT
TYPICAL BIRD PIE AS IT IS
FREQUENTLY KNOWN.
THESE FISCAL CONSTRAINTS,
INCLUDING THIS INABILITY TO KEEP
PACE WITH INFLATION, REALLY
THREATENED THE FISCAL
SUSTAINABILITY AND UTILIZATION
OF THE CLINICAL CENTER, IN ITS
ABILITY TO ATTRACT HIGH QUALITY
WORKFORCE.
SO, THE NEED TO HAVE SORT OF A
COHESIVE PROGRAMMATIC VISION TO
ENABLE BOTH INTERNAL AND
EXTERNAL INVESTIGATORS CAME OUT
OF THIS.
THE BUDGET WAS IMPORTANT AS I
SAID, WE WEREN'T ABLE TO KEEP UP
WITH THE RISING AND ESCALATION
OF THE COST OF DOING CLINICAL
RESEARCH, BUT IT TURNS OUT THAT
IT WASN'T JUST THE BUDGET,
ALTHOUGH THE BUDGET IS OFTEN
TIMES A MAJOR DRIVER, IT WAS
REALLY THE VISION AND THE ROLE
OF THE CLINICAL CENTER.
THE CLINICAL CENTER AGAIN PART
OF THE INTRAMURAL PROGRAM REALLY
FOCUSED ITS ACTIVITIES AROUND
ACTIVITIES RELATED TO INTRAMURAL
INVESTIGATORS, AND THE QUESTION
WAS SHOULD IT PLAY A MUCH LARGER
ROLE, SHOULD IT BE THE HOSPITAL
FOR THE NATION, NATIONAL
TREASURE, IMPLYING THAT IN ARK
DITION TO THE INTRAMURAL
INVESTIGATORS, THERE SHOULD BE
ACTIVITIES SET UP FOR EXTRAMURAL
INVESTIGATORS AS WELL.
THIS IS PARTICULARLY TRUE
BECAUSE SOME OF THE UNIQUE
FEATURES OF THE INTRAMURAL
PROGRAM, THE ABILITY TO
PERFORM VERY DETAILED IMAGING
MODALITIES, PETS AND MRI,
SEVERAL GENERATIONS OF THAT.
THE ABILITY TO DEEPLY PHENOTYPE
INDIVIDUALS FOR PEOPLE WHO COME
TO THE NIH, INCLUDING PEOPLE WHO
COME WITH RARE DISEASE THAT YOU
HEARD ABOUT, AND THE CLINICAL
CENTER HAS A UNIQUE ABILITY TO
PROVIDE GMP FACILITIES TO
DEVELOP DRUGS THAT MIGHT BE
USEFUL IN CLINICAL STUDIES,
THERE WAS ALSO A NEED THAT WAS
WAS A
NEED THAT WAS IESHES DENTIFIED
IN TERMS OF GOVERNANCE OF THE
CLINICAL CENTER, IT WAS A VERY
COMPLICATED SYSTEM OF OVERSIGHT
AT THE TIME OF THIS REPORT.
NOT ONLY WAS THE DIRECTOR OF THE
CLINICAL CENTER SORT OF DIRECTLY
RESPONSIBLE FOR THE HOSPITAL,
BUT HE SHARED THAT ROLE WITH THE
DEPUTY DIRECTOR OF INTRAMURAL
RESEARCH WHO WAS ALSO THE
INDIVIDUAL SCIENTIFIC DIRECTORS,
AND CLINICAL DIRECTORS OF THE
INSTITUTES THAT BECAUSE THEY
CONTROLLED THE PURSE STRING, HAD
SOME ROLE IN DECISION MAKING
PROCESS, THERE WAS AN ADVISORY
BOARD SET UP TO THE CLINICAL
RESEARCH THAT REPORTED AND
ADVISED THE CLINICAL CENTER
DIRECTOR.
IN ARK DITION EACH OF THE
INDIVIDUALS WHO ARE PERFORMING
RESEARCH IN THE CLINICAL CENTER
HAD THEIR OWN BOARD OF
SCIENTIFIC COUNCIL WHICH YOU
HEARD ABOUT THIS MORNING IN
TERMS OF FACA AUTHORITIES.
SO HOW THESE INDIVIDUALS DID ON
ON THOSE BSC REPORTS ALSO HAD A
MAJOR ROLE IN WHETHER THEY WOULD
CONTINUE WITH THE SAME RESOURCES
OR HAD THOSE RESOURCES CHANGED.
THERE WAS A MEDICAL COMMITTEE,
ALSO THEY PLAYED A ROLE, SO
THESE WERE ON ALL THE INPUTS
THAT WENT INTO THE CLINICAL
CENTER AND IT WAS THOUGHT THE
GOVERNMENT STRUCTURE SHOULD BE
SIMPLIFIED THAT WAS A MAJOR
ACCOMPLISHMENT AND FINALLY A
NEED FOR A BUDGET THAT'S LINKED
TO A STRONG PLANNING PROCESS TO
REMAIN STABLE SO NEXT SLIDE,
PLEASE.
THIS JUST TELLS YOU A LITTLE BIT
ABOUT WHAT WAS IN THAT REPORT
THAT CAME OUT.
IT RECOMMENDED REENVISIONING THE
CLINICAL CENTER ROLE TO BETTER
SERVE THE INTRAMURAL AND
EXTRAMURAL RESEARCHERS, THE
BOARD ALSO SUGGESTED SIMPLIFYING
THE GOVERNMENT STRUCTURE SO THAT
THE PRESENT MOMENT A LOT OF
THAT'S NOW BEEN COLLAPSED TO
WHAT'S KNOWN AS THE CLINICAL
CENTER GOVERNING BOARD AND THE
CLINICAL CENTER DIRECTOR WHILE
IT GETS ADVICE, IT REALLY FOR
THE MAJOR BUDGETARY AND OTHER
CONSIDERATION TURNS TO THE
CLINICAL CENTER OF GOVERNING
BOARD FOR THAT FOR CERTAINLY THE
BUDGET AUTHORITY AND OTHER
SUGGESTIONS ABOUT THE FUTURE.
AS A RESULT OF THE SMRBs
RECOMMENDATION THE DIRECTOR
CONVENED 2 WORKING GROUPS TO
HELP DRIVE THE SUBSEQUENT CHANGE
OF THE CLINICAL CENTER INCLUDING
A RED -- THE RED TEAM WHICH
WORKED ON SOME OF THE FACILITY
ISSUES WITNESS THE INSTITUTE,
WITHIN THE CLINICAL CENTER, NEXT
SLIDE PLEASE.
SO THIS WAS A REPORT ON
TRANSLATIONAL MEDICINE AND
THERAPEUTICS THAT I MENTIONED
AND THE DRIVING FORCE OF THE WHY
BEHIND THIS WAS THAT IN 2010
THERE WAS A PATIENT PROTECTION
AND AFFORDABILITY CARE ACT,
YOU'RE AWARE OF THE AFFORDABLE
CARE ACT PUBLIC LAW SHOWN THERE
AND IT WAS ENACTED AND
AUTHORIZING NIH TO ESTABLISH A
CURES ACCELERATION NETWORK TO
ADVANCE THE DEVELOPMENT OF HIGH
NEEDED CURES PARTICULARLY BY
REDUCING THE BARRIERS BETWEEN
RESEARCH DISCOVERY AND CLINICAL
TRIALS IN THE AREAS AT THE
PRIVATE SECTOR WAS UNLIKELY TO
PURSUE.
SHOWN ON THE SORT OF THE GRAPHIC
PICTURE WHICH SORT OF LOOKS LIKE
A RAINBOW IF YOU CAN READ THAT,
IT SHOWED TARGET VALIDATION,
CLINICAL AND PRECLINICAL STEPS
THAT MANY OF YOU ARE FAMILIAR
WITH BUT IT SHOWS DRUGS AND
BIOLOGICS AND VACCINES AND EVEN
DEVICES.
MANY OF THE PRECLINICAL WORK OR
TARGET VALIDATION WORK SORT OF
OCCURSOT RIGHT OR LEFT SIDE OF
THIS GRAPH AND 1 GETS TO A POINT
THAT THERE ARE CLINICAL
APPLICATIONS, A LOT OF THIS IS
VALIDATED BUT A LOT OF IT COMES
TO WHAT'S CONSIDERED THE VALLEY
OF DEATH, IN WHICH THE N IH OR
OTHER FEDERAL AGENCIES DON'T
FUND IT, ON THE OTHER HAND
DRUGS, VACCINES OR OTHER AGENTS
HAVEN'T BEEN SUFFICIENTLY
DERISKED TO IMMEDIATELY GET A
THERAPEUTIC COMPANY OR A
BIOLOGIC OR A PHARMACEUTICAL
COMPANY TO INVEST INTEREST IN
PHASES, PHASE 2 THROUGH 4 OF THE
CLINICAL STUDY AND AGAIN THIS
WAS REALLY 1 OF THE IMPETUS
BEHIND SETTING UP THIS GROUP,
WORKING GROUP OF THE SMRB TO
ADVISE ON THE DEVELOPMENT OF THE
CURES ACCELERATION THAT WORK ON
HOW TO BRIDGE THIS SO CALLED
VALLEY OF DEATH.
THEY WERE CHARGED WITH
IDENTIFYING ATTRIBUTES AND
ACTIVITIES AND FUNCTIONAL
CAPABILITIES, AND ALSO BROADLY
ASSESSING THE NIH LANDSCAPE FOR
X-NET PROGRAMS, NETWORKING
CENTERS THAT COULD BE INCLUDED
IN THIS NETWORK AND REALLY
RECOMMENDING THE OPTIMAL
ORGANIZATION.
NEXT SLIDE, PLEASE.
SO THE RECOMMENDATIONS THAT CAME
OUT OF IT WAS THAT THE BOARD
AFFIRM THAD A NEW TRANSLATIONAL
MEDICINE AND THERAPEUTIC CENTER
BE CREATED IN FACT, THE NATIONAL
CENTER FOR ADVANCING OR NCATS
WAS ACTUALLY DEVELOPED AS A
DIRECT RESULT OF THIS.
WE MENTIONED 1 ORGANIZATION THAT
WAS NOT FOLLOWED THROUGH, BUT
THIS IS OTHER THAN CERTAINLY 11
AS A DIRECT RESULT OF THE
DELIBERATION VERSION 1.0 SMRB
BOARD.
IT ALSO ENDORSED NIH COMMITMENT
TO UNDERTAKE MORE EXTENSIVE
ATHAT WILL SIS, ON THE PARTS OF
THE NIH THAT MIGHT BE
INCORPORATED MIGHT BE EXISTING
PARTS, MIGHT BE INCORPORATED
INTO THIS NEW INSTITUTE AND THEN
THE BOARD WAS ASKED TO
PERIODICALLY REPORT ITS FINDINGS
BACK TO THE FULL NIH.
OKAY, NEXT SLIDE, PLEASE.
THIS IS THE REPORT ON ASSESSING
THE VALUE OF BIOMEDICAL
RESEARCH.
OF COURSE WE TALK ABOUT TRUST
EARLIER, THE AMERICAN PUBLIC
ENTRUSTS NIH WITH A SUBSTANTIAL
INVESTMENT THAT YOU JUST HEARD
ABOUT AND OVER-IT'S 120 + YEAR
HISTORY, NIH CONTRIBUTED TO MANY
SCIENTIFIC BREAKTHROUGHS THAT
HAVE HAD A TANGIBLE IMPROVEMENT
ON PUBLIC HEALTH BUT REALLY,
IT'S A CRITICAL COMPONENT OF
NIH'S STEWARDSHIP TO KIND OF
SYSTEMATICALLY AND
COMPREHENSIVELY CAPTURE WHAT
THESE IMPROVEMENTS WERE AND HOW
THAT RELATED TO THE NIH FUNDING.
OF COURSE, IT'S HARD TO ESTIMATE
THAT FYOU THINK ABOUT IT FIRST
OF ALL THERE'S A TIME LAG
BETWEEN DISCOVERIES AND
ULTIMATELY THOSE DISCOVERIES
BEING TRANSLATED CLINICAL TRIALS
BEING DONE, AND ULTIMATELY THAT
CHANGING GUIDELINES.
THERE COULD BE MULTIPLE SOURCES
FOR THAT FUNDING, SO MANY PEOPLE
WHO MAKE THESE DISCOVERIES NOT
ONLY HAVE FEDERAL SUPPORT BUT
QUITE SUBSTANTIAL MONIES OF
NONFEDERAL SUPPORT AS WELL SO
ASHES TRIEWKS IS A MAJOR ISSUE
TO BE SIGNIFY SECTIONAL
ANALYSISSED, THEN 1 HAS TO ASK,
WHAT ARE THE -- WHAT ARE THE
METRICS THAT 1 USES.
FOR EXAMPLE, IT'S CLEAR THAT AS
1 FUNDS PROJECTS, SCIENTIFIC
PROJECTS, USUALLY THE SORT OF
THE OUTPUT ARE SCIENTIFIC
PUBLICATIONS, PRESENTATIONS AT
MEETINGS, DEVICES AND THE LIKE,
PATENT APPLICATIONS AND THAT'S
SOMETHING THAT'S EASILY
TRACTABLE.
BUT WHAT EFFECT THAT HAS ON A
MORE BROADER AREA, IN TERMS OF
THE VALUE OF THIS RESEARCH, ON
-- DOES IT -- ANY OF THESE LEAD
TO NEW THERAPIES, INCLUDING NEW
ACSEENS, THESE DISCOVERIES, LEAD
TO 2 DIAGNUMBER OF THETICS OR
POTENTIALLY CURES AND THAT'S
FROM A MEDICAL STANDPOINT AND
THEN FROM A SOCIETAL STANDPOINT,
ULTIMATELY DO THESE LEAD TO A
CHANGE IN LONGEVITY THAT
DR. BERTANOLLI MENTIONED FOR
DALLYS, DISABILITY ADJUSTED LIFE
YEARS.
SO THIS IS SOMETHING THAT THIS
GROUP WAS TARGETED, THEY THOUGHT
IT WAS IMPORTANT TO SORT OF DIG
IN AND LOOK AT THIS, VERY
COMPREHENSIVELY, AND THAT LED
TO, NEXT SLIDE, PLEASE.
THIS REPORT WHICH DESCRIBED THE
RESULTS OF THIS DELIBERATIONS,
THE RECOMMENDATIONS SUMMARIZED
HERE IS THAT THE NIH SHOULD
INTENSIFY ITS EFFORT TO ASSESS
THE VALUE OF BIOMEDICAL
RESEARCH, IT SHOULD EXAMINE THE
CONNECTION BETWEEN THE
GENERATION, COMMUNICATIONS OF
BASIC AND CLINICAL KNOWLEDGE,
AND ITS IMPACT, SOMETHING WE
DISCUSSED A LITTLE BIT EARLIER,
MAKING AN ASSESSMENT SHOULD
ASHES TRIBUTE THE OUTCOME TO ALL
CONTRIBUTORS, BECAUSE OFTEN
TIMES, WE WEREN'T THE SOLE
CONTRIBUTOR AND TO ADJUST A TIME
FRAME LONG ENOUGH TO DETERMINE
WHETHER AND HOW THOSE
CONTRIBUTIONS LED TO DISCOVERIES
AND HOW THEY WERE APPLIED.
I CAN TELL YOU AS AN ASIDE
BEFORE I CAME TO THIS MEETING
THIS MORNING, I HAD TO GIVE
OPENING REMARKS, AT A DIABETES
MELITUS INTERAGENCY COORDINATING
COMMITTEE AS A DIRECT RESULT OF
WHAT NEIL SHAPIRO JUST MENTIONED
THE TYPE 1 DIABETES FUNDS WE ARE
HOPING THEY WILL BE RENEWED BUT
WE HAVE TO BE IN A POSITION TO
THINK ABOUT HOW THOSE FUNDS IN
25 AND 26 COULD BE USED VERY
EFFECTIVELY AND SO WE BRING
TOGETHER A GROUP OF EX PERS WHO
ADVISE US, LOOKING OVER A SERIES
OF PROPOSALS, ON WHERE IS
PROBABLY THE BEST PLACE TO PUT
OUR PROMISE AND I HAVE TO SAY,
THAT IN OVER THE HISTORY, WE
WERE ABLE TO ACTUALLY DEVELOP
THROUGH A SMALL BUSINESS GRANT
THE VERY FIRST CONTRACT FOR A
WAY TO NONINVASIVELY MEASURE
GLUCOSE WHICH ULTIMATELY LED TO
THE SERIES OF CONTINUOUS
DPLUICOSE MONITORS, 2 OF WHICH
YOU CAN BUY AT CVS OR WALGREEN'S
NOW, IT WASN'T SOMETHING THAT
WAS IMMEDIATELY OBVIOUSLY 25
YEARS AGO WHEN WE INVESTED IN
THIS THAT THIS WOULD NOW BE THE
BASIS OF AN ARTIFICIAL PANCREAS
TECHNOLOGY WHERE YOU CAN LINK
CONTINUOUS GLUCOSE MONITOR WITH
AN INSULIN PUMP AND TAKE THE
PLACE OF THE PANCREAS IN
INDIVIDUALS WITH TYPE 1
DIABETES.
THIS IS THE KIND OF ASSESSMENT
THAT THIS GROUP WAS ASKING FOR.
NEXT SLIDE, PLEASE.
THIS IS A SORT OF COMPLICATED
SLIDE BUT IT POINTS OUT A NUMBER
OF THE AREAS IN TERMS OF
ASSESSING THE VALUE OF THIS
BIOMEDICAL RESEARCH, THAT 1
SHOULD FOCUS IN ON, AND AGAIN,
AT THE END OF THIS, WE WILL GIVE
YOU A QR CODE IF YOU WANT TO
LOOK AT ALL THESE REPORTS, IN
SOME DETAIL, BUT AGAIN THE NIH
SHOULD CONTINUE TO ESTABLISH A
TRANSNIH COMMITTEE ON,A
ASSESSESMENTS, TO LOOK AT MANY
DIMENSIONS OF THE VALUE OF
BIOMEDICAL RESEARCH AND IT
SHOULD BEGIN WITH THE
IDENTIFICATION OF THE PURPOSE
AND THE AUDIENCE, WHO IS IT THAT
WE'RE PRESENT THANKSGIVING
INFORMATION TOO, SOMETHING I
THINK DR. CHANG ASKED THIS
MORNING.
OKAY, NEXT SLIDE, PLEASE.
HERE'S A REPORT ON PRECOLLEGE
ENGAGEMENT.
I THINK THIS IS THE LAST OF THE
4 I WILL BE DISCUSSIONING EMPLOY
WHAT IS THE WHY HERE?
THAT THERE'S REALLY A TREND IN
THE PROFILE OF CURRENT AND
RISING BIOMEDICAL WORKFORCE AND
THERE'S CONCERN BOTH IN THE
PREPARATION AND DIVERSITY OF THE
U.S. FUTURE BIOMEDICAL RESEARCH
AND THE ABILITY TO PROMOTE IT.
WE'RE ALL AWARE OF STEM AND THE
USE OF IT, AND AS THE U.S.
GRAPPLES WITH PRECOLLEGE
SCIENCE, PEOPLE ENGAGED IN
TECHNOLOGY, ENGINEERING AND
MATHEMATICS, AND THAT CAN'T JUST
START OFF AT COLLEGE, IT HAS TO
START IN HIGH SCHOOL AND EVEN
EARLIER AND THEN I DIVERSITY OF
STUDENTS SEEKING DEGREES AND
CAREERS IN THIS FIELD REALLY
DIDN'T AT THE TIME OF THIS
REPORT REALLY REFLECT THE
NATION'S RAPIDLY CHANGING
DEMOGRAPHIC PROFILES.
AND SO THIS IS THE WHY, WHY
AMONG ALL THE THINGS THAT COULD
BE STUDIED, THE NIH TASKED THE
SMRB WITHA VISING HOW NIH COULD
MAXIMIZE ITS INFLUENCE THROUGH
ITS EXISTING ORGANIZATIONS AND
STRUCTURES TO INFLUENCE AND
INCREASE PRECOLLEGE BIOMEDICAL
SCIENCE ENGAGE AM.
SHOWN ON THE RIGHT THERE, IS
REALLY A CONCEPTUALIZATION OF
THE WORKFORCE AND SOMETIMES WHEN
YOU THINK OF WORKFORCE, WE TALK
ABOUT PRINCIPAL INVESTIGATORS OR
CLINICAL SCIENTISTS OR GRADUATE
STUDENTS, POST DOCTORAL
RESEARCH, BUT THIS REPORT SORT
OF CHALLENGED US TO THINK OF
MUCH BROADER, TO THINK ABOUT
TECH TRANSFER OFFICE, TO THINK
ABOUT SCIENCE TEACHERS, TO THINK
ABOUT CLINICAL TRIAL
COORDINATORS, PEOPLE WHOM
GETTING THIS EDUCATION, COLLEGE
COULD LEAD TO A SUCCESSFUL
CAREER BEING IN THE BIOMEDICAL
RESEARCH ECOSYSTEM.
NEXT SLIDE, PLEASE.
SO QUITE SIMPLY THE
RECOMMENDATIONS THAT CAME OUT OF
THIS, AND I THINK THIS
PARTICULAR -- THIS WAS AMONG THE
LAST REPORTS THAT CAME OUT.
IT FOCUSED ON PRECOLLEGE EFFORTS
ON MOST OF THE PRESSING
WORKFORCE NEEDS, BROADENING
THESE WORKFORCE CATEGORIES TO AT
LEAST CONSIDER THEM TO BE
SUCCESSFUL OUTCOME, NOT JUST THE
NUMBER OF PRINCIPLE
INVESTIGATORS OR CLINICAL
SCIENCES THAT 1 PRODUCES, TO
STREAMLINE AND INCREASE
COORDINATION WITH EXISTING
PRECOLLEGE ACTIVITIES, AND THEN
REALLY TO DEVELOP STANDARD
METRICS OF SUCCESS FOR EXISTING
NIH PRECOLLEGE STEM ACTIVITIES.
I THINK THIS NEXT SLIDE JUST
KIND OF SHOWS YOU BACK IN 2013,
I BELIEVE, SORT OF THE LIST OF
ACTIVITIES WHERE NIH WAS SO
PRODUCING CLASSROOM MATERIALS,
OR HEALTH INFORMATION, OR
STUDENT EXPERIENCE, SUMMER
PROGRAMS FOR EXAMPLE, IT SHOWS
THE VARIOUS CATEGORIES, TEACHER
DEVELOPMENT AND OTHER CAREERS,
THIS BEING 1 OF THE AREAS TO
FOCUS ON OF COURSE BACK IN 2013,
THIS WAS SORT OF THE BASE LINE,
AND SO AS -- AFTER THE REPORT
COMES OUT IN 2015, THIS IS 1 OF
MANY, METRICS THAT 1 CAN USE TO
EVALUATE SUCCESS.
AND THE FINAL SLIDE, THERE'S
REALLY AN ARCHIVE REPORT OF ALL
OF THESE SMRBOT WEBSITE AND THIS
IS LARGELY FOR THE PEOPLE
VISITING US VIRTUALLY, IF YOU
WANT TO TAKE A PICTURE OF THIS
QR CODE THIS WILL TAKE YOU
DIRECTLY TO THAT WEBSITE SO YOU
WILL HAVE THE OPPORTUNITY TO
READ ABOUT THESE VARIOUS
PROGRAMS AND AS OUR CHAIR HAS
CHALLENGED US, WE SHOULD ALL DO
OUR HOME WORK AND READ ALL THESE
REPORTS BEFORE OUR NEXT FORMAL
MEETING.
AND WITH THAT LET ME CLOSE AND
SEE IF THERE ARE ANY PRESSING
QUESTIONS
>> IT STARTED -- WHEN WAS THE
FIRST MEETING, WHAT YEAR?
HOW MANY YEARS BEFORE IT STARTED
MEETING?
2009 SO IT WAS THREE YEARS
BEFORE IT STARTED MEETING AND
THEN I CAME ON BOARD I THINK IN
THE SECOND ITERATION BECAUSE I
LOOKED UP ON MY C.V. SO THE
FIRST YEAR OF BEING DIRECTOR I
GOT APPOINTED TO IT AND REMEMBER
SOME OF THOSE REPORTS.
>> RIGHT.
AND THE FIRST MEETING WAS IN
2009 AND THE FIRST REPORT CAME
OUT IN 2010.
>> SO THAT ALL MAKES SENSE AND
THEN DID YOU SAY WHEN IT MET
LAST.
>> 2015.
>> THAT'S WHEN -- BUT IT STILL
ISSUED A REPORT IN 2016.
>> 2016 THE LAST REPORT.
>> NO, I JUST WANTED TO MAKE
SURE I UNDERSTOOD.
IT DOES -- YOU MADE THE POINT
BUT I WOULD REITERATE ONCE IT
STARTS GOING -- THE PRINCIPLE
REPORT WAS THE FIRST TIME.
>> THE FIRST YEAR THERE WERE
ACTUALLY 2010 WAS THE FIRST
REPORT.
THERE WERE THREE OTHER REPORTS.
>> DOES EVERYONE KNOW THE
MAXIMUM NUMBER OF WORKING GROUPS
IN PARALLEL.
YOU CAN'T INSPECT IT.
>> I'M REMINDED BY THE COMMENT
MADE BY FORMER COLLEAGUES ON
THESE TYPES OF ADVISORY BOARDS,
DON'T BOIL THE OCEAN.
SO PROBABLY THEY'LL WANT TO BE
MORE PRECISE, YEAH.
PROBABLY WE NEED TO BE MORE
PRECISE AND THEN LET'S SEE WHERE
IT TAKES US.
>> SO IT STRIKES ME AS WE LISTEN
TO WHAT YOU'RE SAYING AND GOING
THROUGH SOME OF THE REPORTS THAT
AN YOU SUMMARIZED NICELY BUT
SOME IS OBVIOUS ONCE YOU HAVE
THE DATA.
YOU LOOK AT THE FIRST CENTER
THAT HAD 1600 PHYSICIANS AND 650
NURSES AND IT'S LOGICAL THAT'S
NOT GOING TO BE A FINANCIALLY
STABLE ENTITY.
WE SHOULD HAVE BETTER ACCESS TO
DATA THAN 10 YEARS AGO.
ONCE THE DATA IS THERE WE CAN
ALL SEE IT AND WE CAN MAKE AN
ASSESSMENT ON WHAT WE THINK OUR
OPINION IS.
>> WE SHOULD PRIORITIZE.
>> EXACTLY.
THE BY THE NUMBERS PART OF IT
WILL WE BE ABLE TO --
>> AS LONG AS WE CAN ARTICULATE
WHAT WE NEED' WE WILL GET IT.
SOME IS OFF THE SHELF AND SOME
WILL HAVE TO BE GENERATED BUT
WE'LL PROVIDE THE DATA REQUIRED.
>> THAT'S GREAT.
AS YOU READ THROUGH IT AT THAT
TIME AND HOPEFULLY THAT WILL
HAPPEN NOW IT BECOMES -- I WON'T
SAY OBVIOUS BUT BECOMES PRETTY
CLEAR WHEN YOU LOOK AT PURPOSE,
VISION, FINANCIAL STABILITY,
OUTCOME, VALUE, THIS IS EITHER
WORKING OR NOT OR IT'S WORKING
MOSTLY JUST NEEDS MORE
EFFICIENCIES, THAT TYPE OF
THING.
>> SOME OF THE QUESTIONS LEND
THEMSELVES TO THAT CLARITY.
OTHER QUESTIONS PERHAPS ARE
LET'S MORE COMPLICATED.
I SEE JEANNE AND THEN DEB.
>> THAT WAS INCREDIBLY HELPFUL.
I'M NOT SURE THIS IS A RELEVANT
QUESTION BUT IS IT RELEVANT OR
HELPFUL TO TALK ABOUT WHY THE
COMMITTEE STOPPED MEETING GIVEN
WHAT SOUNDED LIKE VARYING USEFUL
PRODUCTS BASED ON WHAT YOU JUST
SUMMARIZED.
>> I GUESS I'M GOING IT TAKE
THAT ONE.
SO, WHILE DR. COLLINS WAS
DIRECTOR OF NIH HE INCREASINGLY
USED THE ADVISORY COMMITTEE TO
THE DIRECTOR TO WRESTLE WITH
THESE TYPES OF QUESTIONS.
PRIOR TO DR. COLLINS AND IT WAS
DR. SAHUNE COP CONCEIVED THE
SCIENTIFIC MANAGEMENT REVIEW
BOARD AND THERE WAS AN INTEREST
IN REDUCING THE NUMBER OF FACA
COMMITTEES AND AS YOU HEARD THIS
MORNING, NIH HAS A LARGE NUMBER
OF THESE MEETINGS AND BECAUSE
THE MSRB HAD MORE OR LESS GONE
DORMANT WE OFFERED IT UP
INTERESTINGLY ENOUGH IT WAS
NEVER DONE AWAY WITH BUT WAS
DORMANT AND WHEN DR. BERTAGNOLLI
CAME ON BOARD SHE DECIDED THIS
WOULD BE A VERY VALUABLE TOOL TO
AUGMENT THE OTHER SORTS OF
THINGS YOU'VE BEEN THINK ABOUT
AND IN ADDITION WE DID GET
REPORT LANGUAGE BY THE CONGRESS.
SO THE VARIOUS THINGS WORK TAKEN
TOGETHER MADE IT APPROPRIATE TO
RESTART THIS COMMITTEE.
SO HOPEFULLY THAT HELPS EXPLAIN.
OKAY, DEB AND THEN MIKE.
>> YEAH, THANK YOU, THAT WAS
EXTREMELY HELPFUL.
I WAS VERY INTERESTED IN THE
REPORT ON THE CLINICAL CENTER
BECAUSE OF OUR UPCOMING
DISCUSSIONS AND I WAS VERY
INTERESTED AT THE FACT IT WAS
DETERMINED THAT THE FINANCIAL
MODEL WAS NOT A VIABLE ONE AND
THEN SOLUTIONS WERE PROPOSED TO
ADDRESS THAT SUCH AS MAKING THE
CLINICAL CENTER AVAILABLE FOR
INVESTIGATORS AND A SCHEME WAS
LAID OUT FOR THAT AND OF COURSE
NOTHING HAPPENED WITH THAT AND
WONDERING IF THERE'S LESSONS
LEARNS OR A SPECIFIC TYPE OF
PROCESS CARRIED OUT INTERNALLY
AT NIH TO CONSIDER AND ADDRESS
ALL THE RECOMMENDATIONS AND
SECONDLY, ARE THERE LESSONS
LEARNED ABOUT RECOMMENDATIONS
THAT WERE PUT FORWARD THAT WERE
POTENTIALLY VERY DISRUPTIVE AND
THE DECISION WAS MADE NOT TO
POWER THROUGH JUST FOR OUR
FUTURE WORK IS THERE SOMETHING
TO BE LEARNED THERE?
>> I THINK TO ANSWER THAT
SPECIFIC QUESTION RELATED TO
THAT REPORT ON THE CLINICAL
CENTER FROM MY REMEMBRANCE OF
THIS, THERE WERE AS I POINTED
OUT THREE OR FOUR
RECOMMENDATIONS ONE WAS ACTED
UPON QUICKLY RELATED TO THE OF
THE CLINICAL CENTER.
SO NOW THERE'S A SINGLE CLINICAL
CENTER GOVERNING BOARD THAT
ADVISES THE CLINICAL CENTER
DIRECTOR.
THERE WAS ALSO PUT IN PLACE THE
RENT WHICH CONSIDERED SOME
ASPECTS OF THE CLINICAL CENTER
THAT REALLY SORT OF NEEDED
IMMEDIATE ATTENTION.
THE QUESTION ABOUT THE VISION
AND THAT IS OPENING UP TO
EXTRAMURAL AND INTRAMURAL WAS
ACTED UPON TO SOME EXTENT.
THERE'S A BENCH TO BEDSIDE AWARD
THAT ARE MADE THAT ALLOW THE
CLINICAL CENTER TO BE USED BY
INTRAMURAL AND EXTRAMURAL
COLLABORATORS BUT AS PART OF
THAT, THERE WERE AT LEAST TWO OR
THREE MEETINGS WITH A NUMBER OF
ACADEMIC INSTITUTIONS IN THIS
AREA TO GET THEIR SENSE OF HOW
THIS COULD BEST BE
OPERATIONALIZED.
THERE WERE A NUMBER OF OPTIONS
SUGGESTED AND OTHER THAN THIS
AGREEMENT OF THE BENCH TO
BEDSIDE, THERE WEREN'T UNANIMOUS
OR EVEN MAJORITY AGREEMENT OB
MANY OF THOSE DECISIONS.
BUT AT LEAST THERE WAS SOME
PROGRESS.
THE THIRD AREA WAS THE STABLE
FINANCING FOR THE CLINICAL
CENTER AND MANY AREAS WERE
MAPPED OUT INCLUDING HAVING A
LINE ITEM.
I THINK WHEN NEAL JUST MENTIONED
THE FUNDING OF THE NIH, THERE'S
27 INSTITUTES BUT ONLY 24
INSTITUTES ACTUALLY GET AN
APPROPRIATION FROM CONGRESS.
THE CLINICAL CENTER, THE CENTER
FOR INFORMATION TECHNOLOGY AND
THE CENTER FOR SCIENTIFIC REVIEW
RELY ON CENTRAL SERVICES TO
PROVIDE THEIR FUNDING.
SO ONE OF THE OPTIONS THAT WAS
ENVISIONED AND RECOMMENDED TO
THIS GROUP WAS HAVING A SEPARATE
LINE ITEM AND THAT'S BEEN A
LITTLE BIT MORE OF A CHALLENGE
TO ANSWER THAT QUESTION.
>> OKAY.
THANK YOU.
WE HAVE MIKE AND THEN WE HAVE
ONE MORE.
>> THANK YOU, I THOUGHT THAT WAS
AWESOME.
AS I LOOK BACK ON THESE WORKING
GROUP REPORTS, TO ME IT SEEMS
LIKE SOME OF THEM IN THE TEN
PLUS YEARS THAT HAVE GONE SINCE
THE REPORTS WERE PUBLISHED I DO
THINK SOME OF THEM WERE
COMPLETELY ACTIONED AND FOR
OTHER REPORTS IT SEEMS LIKE
WE'RE STILL ASKING THOSE
QUESTIONS YOU WERE ASKING BACK
IN 2009.
AND I DON'T THINK WE'RE STILL
ASKING THEM BECAUSE WE HAVEN'T
DONE ANYTHING, THEY'RE JUST
AHARD QUESTIONS THAT ARE BEING
ASKED.
FROM THAT PERSPECTIVE, I WAS
WONDERING IF YOU HAVE ADVICE.
TO ME IT SEEMS LIKE WE SHOULD WE
DECIDE BIG QUESTIONS OR MORE
BITE-SIZED QUESTIONS?
ANOTHER QUESTION I'M WONDERING
IS HOW DO WE SELECT QUESTIONS
THAT HAVE THE BEST PATHWAY
TOWARD BEING IMPLEMENTED AND
ANOTHER QUESTION IS WE MAY ASK
MAY NEED ADDITIONAL RESOURCES
AND DO YOU HAVE ADVICE HAVING
DONE THIS ONCE BEFORE OF WHAT
QUESTIONS WE SHOULD DECIDE TO
TACKLE?
>> YEAH, YOU KNOW, I THINK YOU
RAISE VALUABLE OPTION OR
CONFIGURATION.
DO YOU TACKLE VERY LARGE
TAUNTING PROBLEMS OR DO YOU TAKE
SMALL PALATABLE PIECES THAT
MAYBE NOT HAVE THE EXTERNALITIES
AND MAYBE DO BOTH BUT ING TIME
LINES WILL BE LONGER FOR SOME
THAN OTHERS.
I'M SURE THERE ARE AREAS WE CAN
CONSIDER AND AGAIN THIS IS GOING
TO BE SOMETHING THAT ANDREA AND
WE WILL SORT OF THINK ABOUT
UNDER THE CURRENT CIRCUMSTANCES.
I POINTED OUT THE CLINICAL
CENTER THOUGH BUDGET WAS A MAJOR
ISSUE, THERE WERE OTHER ISSUES
THAT LAT TO BE TACKLED AND SOME
RECOMMENDATIONS MADE WERE
IMPLEMENTED WHICH PARTIALLY
IMPROVED THE SITUATION BUT GIVEN
WHERE WE ARE TODAY, WHICH IS
DIFFERENT THAN 10 YEARS AGO,
SOME OF THE PROBLEMS MIGHT BE
MORE DAUNTING AND TAKE A LONGER
TIME HORIZON TO ACCOMPLISH.
>> THAT DOESN'T MEAN WE
SHOULDN'T LEAVE ANY STONE
UNTURNED.
>> YES.
>> I THINK WE MIGHT SPEND MORE
TIME ON ONE THING OR ANOTHER BUT
WANT TO MAKE SURE WE DO THAT.
>> WILL LINDSEY.
>> YES, THANKS VERY MUCH GRIF
FOR REVIEWING THAT HISTORY.
SUPER HELPFUL.
IN ADDITION TO THE QUESTION OF
WHAT LESSONS WERE LEARNED WHICH
I THINK IS VERY IMPORTANT,
BECAUSE SOME PREVIOUS REPORTS
WERE IMPLEMENTS TO SOME EXTENT,
IS THERE AN EXPECTATION WE
ASSESS WHETHER THE EXPECTATIONS
WERE MED OR CAN WE REALLY HAVE
MORE OF A FORWARD LOOKING
APPROACH.
WHAT CHALLENGES DO WE FACE TODAY
AND WHAT RECOMMENDATIONS MIGHT
WE RECOMMEND TO ADDRESS THOSE?
>> THAT'S A GOOD POINT.
I DO A SURVEY OF WHAT THE
OUTCOME WAS OF MAYBE VERSION 1.0
OR IF I UNDERSTAND THE QUESTION
CORRECTLY, ARE THERE STILL SOME
AREAS THAT ARE STILL REMAINING
PROBLEMATIC NOW AND SHOULD WE
LOOK AT THEM AGAIN OR JUST
LOOKING BACKWARDS, DOES THIS
GIVE US A BETTER PREDICTION OF
WHAT AREAS WE MIGHT BE MORE
SUCCESSFUL IN ACCOMPLISHING?
IT'S A VALUABLE POINT.
AGAIN, I CAN'T SPEAK TO THAT AS
A GROUP COLLECTIVELY WE'LL HAVE
TO DECIDE.
BUT I THINK YOUR QUESTION, IF I
GOT YOU RIGHT, ARE THERE STILL
AREAS THAT OR RECOMMENDATIONS
PROPOSED SAY, 10 YEARS AGO THAT
ARE STILL PROBLEMS AND WE SHOULD
REVISIT THEM IF THAT'S WHAT
YOU'RE ASKING.
I THINK THAT'S SOMETHING WE
SHOULD CONSIDER.
THAT'S MY OWN PERSONAL OPINION.
>> ANY FINAL COMMENTS OR
QUESTIONS?
>> YES.
>> SO, EARLIER IN THE DAY WE
TALKED ABOUT A PROPOSAL THAT
DIDN'T GO FORWARD AND I THINK
LARRY MENTIONED SOMETHING ABOUT
LACK OF STAKEHOLDER ENGAGEMENT.
COULD YOU COMMENT ON HOW THE
PRIOR GROUP ENGAGED STAKEHOLDERS
AND PERHAPS OTHER ADDITIONAL IN
YOUR EXPERIENCE MAY BE HELPFUL.
>> WELL, ON MANY OF THESE GROUPS
I WAS ON A WORK GROUP THE
COMMITTEE OR THE WORKING GROUP
WAS VERY INTENTIONAL ABOUT
HAVING SEVERAL PANELS TO GIVE
REPRESENTATION PRESENTATIONS AND
SOME DIDN'T COME BUT SENT A LONG
DESCRIPT OF THEIR VIEW AND THE
RATIONALE.
I WE DID TRY TO MAKE SURE THAT
EVERY VOICE WAS HEARD BUT WE
WERE FOCUSSING IN I THINK ON
PEOPLE IN ADVOCACY GROUPS AND
PROFESSIONAL SOCIETIES AND I
THINK AS POINTED OUT, THERE ARE
OTHER GROUPS THAT PERHAPS COULD
HAVE HAD A CHANCE TO WEIGH IN SO
WE WOULD HAVE HAD A BETTER
ESTIMATE OF WHAT THE LIKELY
OUTCOME OF WOULD HAVE BEEN.
SO I WANT TO MAKE SURE THAT NO
STONE IS UNTEURNED AND HAVE TO
THINK MORE BROADLY ABOUT WHO TO
GET INPUT FROM AS WE DELIBERATE
ADDITIONAL ISSUES, I THINK.
>> OKAY.
PART 2, DR. TABAK.
>> AFTER LARRY SPEAKS WE WILL
HAVE TIME FOR A SHORT BREAK.
>> OKAY, THANKS, GRIF.
SO, NOW I WANT TO DO A DEEP DIVE
INTO THIS ONE REPORT, WHICH WAS
THE FIRST, TALKING ABOUT HOW ONE
GOES ABOUT DELIBERATING
ORGANIZATIONAL CHANGE AND
EFFECTIVENESS.
SO, A FEW INTRODUCTORY REMARKS.
UM, I THINK MANY AND PERHAPS ALL
THE PRINCIPLES DESCRIBED IN THIS
REPORT MAY PROVE USEFUL TO GUIDE
THE CURRENT COMMITTEE'S WORK BUT
PLEASE UNDERSTAND WE ARE NOT
BOUND BY THIS REPORT.
I'M JUST PRESENTING IT TO
PROVIDE YOU BACKGROUND.
YOU CAN ACCEPT, MODIFY OR IGNORE
ANYTHING.
BUT THERE MAY BE SOME THINGS
HERE THAT AT LEAST COULD BE A
STARTING POINT FOR HOW THE GROUP
CHOOSES TO GO FORWARD.
OKAY.
SO YOU'VE HEARD ABOUT THIS
BACKGROUND AND THERE IS A GREAT
DEAL OF INTEREST IN THE
COMMUNITIES, PLURAL, ABOUT THE
NUMBER AND TYPES OF NIH
INSTITUTES AND CENTERS.
OBVIOUSLY WE ALL UNDERSTAND THAT
INTERDISCIPLINARY,
MULTIDISCIPLINARY TYPES OF
RESEARCH ABOUND NOW.
NOT SO MAYBE 40 YEARS AGO.
AND CLEARLY AND EVERY ONE OF US
COULD COME UP WITH AN EXAMPLE OF
DISCOVERY IN ONE FIELD HAS A
PROFOUND IMPACT ON A COMPLETELY
UNRELATED FIELD.
IT'S ACTUALLY FUN TO DO THAT
EXERCISE.
AND SO IT'S POSSIBLE THAT A
STRICT DISEASE FOCUS AND
ORGANIZATIONAL UNITS MAY NOT
FULLY CATALYZE SCIENTIFIC
DISCOVERIES THAT LEAD TO THE
MORE SUCCESSFUL TRUTH.
IT'S A QUESTION THAT NEEDS TO BE
ASKED.
YOU'VE SEEN THIS SLIDE OFTEN.
ONE COMMENT THAT'S BEEN MADE
MANY TIMES IS THAT THE BUDGETS
OF THE NIH INSTITUTES HAVE GROWN
IN EXTRICABLY AND THAT THE NOT
TRUE AND NCI WAS ONE OF THE TWO
INSTITUTES CREATE AND OTHERS
WERE CREATED EARLY ON AND
THEY'RE BUDGETS HAVE NOT GROWN
TO THE SAME EXTENT.
AGAIN, I'M NOT MAKING A VALUE
JUDGMENT WHETHER IT'S GOOD OR
BAD BUT THE BLANKET STATEMENT
THAT WELL, THEY'VE BEEN AROUND
SO LONG AND KEEP GROWING
UNCHECKED.
THAT'S NOT REALLY AN ACCURATE
STATEMENT.
SO, JUST TO GIVE YOU A LITTLE
BIT BACKGROUND THE NRC IN 2003
OBSERVED THE FOLLOWING TWO
THINGS.
THE EXISTING STRUCTURED RESULT
WITH A SET OF COMPLEX EVOLVING
SOCIAL AND POLITICAL
NEGOTIATIONS AMONG A VARIETY OF
CONSTITUENCIES INCLUDING
CONGRESS, THE ADMINISTRATION,
THE SCIENTIFIC COMMUNITY, HEALTH
ADVOCACY COMMUNITY AND OTHERS
INTERESTED IN RESEARCH, RESEARCH
TRAINING AND PUBLIC POLICY
RELATED TO RESEARCH.
THIS IS TRUE TODAY AS IT WAS
BACK IN FWROOE.
-- 2003 FOR ANY POINT OF VIEW OR
PERFECT BUT NOT ONE CONGRESS OR
THE SCIENTIFIC COMMUNITY WOULD
HAVE BUT A USEFUL AND LIVELY
PRODUCTIVE OUTCOME, ETCETERA.
SO THE POINT BEING THAT THIS
ISSUE HAS BEEN OBSERVED
MR. YEARS AGO AND IN FACT IF
YOU'RE INSISTENT YOU CAN FIND
DISCUSSIONS OF THIS IN THE '50
RASE AND '60s AND THIS SAYS IT
PRETTY CLEAR.
THIS FRAMEWORK PROVIDED SOME
GUIDING PRINCIPLES AROUND STEPS
AND CONSIDERATIONS AND THEN
UNDERPINNING ATTRIBUTES.
AGAIN, SOME OF WHICH, ALL OF
WHICH, NONE OF WHICH MAY BE
USEFUL TO YOU.
AMONG THE GUIDING PRINCIPLES,
WE'RE DOING THIS TO STRENGTHEN
THE ABILITIES OF NIH TO CARRY
OUT IT'S MISSION.
HOPEFULLY EVERYONE AGREES WITH
THAT.
PROVIDE ENVIRONMENT FOR
COLLABORATION, COORDINATION AND
INTERACTION.
BRING TOGETHER SYNERGIES,
ENHANCE PUBLIC UNDERSTANDING,
CONFIDENCE AND SUPPORT AND
INCREASE OPERATIONAL EFFICIENCY.
HARD TO VOTE AGAINST ANY OF
THOSE GUIDING PRINCIPLES BUT
PERHAPS WE CAN UPDATE THEM,
PERHAPS THEY CAN BE MADE
CLEARER, BETTER, SO FORTH.
THE STEPS AND CONSIDERATIONS
THAT ONE NEEDS TO TAKE.
THE FIRST STEP, ASSESS THE NEED
FOR CHANGE.
TO USE THE COLLOQUIAL, WHAT'S
BROKEN.
STEP TWO, EVALUATE OPTIONS FOR
CHANGE, HOW DO YOU FIX IT, STEP
THREE, IMPLEMENT AND EVALUATE
THE CHANGE AND THE DISCUSSION WE
JUST HAD SPEAKS TO THAT.
THERE WERE CERTAIN THINGS THAT
WERE IMPLEMENTED.
CERTAIN THINGS WEREN'T.
WHY NOT?
COULD THAT BE INSTRUCTIVE GOING
FORWARD PARTICULARLY IF IT'S THE
SAME OR RELATED QUESTION.
AND THE UNDERPINNING ATTRIBUTES
AND HOPEFULLY NO ONE HAS ISSUES
WITH THESE, TRANSPARENCY
COMMUNICATION AND
ACCOUNTABILITY.
WE HAVE TO DO EVERYTHING
POSSIBLE TO MAKE SURE THAT AS
MANY STAKEHOLDER GROUP
UNDERSTAND WHAT WE'RE DOING, WHY
WE'RE DOING IT SO THERE'S NO
SURPRISES IN THE END.
SO, THE GROUP DECIDED ON A
WORKING DEFINITION OF
ORGANIZATIONAL CHANGE.
ANY MODIFICATION OF THE
STRUCTURE OR ITS WAYS OF
ARRANGING AND COORDINATING THE
COMPONENT PARTS TO ACHIEVE ITS
MISSION, THIS IS DRIVEN BOTH
INTERNALLY AND EXTERNALLY.
STRUCTURAL ORGANIZATIONAL CHANGE
ENTAILS A CREATION OF NEW
ORGANIZATIONAL COMPONENTS AND/OR
MERGER OR ELIMINATION OF NIHs 27
INSTITUTES AND CENTERS.
FUNCTIONAL ORGANIZATIONAL CHANGE
CONSISTENT OF THE DESIGN AND
IMPLEMENTATION OF NEW MECHANISMS
FOR COORDINATING THE WORK OF
EXISTING COMPONENTS AND VARIOUS
WAYS OF ACCOMPLISHING THAT.
SO IN OTHER WORDS, THERE'S TWO
PATHWAYS AND THEY ARE NOT
MUTUALLY EXCLUSIVE.
YOU CAN MERGE TWO INSTITUTES
TOGETHER AND CREATE SOMETHING
NEW OR FUNCTIONALLY YOU CAN HAVE
THEM WORK MORE CLOSELY TOGETHER
USING VARIOUS MECHANISMS NORAH
CAN SPEAK TO BECAUSE WE INVOKED
FUNCTIONAL CHANGE WITH NNIA AND
NIDA.
AND IN TERMS OF ASPECTS OF
ORGANIZATIONAL CHANGE.
CHANGE IN GOVERNMENTAL ENTITIES
IS COMPLICATED BY TLAURT AND
LACK OF WELL DEFINED AND
UNIVERSALLY AGREED UPON METRICS
AND POWERFUL STAKEHOLDERS AND
CONSTITUENCIES.
THAT'S NOT CHANGED.
IN THE SECTOR THE METRICS CAN
INFORM DISCUSSIONS.
IN YOUR ORGANIZATIONS AND
ACADEMIC ORGANIZATIONS, IF YOU
HAVE THESE METRICS, PERHAPS SOME
HAVE BEEN USEFUL TO YOU AS YOU
LEAD CHANGE IN YOUR
ORGANIZATIONS.
WE HOPE YOU'LL SHARE THOSE
EXAMPLES WITH US AND IF THIS
ISN'T TAKEN ADVANTAGE OF WE
BRING IN EXPERTS WHO ALSO THINK
ABOUT THIS DEEPLY.
MAJOR CHANGES READILY
IMPLEMENTED IN THE FACE OF
CRISIS THREATENING THE EXISTENCE
OF THE ORGANIZATION.
WE REFERRED TO THE RED TEAM
REPORT.
WE HAD A SENTINEL EVENT IN THE
CLINICAL CENTER THAT REQUIRED
IMMEDIATE WORK AND THAT DID
CATALYZE CHANGE THERE.
CHANGE REQUIRES INVESTMENTS IN
TIME AND POLITICAL.
SUFFICIENT RESOURCES FOR
IMPLEMENTATION AND ATTENTION OF
ORGANIZATIONAL LEADERS.
PART OF THE FAILURE, IF YOU WILL
OF IMPLEMENTING EVERYTHING IS
ALONG THE WAY THERE'S LEADERSHIP
CHANGES.
WHEN YOU HAVE A NEW LEADER, HE
OR SHE HAS SOME NEW IDEAS SO NOT
NECESSARILY DO YOU FEEL YOU HAVE
TO FOLLOW THE BLUEPRINT OF YOUR
PREDECESSOR.
NOT ALWAYS BUT THAT'S SOMETIMES
THE CASE.
OKAY.
SO THE FUNDAMENTAL PREMISE AND
GUIDING PRINCIPLES.
ANY ORGANIZATIONAL CHANGE AT NIH
HAS TO SEEK TO IMPROVE THE
AGENCY'S ABILITY TO FULFILL ITS
MISSION.
TO THE NIH MISSION STATEMENT IS
THERE.
PARENTHETICALLY WE'RE IN THE
THROES OF WORKING THROUGH
DELIBERATIVE PROCESS TO SEE IF
WE WANT TO CHANGE THE MISSION
STATEMENT THERE'S ISSUES RELATED
TO CALLING OUT THE BURDENS OF
DISABILITY AND SOME MEMBERS OF
THE DISABILITY COMMUNITY ARE
OFFENDED BY THAT AND SOME ARE
OFFENDED BY THE QUESTION SHOULD
WE REMOVE IT.
WE COUNTED ALL THE VOTES AND
THEY'RE EXACTLY THE SAME ON BOTH
SIDES OF THE ARGUMENT AND
CONTINUE TO WORK THAT BY WAY OF
BACKGROUND.
BUT THAT SAID, CHANGE TO THE
FOUR BULLETS LISTED THERE, I'M
NOT GOING TO READ THROUGH THEM,
BUT YOU CAN SEE THESE ARE PRETTY
MUCH UNDERSTANDABLE AND I DON'T
THINK ANYBODY WOULD BE SURPRISE
BY THIS.
SO, WE HAVE TO STRENGTHEN NIH'S
ABILITY TO CARRY OUT ITS
MISSION.
I THINK EVERYBODY APPRECIATED
WE'VE GOT TO CONTINUE TO ADAPT
BOTH STRUCTURALLY AND
FUNCTIONALLY TO THIS HIGHLY
DYNAMIC SCIENTIFIC DISCOVERY AND
TRANSLATIONAL PROCESS TO MEET
UNFORESEEN CHALLENGES AND
CAPITALIZE ON EMERGING
OPPORTUNITIES.
WELL, JUST THINK BACK A FEW
YEARS WHEN WE WERE CONFRONTED
WITH THE GREATEST PANDEMIC OF
OUR GENERATION AND WE LEARNED A
LOT ABOUT STRESSES IN OUR
ORGANIZATION AND LEARNED SOME
THINGS WE WERE ABLE TO NAVIGATE
PRETTY QUICKLY AND SOMEWHERE WE
HAD SOME BARRIERS.
THAT MAY GAVE US SOME INSIGHT
GOING FORWARD OR AT LEAST SUBSET
OF THESE THINGS.
BUT IN FACT, THIS WAS
HYPOTHETICAL WHEN IT WAS
WRITTEN, UNFORESEEN CHALLENGES.
NOW WE KNOW THEY CAN ACTUALLY
EMERGE.
THE SECOND IS THAT WE SHOULD
PROVIDE AN ENVIRONMENT TO ENABLE
MORE EFFECTIVE COLLABORATION.
AGAIN, I THINK NO BUN WOULD
AGREE WITH THAT THE QUESTION IS
HOW BEST TO DO THAT BECAUSE
OBVIOUSLY THERE'S MANY WAYS OF
DOING THAT.
ORGANIZATIONAL CHANGE AND BRING
TOGETHER UNITS WHERE THERE'S
ENERGIES.
BRING TOGETHER IS AMBIGUOUS
PURPOSELY.
AGAIN IS IT STRUCTURAL OR
FUNCTIONAL OR COMBINATION
THEREOF.
CONFIDENCE IN AND SUPPORT FOR
SCIENCE IN THE NIH, WELL THAT
WAS PRESCIENT AND HERE WE ARE
AND ALL THOSE THINGS ARE TRUE
AND HOW DO WE GO ABOUT
IMPROVING?
WE HAD INITIAL DISCUSSION ABOUT
THIS ALREADY.
WE HAVE TO WORRY ABOUT NIH SO
IT'S ONE WE HAVE TO TAKE INTO
ACCOUNT.
ORGANIZATIONAL CHANGE SHOULD
INCREASE OPERATIONAL EFFICIENCY
AND A HIGH RETURN ON PUBLIC
INVESTMENT.
FROM A STRICTLY ADMINISTRATIVE
VIEW POINT THERE'S ECONOMIES OF
SCALE TO BE HAD.
NOT NECESSARILY BY MERGING
EVERYTHING BUT THERE ARE
NEVERTHELESS ECONOMIES OF SCALE.
SOME OF THE INSTITUTES HAVE
REALLY PIONEERED THE USE OF
MACHINE LEARNING TO REALLY
INCREASE EFFICIENCY OF CERTAIN
ROUTINE KINDS OF THINGS.
THERE'S THAT TYPE OF
APPLICATION.
SO I THINK WE'RE NOW IN A SPACE
WHERE IT'S MUCH MORE
SOPHISTICATED THAN SIMPLY TAKING
TWO ENTITIES, MUSHING THEM
TOGETHER AND SAYING NOW WE NEED
ONE OF EVERYTHING.
OBVIOUSLY THAT'S A TREMENDOUS
OVER SIMPLIFICATION.
I THINK WE CAN GO WELL BEYOND
THAT SIMPLE PARADIGM.
OKAY.
SO THE PROCESS OF EVERYTHING.
SO THE FIRST, ASSESS THE NEED
FOR CHANGE.
CLARIFY THE NATURE OF THE
ALLEGED NEED.
SIMPLE TO SAY, NOT NECESSARILY
EASY TO DO.
AND ABOUT THE EVIDENCE REQUIRED
FOR ESTABLISHING SUCH A NEED TO
THE CLAIR'S POINT, ARE WE GOING
TO GET THE DATA
>> YES, BECAUSE WITHOUT THE DATA
WE'RE WORKING BLIND.
IS THERE A HEALTH PROBLEM OR
IMPORTANT AREA OF SCIENTIFIC
INQUIRY BEING NEGLECTED OR
INADEQUATELY ADDRESSED AND GOING
BACK TO THE NCATS THERE WAS A
THOUGHT THERE WAS A VOID IN
ENHANCING TRANSLATIONAL SCIENCES
IN GENERAL AND THE IMPETUS WHERE
NCATS WERE BORN.
IS THERE A WAY TO IMPROVE THE
WAY THE AGENCY'S FULFILL OUR
MISSION AND WHAT IS THE BEST
APPROACH.
HOW DO WE FOSTER INNOVATION AND
SCIENTIFIC ADVANCEMENT.
HOW DO WE PROTECT AND IMPROVE
PUBLIC HEALTH?
AGAIN, PRESCIENT.
WE WEREN'T NECESSARILY THINKING
AS SERIOUSLY ABOUT IT THEN AS WE
DO TODAY BECAUSE OF WHAT WE'VE
BEEN THROUGH IN TERMS OF THE
PANDEMIC.
STEWARDING THE HUMAN AND
PHYSICAL RESOURCES TO PREVENT
DISEASE, PROMOTING SCIENTIFIC
INTEGRITY, PUBLIC ACCOUNTABILITY
AND SOCIAL RESPONSIBILITY AGAIN
HAVING COME THROUGH THE
PANDEMIC, THIS SORT OF TAKES ON
A BIT OF A NEW MEANING AND MORE
IMPORTANT MEANING I THINK.
HOW DO YOU EVALUATE THE OPTIONS
FOR CHANGE?
SUFFICIENT NEED FOR CHANGE CAN
BE DEMONSTRATED THE NEXT STEP IS
TO CLEARLY EVALUATE THE OPTIONS.
WHAT ARE THE VIABLE OPTIONS,
WHAT ARE THE RISK BENEFIT
ANALYSTSES FOR EACH OPTION AND
SOLICIT AND ANALYZE KEY
STAKEHOLDER PERSPECTIVES ON EACH
OPTION, IDENTIFY AND ANALYZE THE
BROADER IMPLICATIONS OF EACH
OPTION.
AS WE THINK BACK AND WITH THE
BENEFIT OF HINDSIGHT AND WE
ALREADY ALLUDED TO IT, STEP C,
ANALYZING KEY STAKEHOLDER
PERSPECTIVES, WE HAVE TO BE MUCH
BROADER IN OUR VIEW OF WHO THOSE
STAKEHOLDERS ARE.
SO WE DON'T RUN OURSELVES INTO
ANOTHER IMPRACTICAL OR
IMPOSSIBLE SITUATION.
SO THIS IS A CARTOON FOR THOSE
WHO ARE VISUAL.
I AM NOT BUT IT LISTS THE
SPECTRUM OF OPTIONS FROM NO
CHANGE TO A NEW INSTITUTE ON
YOUR RIGHT.
YOU CAN MERGE INITIATIVES AMONG
TWO OR MORE INSTITUTES, WHICH
CREATES A NEW INITIATIVE.
YOU CAN PUT INITIATIVES ACROSS
MULTIPLE INSTITUTES AND CENTERS.
YOU CAN CLUSTER FUNCTIONS, YOU
CAN MERGE INSTITUTES OR MAKE A
HYBRID NAME OR CREATE AN
ENTIRELY NEW INSTITUTE.
AGAIN, AS YOU READ FROM LEFT TO
RIGHT, FUNCTIONAL OR MORE ON THE
LEFT SIDE OF THE SCHEMA AND THE
STRUCTURAL CHANGES MORE ON THE
RIGHT SIDE OF THE SCHEMA, THEY
ARE CAN ACCOMPLISH DIFFERENT
THINGS.
NIH NOW HAS EXPERIENCE WITH
EVERY SINGLE ONE OF THESE.
INCLUDING THE NEW INSTITUTE AND
NIBIB AND NCATS 10 YEARS LATER.
HOW DO YOU IMPLEMENT AND
EVALUATE ONCE THE NEED FOR
CHANGE HAS BEEN ESTABLISHED?
ANY APPROPRIATE SOLUTION HAS
BEEN IDENTIFIED AND THE THIRD
AND FINAL STEP IMPLEMENT AND
EVALUATE AND THOSE WHO HAVE GONE
THROUGH MAJOR RE-ORGANIZERS THIS
IS TEXTBOOK.
OPERATIONALIZE WITH TIME FRAMES
AND TASK AND KEY
RESPONSIBILITIES AND
ACCOUNTABILI
ACCOUNTABILITIES.
HOW DO YOU SPECIFY THE CHANGE AT
INTERVALS AND RELEVANT DATA AND
INFORMATION AND COMMUNICATION.
YOU CANNOT OVER COMMUNICATE IN A
CHANGE MANAGEMENT PROCESS.
THERE'S NO SUCH THING AS OVER
COMMUNICATE AND WHEN YOU THINK
YOU'VE COMMUNICATED ENOUGH,
COMMUNICATE MORE.
YOU KNOW THAT TO BE A TRUTH.
FINALLY, THE PINNING ATTRIBUTES,
WE HAVE TO BE TRANSPARENT AND
HENCE THE WAY WE SET THIS UP,
THERE'S GOT TO BE COMMUNICATION
AT LARGE TO ALL INTERESTED
PARTIES AND OF COURSE THE
ACCOUNTABILITY.
AND FRANKLY, OUR VIABILITY AND
VITALITY DEPEND ON THE TRUST OF
THE PUBLIC.
WE'VE SEEN THIS NOT JUST DURING
THE PANDEMIC BUT IN YEARS PAST.
AND SO EVERY CONTRIBUTOR TO THIS
PROCESS HAS TO BE CONSCIOUS OF
THE PUBLIC TO WHICH HE OR SHE IS
ULTIMATELY ACCOUNTABLE.
OKAY.
SO I RAN THROUGH THAT PRETTY
QUICKLY BUT I HOPE NOW WE CAN
TAKE A LITTLE TIME AND TO BEGIN
TO START TO THINK THROUGH SOME
OF THESE THINGS BECAUSE AGAIN,
YOU CAN ACCEPT IT ALL OR REJECT
IT ALL OR COME SOMEWHERE IN THE
MIDDLE.
WHY DON'T YOU PULL BACK UP THE
SCRIPT.
>> THANK YOU, THAT WAS EXTREMELY
HELPFUL.
WHEN YOU ALL RECEIVE THE
DOCUMENT YOU'LL NOTE FROM WHAT
LARRY'S SUMMARY WAS, PAGE 15, 19
AND 23 ARE VERY SUCCINCT AND I'M
VISUAL SO THEY HAVE COLORS TO
TALK ABOUT JUST WHAT LARRY WAS
EMPHASIZING.
I WONDER IF WE CAN GO BACK TO
THIS SLIDE.
I'LL CHALLENGE US BETWEEN NOW
AND THE NEXT TIME WE COME
TOGETHER IF WE WANT TO FOLLOW
THIS EXACTLY WHICH IS FINE, IF
WE WANT TO MAKE SEPARATE
SUBCATEGORIES.
I'VE HAD A FEW HOURS TO THINK
ABOUT THIS AND WE MAY NEED
EFFICIENCIES BASED ON THE CHANGE
YOU OUTLINED, FINANCIAL
STABILITY, DEFINITIONS FOR
SUCCESS AND ONE THING I WANTED
TO EMPHASIZE I THINK WAS IN YOUR
SLIDES IS IMPORTANT IS THE VALUE
OF THAT INSTITUTION.
SO I THINK WE SHOULD THINK ABOUT
ASSESSING THE VALUE AND IF THE
VALUE IS TANGIBLE OR NOT AND IT
MIGHT BE BOTH.
IT MAY BE TANGIBLE AND
INTANGIBLE BUT IF IT'S NOT
TANGIBLE, IS THAT SOMETHING WE
CAN MAKE RECOMMENDATIONS TO HELP
IT BE MORE TANGIBLE SO THE VALUE
OF THAT SITUATION CAN BE
HIGHLIGHTED?
AND SOME ARE GREAT BUD NEED IN
DEPTH OVERHAUL OR NEED
EFFICIENCIES AND THAT PLAY MEAN
AN EFFICIENT OR MERGING WITH
OTHER INITIATIVES AND COME UP
WITH WHAT WE NEED AS OUR
ORGANIZATIONAL CHANGE MAP SO HE
WHEN WE GO THROUGH THEM WE CAN
USE THE SAME MAP WITH EACH
INSTITUTE THAT WE G
INFORMATION FOR.
JUST WANTED TO HIGHLIGHT THAT.
>> COMMENTS OR QUESTIONS.
>> OKAY.
COMMENTS OR QUESTIONS?
I KIND OF LIKE THE SUGGESTION
THAT IF WE COULD VISIT THE EIGHT
OR NINE REPORTS OR WHATEVER AND
SEE WHAT THINGS HAVE BEEN DONE
VERSUS NOT DONE AND IF THOSE ARE
ISSUES STILL RELEVANT TO FOCUS
ON.
THAT FOR THE WOULD BE HELPFUL AS
AN OUTSIDE PERSON.
TO SEE WHAT THE FORMER GROUPS
HAD.
AND THICKS LIKE THAT THAT ARE
VERY IMPORTANT FOR ALL OF US, I
THINK THAT WOULD BE REALLY
HELPFUL.
IT SOUND LIKE THE ORGANIZATIONAL
ONE IS SOME FROM YOUR
PRESENTATION, THANK YOU VERY
MUCH, IS ON A LOT OF PEOPLE'S
MINDS.
I WANT TO MAKE A COMMENT THERE
FOR ME AS BE AN OUTSIDER LOOKING
AT NIH THOUGH I'M FUNDED BY THE
NIH BUT WHEN WE WERE TRYING AT
MY INSTITUTION TO CREATE WHAT WE
CALL RESEARCH PRIORITY AREAS
LIKE CANCER AND CARDIOVASCULAR
DISEASE, WE USED THE NCI
DESIGNATION AND CTSA DESIGNATION
TO BASICALLY STRUCTURE OUR
ENTIRE APPROACH HOW TO ALIGN
OURSELVES AND ALSO IT HELPED US
IMMENSELY IN RELATIONSHIP TO OUR
HEALTH CARE PROCESS.
HEART, LUNG AND BLOOD, WHERE I
GET FUNDING THEY DON'T HAVE THAT
KIND.
SO FOR OUTSIDE PEOPLE TRYING TO
DO THINGS WE THINK ARE WONDERFUL
PROGRAMS THAT HAVE HELPED US
ALL, IT SEEMS LIKE THOSE KINDS
OF DIFFERENCES SHOULDN'T EXIST
FOR INSTITUTES HONESTLY.
IF THIS IS A PRIORITY THEN WE
SHOULD HAVE IS SOME OF THESE
COMMENTS NO MATTER WHAT THE AREA
OF STUDY THAT FORMULATED A
STRONG PROGRAM EXTERNALLY YOU
WANT TO SUPPORT.
>> LINDSEY AND THEN NORA.
>> I WANTED TO REACT TO COMMENTS
ANDREA MADE AND MY QUESTION IS
WHAT SORT OF DATA WILL WE HAVE
TO INFORM THESE SORTS OF
ASSESSMENTS.
WHAT ABOUT THE QUALITY OF THE
DATA?
I HAVE CONCERNS THOSE SORTS OF
ASSESSMENTS THAT WOULD BE
EXTREMELY HELPFUL AND
INFORMATIVE NOT SURE WE HAVE
DATA THAT WE CAN ALL AGREE SPEAK
TO THESE THINGS IN A CONSISTENT,
ACCURATE WAY.
I'M WONDERING WHAT AT WHAT POINT
WE'LL HAVE ACCESS TO CONSIDER.
UP THIS EXAMPLE THE EXAMPLE IS
LESS SO.
IT MIGHT BE WHAT TYPE OF DATA
WOULD YOU WANT TO HAVE TO MAKE
THOSE ASSESSMENTS AND THE ONUS
IS ON US TO SEE IF WE CAN FIND
THOSE DATA OR DEVELOP THEM
DEPENDING ON THE NATURE.
>> I THINK THE DATA IN THE
PREVIOUS REPORT IS THE MINIMUM.
HOW MANY EMPLOYEES BUT IF
THERE'S ANYTHING ELSE WE CAN
THINK OF IN THE MEANTIME WE
SHOULD JUST REQUEST IT.
WITH A LITTLE GO WITH NORA THEN
JEANNE.
>> AS I THINK ABOUT IT IN TERMS
OF WHAT WE WANT TO ACHIEVE AND
WHAT I WOULD SAY TO MY OWN
FRIEND IS FROM WHERE WE GO TO
NOW THE STRUCTURE OF THE
ORGANIZATION WE MAY HAVE HAD IS
NOT THE SAME NOR I THINK I LIKE
THAT ONE VERY MUCH BECAUSE AS
LARRY SAID, WE HAVE ALL THESE
INITIATIVES HOWEVER, HOW WE ARE
FUNDING RESEARCH IS GOING MORE
TO FUNCTIONAL RESOURCES AND
INVESTMENTS AND WE WERE
DISCUSSING THIS, LARRY, IF WE
COULD GET NOT JUST SHOWING THE
INTERACTIONS IN THE SLIDE AND
SPEAKING WITH ONE ANOTHER AND
HOW THAT CHANGED OVER TIME.
IT WOULD BE ALSO EXTREMELY
VALUABLE IF WE HAVE A SENSE
ABOUT HOW THE DOLLAR AMOUNT HAS
BEEN INCREASING OVER TIME IT'S
MOSQUE TOWARDS THE FUNCTIONAL
INTEGRATION WHICH IS THE WAY THE
BRAIN WORKS.
ONE OF THE MORE CHALLENGES
ASPECTS WE NEED TO ADDRESS IS
HOW WE ACCESS TO COMPLEX QUALITY
DATA THAT CAN ENABLE US TO
ADDRESS CO QUESTIONS AND
TARGET THEM.
THAT REQUIRES AN INTEGRATED
FUNCTIONAL MODEL.
I THINK IN LOOKING AT HOW WE
ACTUALLY MOVE FORWARD, WE HAVE
TO CONSIDER THAT ELEMENT OF
WHERE IS THE SCIENCE GOING AND
WE HAVE THE CURRENT STRUCTURES
THAT IF WE EMPLOY THEM THAT WAY
LD
CRYSTALIZE AND DON'T
ADVANCE.
MY POINT IS WE NEED TO SEE INTO
THE FACT THAT THINGS ARE BEING
DONE VERY DIFFERENTLY THAN EVEN
ONE DECADE AGO.
>> WE HAVE JEANNE AND THEN MIKE.
>> THANKS AGAIN.
VERY HELPFUL L
MY QUESTION IS ALONG THE LINE OF
SOME OF THESE PROPOSALS AND
THINGS IN THE REPORT WE RECEIVED
FROM HOUSE AND SENATE GROUPS ARE
VERY SPECIFIC ABOUT INSTITUTE
REFORM.
GETTING TO THE DATA OF WHAT'S
NEEDED AND I MENTIONED THIS I.C.
DIRECTOR'S MEETING WE'VE BEEN
TALKING ABOUT HAVING EXTERNAL
REVIEWS AND TRYING TO CLARIFY
THE PROCESS, I DO WONDER IF IT'S
WORTH OUTLINING THE QUESTIONS
AND DO WE HAVE GUIDANCE AND HOW
DO WE GET THE DATA
>> FOR INSTITUTE SPIFFING
HARDCORE STUFF IT WILL BE
IMPORTANT TO LOOK AT SOME OF
THOSE PIECES OF DATA.
THANKS.
6:
>> THE PROBLEM WE ARE TRYING TO
SOLVE IS ALL THE THINGS MONICA
HIGHLIGHTED.
DOING A BETTER JOB OF DISCOVERY
TO REAL WORLD TRANSLATION.
I THINK IT'S EASY TO PUT ON NIH
BECAUSE OF OUR ORGANIZATIONAL
STRUCTURE NOTHING'S NOT
HAPPENING QUICKLY ENOUGH.
ONE OF THE CHALLENGES IS WE HAVE
SOME OF THE SMARTEST PEOPLE
WORKING AND THEY'RE TOLD THEY
HAVE TO PUT OUT A PIECE OF
SCIENCE AND THERE'S SOMETHING
ABOUT THE SCIENTIFIC SYSTEM THAT
COULD BE ADDRESSED TO HELP
EVERYBODY WORK TOGETHER AS A
TEAM AND WE LACK THE FUNDAMENTAL
INCENTIVE TO PROMOTE TEAM
SCIENCE.
I SUGGEST THAT'S ONE THING THE
GROUP CONSIDER.
WHAT WE CAN DO AT NIH TO HELP
PUSH THE SCIENTIFIC CULTURE TO
TEAM SCIENCE AND INCENTIVIZINGZ
IT.
MY SECOND COMMENT IS IT'S WORTH
LOOKING AT WHAT IS DIFFERENT NOW
AND WHAT'S EITHER WORK NOT AS
WELL IN THE WORLD COMPARED TO TO
2015.
AND MAYBE WHAT THE OPPORTUNITIES
ARE.I WOULD SLLY HIGHLIGHT
OBVIOUSLY MISTRUST IN SCIENCE,
INFORMATION OVERLOAD AND PEOPLE
ARE GETTING THEIR NEWS FROM
SHORT BLURBS ON SOCIAL MEDIA AND
DATA SCIENCE AND COMPUTATIONAL
TECHNOLOGY TO ALLOW US TO MAKE
THE CONNECTIONS YOU AND ANDREA
TALKED ABOUT.
I HOPE THOSE SOME HAVE OF MY
THOUGHTS IN REACTION.
>> ANY THOUGHT IS STARTING OFF
WITH THE THINGS THAT HAVE COME
UP ARE THE NEXT GENERATION AND
WHAT WE RECOMMEND AND IMPACT THE
NEXT GENERATION AND HOW DO WE
BECOME NIMBLE FOR TECHNOLOGY
LIKE A.I.
HOW DO THEY TRANSLATE TO THE
PUBLIC.
IMPACT TEAM SCIENCE AND
RECOMMENDATIONS ON THOSE SO
THEY'RE NOT THECOMMENDINS
THAT DON'T HAVE IMPACT AND THE
PRIOR REPORTS RECOMMENDED AND
WAS IT ADOPTED, YES, NO.
IF YES WHAT WAS THE OUTCOME AND
IF NO WHY.
TO HAVE AN EASY VISUAL TO ALIGN
WITH WHATEVER WE DETERMINE THE
OVER ARCHING GOALS.
IT'S ALL IN THE REPORT BUT YOU
HAVE THE ASSESSMENTS OR CHECK
MARK ON THINGS CHECK MARKED OR
UNCHECK BOX OB PAGE 15 THERE'S
THE GUIDING PRINCIPLES AND THE
STEPS AND CONSIDERATIONS AND
UNDER THAT THE UNDERPINNING
ATTRIBUTES.
YOU CAN MAKE A SIMILAR IMAGE.
>> NOW JOSHUA AND JAMES.
>>
>> I HAD A DEPRESSING THOUGHT
AND MY DEPRESSING THOUGHT IS ARE
WE TRYING TO INTELLIGENCE AND
RATIONALITY TO SOMETHING
UNPREDICTABLE.
WE TALKED ABOUT THE BREAKTHROUGH
FINDING IN FUNDAMENTAL SCIENCE
COULDN'T HAVE BEEN PREDICTED.
ARE WE TRYING TO CREATE A
STRUCTURE WHERE WE CAN'T PREDICT
WHERE THE REAL BREAKTHROUGHS
WILL BE THE ONES THA CHANGE
SCIENCE AND MAY CHANGE OUR
ABILITY TO TREAT DISEASE.
BECAUSE IF WE COULD DO THAT WE
SHOULD POUR ALL OUR RESOURCES
INTO THOSE AREAS AND WE DON'T
KNOW HOW TO DO THAT.
THINK IT IS UNKNOWABLE.
THAT'S MY DEPRESSING THOUGHT AS
I WAS THINKING ABOUT SOME OF
THESE COMMENTS.
SORRY TO GO THERE BUT IT
OCCURRED TO ME WE'RE TRYING TO
BRING LOGIC TO SOMETHING THAT
PROBABLY ISN'T LOGICAL.
>>
>> THERE'S SOME PLACES WHERE IT
DOES LEND ITSELF.
>> I THINK OF IT AS WE ARE
TRYING TO MAKE STRUCTURE SO WHEN
UNPREDICTABLE THINGS HAPPEN THEY
CAN BE MORE EFFECTIVE.
>> THANK YOU.
JAMES AND THEN ERIC.
THANK YOU, I READ REPORTS AND MY
REACTION WAS TO SAY THAT IS
NINNING TO TO HAVE A CHANCE TO
HAVE A REBUTTAL.
SOME OF THESE THINGS STATED
WHICH I ALMOST FIND OFFENSIVE
LIKE.
CAN YOU READ ONE SENTENCE TO YOU
IF THAT'S OKAY?
>> PLEASE.
>> IS THAT ALL RIGHT?
>> YES, OF COURSE.
>> DECADES OF NON-STRATEGIC
GROWTH FOR GAPS AND MISCONDUCT
AND I MEAN -- I THINK THERE
SHOULD BE AN OPPORTUNITY FOR THE
LEADERSHIP AT NIH TO RESPOND AND
THE OTHER WAS WHICH I FIND
CHALLENGING, ENCOURAGING EACH
I.C. TO UTILIZE A HOLISTIC STAGE
APPROACH OUR GOAL IS TO
ELIMINATE DISEASE SPECIFIC
SILOED NATURE OF THE CURRENT
STRUCTURE ENSURE EACH I.C.
IS CONSIDERING THE WHOLE
INDIVIDUAL.
HOW CAN EACH I.C.ONSIDER THE
WHOLE INDIVIDUAL?
THAT DOESN'T MAKE SENSE.
MY POINT IS WILL THE NIH
DIRECTOR OR SOMEONE HAVE A
CHANCE TO OFFER A REBUTTAL TO
SOME OF THESE THINGS AT LEAST TO
DEMONSTRATE AUTHOR NOT CORRECT?
I'M NOT NIH BUT I'VE BEEN
AFFILIATED WITH COUNCILS,
COMMITTEES, STUDY SECTIONS, ALL
THAT FOR 30 YEARS NOW.
AND I DON'T THINK I AGREE WITH
ANY OF THE THINGS I READ.
IN FACT I FOUND SOME OFFENSIVE.
I KNOW WE'RE NOT SUPPOSED TO LET
POLITICS GET INTO WHAT WE'RE
DOING HERE BUT HOW CAN WE NOT?
>> I THINK NIH WILL HAVE AN
OPPORTUNITY TO ENGAGE WITH
MEMBERS OF CONGRESS AND STAFF ON
THESE ISSUES.
I HAVE A HEARING THURSDAY I'LL
BE WITNESS AT AND MONICA WILL
HAVE A HEARING NEXT WEEK I
SUSPECT SOME WILL COME UP AND
CONGRESS TOLD US TO RESTART THE
MSRB AND DELIBERATE ISSUES OF
THESE TYPE WHICH IS WHY WE'RE
ASSEMBLED AND THE WORK OF THIS
COMMITTEE IS VERY IMPORTANT.
WE HAVE TO DO THINGS RAPIDLY
RND BECAUSE EVERYTHING IS
PUBLIC PEOPLE WILL HEAR THE
CONVERSATION AND DISCUSSION.
IN AN INTERIM WAY HOPEFULLY THAT
WILL HELP INFORM SOME THINGS.
I THINK THAT'S INITIALLY THE
APPROACH.
>> AND WE TALKED ABOUT THE
EDUCATION OF THE PUBLIC AND MOST
ARE NOT IN SCIENCE.
I THINK WE SHOULD INCORPORATE
THE LACK OF KNOWLEDGE AND IT
TELLS ME WE'RE NOT INFORMING
ENOUGH WHAT NIH IS DOING AND
THOUGH EVERY INSTITUTE LOOKS
LIKE IT PLAY BE ORGAN SPECIFIC
DOES RELATE TO THE WHOLE PATIENT
POPULATION.
I THINK THAT'S PART OF OUR
EDUCATIONAL CHALLENGE AND I HOPE
YOU KEEP REMINDING US THROUGH
THE PROCESS THAT PART OF IT IS
GOING TO BE A PUBLIC REPORT IS
TO BREAK DOWN SOME OF THE
UNDERSTANDING THAT SOME PLAY
HAVE OF WHAT THE NIH IS OR
ISN'T.
>> I WANT URGE US TO FOCUS ON
IMPLEMENTATION SCIENCE AND I
HAVEN'T HEARD IT ONCE IN THE
PRESENTATIONS I'VE HEARD TODAY.
>> I HEARD THIS FROM SEVERAL
OTHER SPEAKERS THEY'RE TIP
TOEING MY QUESTION WHEN I WAS
TRYING TO JUMP THE QUEUE.
THERE'S A CONTEXT THAT THERE'S
THINGS WE TRY TO ADDRESS AND
WE'LL HEAR FROM KATE KATE
THE BREAK BUT AT SOME POINT WE
NEED A DISCUSSION WILL WE BE
BLUE SKY AND LOOKK FOR
OPPORTUNITIES OR BE MORE
TACTICAL?
WE'LL HAVE MORE DISCUSSION WITH
KATE THOUGH SOME CREPT INTO THAT
DISCUSSION AND JAMES HIT IT HEAD
ON BUT I WAS READY TO DO IT FIVE
PEOPLE AGO.
>> THE TWO REPORTS ARE NOT THE
ONLY DOCUMENTS THAT WILL LIKELY
INFORM OUR DISCUSSIONS.
OTHER GROUPS ARE PREPARING
THEY'RE VIEW OF THINGS
>> ARE WE GOING TO WAIT AFTER
THE KATE'S PRESENTATION TO HAVE
A DISCUSSION ON WHETHER WE THINK
WE SHOULD BE MORE DELIBERATIVE?
>> WE SHOULD START TO THINK
ABOUT IT FOR THE NEXT TIME BUT
THAT'S THE CENTER OF WHAT WE
HAVE TO DECIDE AND I DON'T WANT
TO PUSH US TO DO THAT IN 15
MINUTES.
>> I CAN'T IMAGINE WE CAN SET UP
WORKING GROUPS UNTIL WE HAVE
THAT DISCUSSION.
>> WE'RE THOUGHT DOING IT
BETWEEN NOW AND OUR FIRST
MEETING BUT THINKING EVERYBODY
WRITE DOWN TACTICS TO HAVE A
HEALTHY DISCUSSION.
>> JOANIE AND MEN MARK.
WHAT WE DO DOESN'T END AT NIH
AND IMPLEMENTATION SCIENCE AND
HOW WE NEED TO REQUIRE THE IDEA
OF BROADENING TO THE ECO
SYSTEM OF NOT JUST THE ASPECT OF
WHAT WE DO AND THINKING ABOUT
TRANSFORMATION OF OUR BROADER
ECO SYSTEM AND A HOW WE'RE DOIN
OUR WORK.
I DON'T WANT US TO FORGET WE ARE
IN THAT BROADER CONTEXT.
NOT TO SAY THAT WE NEED TO
DETERMINE WHAT THE CHANGES ARE
IN THE OTHER ECO SYSTEMS BUT TO
RECOGNIZE THAT WE AREN'T IN A
VACUUM AND TO DO IMPLEMENTATION
SCIENCE WILL REQUIRE AN ABILITY
TO UNDERSTAND HOW TO WORK BETTER
WITH OTHER AREAS OF THE ECO
SYSTEM.
>> THANK YOU.
MARK.
>> THANKS.
IT'S BEEN A VERY INTERESTING
DISCUSSION ANDRAGE US TO
RECOGNIZE IT'S ALL ABOUT THE
SCIENCE.
THERE'S SO COMPETING NATIONS WE
HAVE TO MAKE SUREUR NOT TO
IMPLODE.
THAT SAID, RECOGNIZING THE
HORIZONS IT'S PROBABLY A GOOD
RISK AND GOOD WAY TODE
STRUCTURES TO ADVANCE THOSE.
IN MY VIEW WE CREATE AN
INCUBATOR ENVIRONMENT WHERE
SCIENTISTS, YOUNG AND OLD CAN
GET TOGETHER AND ENVISION THE
NEXT AND FUNDAMENTAL PROCESS
THAT NEEDS TO BE EXPLORED TO
UNDERSTAND BETTER SOME DISEASE
PROCESS I SUSPECT WE DON'T HAVE
INNOVATION TO SATISFY HUMAN
NEED.
IF YOU LOOK AT NIH'S OR OTHER
STRATEGIC PLANS THERE'S MANY
CHALLENGES THAT AWA US AND WE
NEED TO CREATE INCUBATORS TO
BEGIN TO APPROACH THEM.
>> THANK YOU.
OTHER COMMENTS OR QUESTIONS?
ARE YOU READY FOR A BREAK?
SMILES WHEN I SAID THAT.
FINALLY, A SMILE.
GREAT.
SO WE'LL COME BACK AT 4:30?
>> YEAH.
YOU HAVE HALF AN HOUR.
WELL, LESS THAN HALF AN HOUR.
IF YOU COME BACK ABOUT 4:25.
>> GOOD AFTERNOON.
FOR THOSE I DON'T KNOW, I'M KATE
KLIMCZAK THE DIRECTOR OF OFFICE
OF LEGISLATIVE POLICY AND
ANALYSIS.
I APPRECIATE THE OPPORTUNITY TO
MEET WITH YOU ALL TODAY TO
PROVIDE AN UPDATE ON
CONGRESSIONAL PROPOSALS WE'VE
SEEN TO DATE RELATED TO NIH
RE-AUTHORIZATION AND MOD
MODERNIZA
MODERNIZATION.
OVER THE PAST YEAR THE LEVEL OF
CONGRESSIONAL INTEREST HAS BEEN
INCREASING AND WE ARE EAGER TO
CONTINUE OUR ENGAGEMENT WITH
VARIOUS CONGRESSIONAL COMMITTEES
AND MEMBERS ON THEIR IDEAS AND
PROPOSALS TO STRENGTHEN NIH'S
STRUCTURE AND POLICIES.
I'M GOING TO TAKE THE NU NEXT
FEW MINUTES TO WALK THROUGH THE
MAIN PROPOSALS AND THE EMERGING
THEMES THAT WE HAVE SEEN AROUND
RE-AUTHORIZATION AND REFORM THAT
HAVE EMERGED OVER THE PAST YEAR
OR SO.
I WON'T HAVE TIME TO GET INTO
THE DETAILS OF EVERY IDEA
PROPOSED BUT I HOPE TO LEAVE YOU
WITH AN UNDERSTANDING OF THE
THREE KEY PROPOSALS AND
RECURRING THEMES THAT COME FROM
THOSE.
AS YOU MAY KNOW WE ARE RAPIDLY
APPROACHING THE END OF THE
CONGRESSIONAL SESSION AND
CURRENT ADMINISTRATION.
I DO EXPECT WE'LL SEE SIMILAR
LEVELS OF CONSIDERATIONAL
INTEREST NEXT YEAR THOUGH A LOT
WELL DEPEND ON WHEN AND HOW NIH
REAUTHORIZATION FITS ON THE
PRIORITIES AND THE CALENDAR.
A BRIEF HISTORY ON THE RECENT
NIH REAUTHORIZATIONS IN 2006
THEY PASSED THE REFORM ACT OF
2006 WHICH AUTHORIZED THE
ESTABLISHMENT OF THE SMRB,
ESTABLISHED THE DIVISION OF
PROGRAM COORDINATION PLANNING
AND INITIATIVES AND AUTHORIZED
THE COMMON FUND AND REAFFIRMED
THE IMPORTANCE OF THE NIH AND
ITS VITAL ROLE IN ADVANCING
BIOMEDICAL RESEARCH.
ABOUT A DECADE LATER CONGRESS
PASSED THE BIPARTISAN 21st CURES
ACT TO INCREASE OUR
ADMINISTRATIVE FLEXIBILITY AT
NIH AND HELP REDUCE BURDEN.
THE CURES ACT ALSO AS MANY OF
YOU KNOW INCLUDED THE INNOVATION
FUND WHICH PROVIDED FUNDING FOR
A NUMBER OF INNOVATIVE PROGRAMS
INCLUDING THE ALL OF US RESEARCH
PROGRAM, THE BRAIN INITIATIVE,
CANCER MOON SHOOT AND
REGENERATIVE MEDICINE INNOVATION
PROJECT.
I WANT TO NOTE WHILE NIH HAS NOT
RECENTLY BEEN REAUTHORIZED, OUR
WORK WILL CONTINUE THROUGH OUR
ANNUAL APPROPRIATION.
AS MENTIONED THERE'S BEEN
GROWING CONGRESSIONAL INTEREST
IN A REAUTHORIZATION
MODERNIZATION REFORM OF NIH.
THE VARIOUS PROPOSALS THAT HAD
BEEN PUT OUT SO FAR HAVE
INCLUDED A NUMBER OF REFORMS TO
NIH'S SUGGESTED REFORMS TO NIH'S
STRUCTURE, POLICIES AND
PROCEDURES.
THE DIFFERENT MEMBERS AND
COMMITTEES THAT HAVE PUT OUT
PROPOSALS HAVE TAKEN DIFFERENT
APPROACHES AND HOW THEY HAVE
EITHER REQUESTED INPUT FROM NIH
STAKEHOLDERS, HOW THEY HAVE
PRIORITIZED CERTAIN TOPICS OR
ISSUES AND ALSO HOW THEY HAVE
ACTUALLY PRESENTED THEIR
PROPOSALS TO THE PUBLIC AND TO
NIH.
THERE ARE THREE KEY PROPOSALS
THAT I'M GOING TO FOCUS ON
TODAY.
LAST YEAR U.S. SENATE HEALTH
EDUCATION LABOR AND PENSION
COMMITTEE RANKING MEM, BILL
KASSIDY RELEASED A REQUEST FOR
INFORMATION.
HE WAS SEEKING IDEAS FROM NIH
PARTNERS HOW NIH COULD IMPROVE
ITS PROCESS FOR APPROVING
RESEARCH GRANTS.
IDEAS TO BETTER SUPPORT THE
BIOMEDICAL WORKFORCE, WAYS TO
BOLSTER COLLABORATION ACROSS
ACADEMIA AND INDUSTRY AND IDEAS
TO INCREASE TRANSPARENCY INTO
NIH ACTIVITIES AND OPERATIONS.
BASED ON A LOT OF THAT FEEDBACK
AND SOME OF HIS IDEAS HE
RELEASED A WHITE PAPER EARLIER
THIS YEAR.
I'LL TALK MORE ABOUT THE
COMPONENTS IN THE RIGHT PAPER IN
A MINUTE.
UNJUNE THE HOUSE ENERGY AND
COMMERCE COMMITTEE RELEASED A
FRAMEWORK FOCUSSING ON
CHALLENGES THE COMMITTEE SEES
FACING NIN, RECOMMENDATIONS AND
THE XT SOLICITED FEEDBACK ON
TERN TOPICS AND QUESTIONS.
NIH STAKEHOLDERS WERE ENCOURAGED
TO ENGAGE AND SHARED THEIR IDEAS
WITH THE COMMITTEE.
FINALLY THE HOUSE LABOR
SUBCOMMITTEE RELEASED ITS
PROPOSED SPENDING BILL.
THAT PIECE OF LEGISLATION
INCLUDED POLICY REFORMS IN THE
ENERGY AND COMMERCE PROPOSAL.
I INCLUDED A PROPOSAL TO
CONSOLIDATE NIH INSTITUTES AND
CENTERS AND BEFORE DIVING INTO
TE DETAILS HERE I ALSO WANTED TO
TAKE A MINUTE TO NOTE MANY OF
NIH'S PARTNERS, STAKEHOLDERS,
ADVOCATES HEARD THE REQUEST FOR
INPUT AND OBLIGE.
WE HAVE SEEN REPRESENTATION OF
ACADEMIC INSTITUTIONS AND GROUPS
THINKING DEEPLY HOW NIH CAN
IMPROVE AND MODERNIZE AND HAVE
PROVIDED A SIGNIFICANT AMOUNT OF
FEEDBACK THAT INFLUENCED
PROPOSALS TO DATE AND I WANT TO
NOTE THEY'VE SPURRED A LOT OF
OUTSIDE INPUT AS WELL THAT'S
BEEN FED TO THE CONGRESSIONAL
COMMITTEES AND MEMBERS THINKING
ABOUT THESE PROPOSALS.
AND FROM PROPOSALS AND
COVERINGS, AND THERE'S STRONG
BIPARTISAN SUPPORT FOR
BIOMEDICAL RESEARCH AND CONGRESS
HAS BEEN CONSISTENTLY GENEROUS
TO NIH IN THE AMOUNT OF FUNDING
ITS PROVIDED TO US YEAR AFTER
YEAR.
THAT THAT HAS BEEN APPROPRIATED
BY THE COMMITTEES AND NIH HAS
WORKED TO BE RESPONSIVE TO THAT
OVERSIGHT BUT DESPITE THE
INVESTMENT AND OVERSIGHT THERE'S
STILL CLEAR OPPORTUNITIES TO
EMIMPROVE MISSION TO IMPROVE THE
WORKFORCE AND ADVANCE CURES AND
TREMES FOR ALL PEOPLE.
AND THERE THE PROCESS IS LONG
OVERDUE AND IT'S BEEN YEARS
SINCE WE HAD OFFICIAL
REAUTHORIZATION AND THE
COMPREHENSIVE CONGRESSIONAL
REVIEW OF HOW NIH OPERATES.
AGAIN, I WANT TO NOTE WE
CONDITION WITH THE ANNUAL
APPROPRIATION.
AND KEY AREAS OF PROPOSED ROW
FORM THAT HAVE COME UP AND THIS
IS OBVIOUS TO MANY THAT LOOKED
AT THE PROPOSALS, STRUCTURAL
REFORMS, LEADERSHIP REFORMS,
POLICY GRANT REFORMS AND REFORMS
RELATED TO FUNDING ARE THE FOUR
AREAS CONGRESS HAS BEEN MOST
INTERESTED IN EXPLORING AND
OFFERING IDEAS ON.
STARTING WITH STRUCTURAL REFORM,
BOTH ENERGY AND COMMERCE AND
HOUSE APPROPRIATIONS PROPOSALS
DID INCLUDE PROPOSALS TO CON
CONSOLIDATE UNDER THES SINCE
FROM 27 TO 15.
THE STATED GOAL FOR THE
CONSOLIDATION IS STREAMLINE THE
INSTITUTES AROUND CENTERS AND
BETTER CONSIDER THE WHOLE
INDIVIDUAL.
I DO WANT TO NOTE THAT OUR
CURRENT STRUCTURE WOMAN THE 27
IS MANDATED BY LAW AND WOULD
HAVE TO BE CHANGED THROUGH
LEGISLATION.
AND CONGRESS APPROPRIATES
FUNDING AMOUNTS TO THE SPECIFIC
INSTITUTES AND CENTERS SO THAT
WOULD ALSO HAVE TO BE ADDRESSED.
THIS PARTICULAR PROPOSAL HAS ED
A SIGNIFICANT AMOUNT OF PUBLIC
AND PRESS ATTENTION SINCE IT
WOULD DRASTICALLY CHANGE HOW NIH
OPERATES AND FUNDS RESEARCH.
IN ADDITION TO THE REFORMS
STAKEHOLDER FEEDBACK TOUCHED ON
MISSION AND LEADERSHIP REFORMS.
IT WAS ONE CLEAR POINT THAT CAME
ACROSS ALL THE PROPOSALS WAS
THERE'S A NEED FOR COMPREHENSIVE
REVIEW AT NIH'S OPERATIONS,
STRUCTURE AND POLICIES THAT'S
WHERE YOU COME IN AND NEAR
UNANIMOUS NIH NEEDED TO
ESTABLISH AND UTILIZE THE MSRB
TO PROVIDE NEEDED FEEDBACK TO
NIH LEADERSHIP 3: -- THE OTHER
IS TERM LIMITS.
THE 21st CENTURY CURES ACT SET
TERM LIMITS BUT NO LIMIT ON THE
NUMBER OF TERMS.
THERE'S GROWING INTEREST ON
SETTING THE TERMS A DIRECTOR CAN
SERVE.
FOR EXAMPLE, THE ENERGY AND
COMMERCE PROPOSAL RECOMMENDS
LIMITING I.C. DIRECTORS TO A
FIVE-YEAR TERM WITH THE ABILITY
TO SERVE TWO CONSECUTIVE TERM IF
APPROVED BY THE NIH DIRECTOR.
BREAKING DOWN SILOS BETWEEN THE
INSTITUTE IS ANOTHER COMMON
THEME WE SAW ACROSS ALL THE
PROPOSALS.
THE CONSOLIDATION PIECE
ATTEMPTED TO ADDRESS THAT ISSUE
BUT OTHER THEMES THAT TOUCHED ON
REDUNDANT RESEARCH
INFRASTRUCTURE AND CLINICAL
TRIAL INFRASTRUCTURE AND
DUPLICATION ACROSS THE I.C.
RESEARCH PORTFOLIOS.
ANOTHER KEY THEME ACROSS THE
PROPOSALS IS OVERSIGHT AND
TRANSPARENCY WITHIN NIH AND FROM
OUR PARTNERS.
WITHIN THE BUCKET THERE'S A
NUMBER OF THINGS.
I WON'T GET TO ALL OF THEM BUT
KEY THINGS TO NOTE INTEREST IN
MAKING AND SEEING MORE
TRANSPARENCY RELATED FOR
DISCLOSURES.
IN ADDITION ANOTHER THEME IS
STRONG CONSISTENT OVERSIGHT OF
MISCONDUCT INCLUDING SEXUAL
HARASSMENT IN ADDITION, FUNDING
REFORM IS ANOTHER AREA THAT
WE'VE SEEN AND DISCUSSION OB NIH
FUNDING STREAMS.
KEY INTEREST IN MAKING SURE NIH
IS ACCOUNTING FOR AND RECOVERING
MISUSED GRANT FUNDING.
ALSO THE ISSUE OF INDIRECT COSTS
OR ADMINISTRATIVE COSTS
CONTINUES TO COME UP THE LABOR
APPROPRIATION PROPOSALS
EXAMINING THE COSTS AND LIMITING
THE ALLOWED COST AND PREVENTING
WASTE AND FRAUD ON THE POLICY
SIDE MANY IDEAS AND SUGGESTIONS
HAVE BEEN OFFERED TO MODERNIZE
AND REFORM NIH GRANT PROCESSES
BUT A FEW COMMON THEMES I WANT
TO TOUCH ON BRIEFLY A LARGER
BUCKET OF RESEARCH MUST BE
CREDIBLE, RELIABLE AND TIMELY.
THINGS UNDER THAT BUCKET A
BALANCED PORTFOLIO ON BASIC TO
TRANSLATIONAL RESEARCH AND THIS
COMES UP IN DISCUSSION.
ENSURING STRICT OVERSIGHT OF
RISKY RESEARCH IS VERY IMPORTANT
AND SUSPEND GRANTS AND ANIMAL
RESEARCH AND HARASSMENT.
STREAMLINING REVIEW IS OF
INTEREST OF ON THE SENATE SIDE.
THE WHITE PAPER INCLUDED
SUGGESTIONS TO PILOTING, TRYING
OUT AND EVALUATING DIFFERENT
APPROACHES TO HENN'S PEER REVIEW
PROCESS SOME IDEAS INCLUDED MORE
GENERALIST TO PEER REVIEW MORE
TRAINING TO ENSURE CONSISTENCY
ACROSS THE PEER REVIEW PROCESS
AND EVALUATING THE BALANCE
BETWEEN FOCUSSING ON METHODOLOGY
AND POTENTIAL IMPACT AND VISION.
BHIEZ NEXT?
WHAT'S NEXT?
THERE'S MANY MANY DIFFERENT
IDEAS AND PROPOSALS AND ACHIEVE
THE PROPOSALS MENTIONED AND
NUMBER OF PARTNERS AND ENGAGED
SHAREHOLDERS HAVE COME UP WITH
PROPOSALS AND THERE'S MORE
PROPOSALS AND I TRIED TO TOUCH
ON THE THEMES WE'VE BEEN SEEING.
THE CURRENT SESSION IS BIND
WINDING DOWN BUT WE EXPECT
CONGRESSIONAL INTEREST WILL
CONTINUE NEXT YEAR AND NEW
CONGRESSIONAL SESSION HEADING
INTO NEXT YEAR WE LOOK FORWARD
TO THE CONTINUED DISCUSSION ON
IDEAS SO FAR.
NEW IDEAS AS THEY ARISE.
THE MESSAGE TO DATE WE'VE BEEN
USING ENGAGEMENT IN DISCUSSION
THERE'S ALWAYS ROOM FOR
IMPROVEMENT AND WE'RE EAGER TO
BE A PART OF THE CONVERSATION TO
IMPROVE AND MAXIMIZE OUR
RESEARCH.
CONGRESS IS A KEY PARTNER FOR US
IN ACHIEVING THAT OBJECTIVE.
SO WE DO HOPE IF THERE'S
MOVEMENT NEXT YEAR TOWARDS
RE-AUTHORIZATION IT WILL BE
AGAIN A BIPARTISAN THOROUGH
PROCESS THAT WE SAW THROUGH 21st
CENTURY CURES AND THE REFORM ACT
2006.
I'LL LEAVE IT THERE.
AND AN ADDITIONAL OPPORTUNITY
FOR THIS TO FEED INTO THE
PROCESS AND WE LOOK FORWARD TO
THE BOARD'S RECOMMENDATIONS.
>> THANK YOU.
IT GIVES US A LOT TO THINK
ABOUT.
>> DO THE CONGRESSMEN AND
SENATORS WERE LEADING THE
REPORTS ARE THEY AWARE WE'RE
WORKING ON A RESPONSE AND THE
SECOND PART IS DO THEY HAVE THE
TIME LINE?
ARE THEY EXPECTING SOMETHING?
>> THEY'RE AWARE SE SMRB IS
MEETING AND MY OFFICE'S JOB IS
OKAY MAKE SURE WE'RE KEEPING ALL
MEMBERS INTERESTED AND
PARTICULARLY THOSE THAT
EXPRESSED AN INTEREST IN THE
SMRB MAKING SURE WE'RE SHARING
UPDATES AS WE GO ALONG SO WE'LL
BE DOING THAT AND BEING UP TERMS
OF PRODUCING A REPORT AND
EAGERLY AWAITING WHAT YOU COME
UP WITH.
>> GREAT.
LINDSEY, YOU'RE UP FIRST.
>> THANK YOU VERY MUCH.
I NOTICED A NUMBER OF COMMENTS
THAT SUGGEST THE NIH HAS NOT
BEEN RESPONSIVE TO VARIOUS
QUESTIONS AND CONCERNS AND
INQUIRIES.
DOES THAT REFLECT WE DOESHTS
HAVE STREAMLINED PROCESSES FOR
COMMUNICATING?
ARE WE BEING OVERWHELMED WITH
QUESTIONS AND CONCERNS?
ARE THEY COMING IN IN A WAY WE
CAN'T EASILY IDENTIFY AND
RESPOND?
I WANT TO UNDERSTAND BETTER.
WE WANT OUR COMMUNICATIONS WITH
CONGRESSIONAL MEMBERS AND STAFF
WE WANT TO BE RESPONSIVE TO
CONCERNS.
WITHOUT KNOWING THE SPECIFIC
CONCERN THEY WERE ASKING ABOUT
IT MAY BE A SPECIFIC REPORT OR
UPDATE ON A PARTICULAR ISSUE.
THOSE ARE THINGS WE STRIVE TO BE
RESPONSIVE ON AND PRIDE
OURSELVES.
ANSWERING THE BIGGER QUESTION ON
THE PORTFOLIO BETWEEN BASIC AND
TRANSLATIONAL RESEARCH IS MORE
OF A DISCUSSION THAN ANSWERING A
CONCERN OR INVOLVING THAT
PROBLEM.
THE ANNUAL APPROPRIATIONS BILL
CONTAINS REPORTING REQUIREMENTS
AND UPDATES.
WE WORK THROUGH THOSE
METHODICALLY TO GET THOSE
UPDATES TO CONGRESS.
THERE'S BEEN A MULTIYEAR PUSH TO
GET THE SMRB RECONSTITUTED SO
SOME MEMBERS WOULD SAY IT TOOK
TOO LONG TO GET RE-ESTABLISHED
DESPITE THEM ASKING FOR IT BUT
NOW THAT IT'S RE-ESTABLISHED
WE'LL KEEP THEM UPDATED AND MAKE
SURE THEY HAVE ALL THE
INFORMATION THEY NEED.
>> THERE'S SOME THINGS THAT WERE
ASKED FOR THAT WE'RE NOT
PERMITTED TO PROVIDE, FOR
EXAMPLE, PERSONNEL ACTIONS.
THERE'S A CERTAIN CONSERVATIVE
SHALT AND WE HONOR THAT.
CONFIDENTIALITY AND WE HONOR
THAT.
MIKE AND THEN NORM.
>> KATE, THANKS.
I THOUGHT I'D GIVE A COUPLE
REACTIONS ON THE TWO REPORTS IN
THE CONTEXT OF SOME OF THE
PRESENTATIONS THIS MORNING.
IN TERMS OF THE ISSUE OF
FUNCTIONAL INTEGRATION, 27 TO
15, I CAN UNDERSTAND TO SAY 27
IS HIGH BUT TO ME THE REALITY IS
PEOPLE HAVE BODY PARTS, SOME
INSTITUTES ARE BASED ON BODY
PARTS OR DISEASES AND PEOPLE
HAVE BODY PARTS OR DISEASES AND
SOME ARE BASED ON METHODOLOGIES
AND ACADEMIC CLINICAL
DEPARTMENTS ARE ORGANIZED BY
DISEASE AND METHODOLOGY AND MY
SUGGESTION ALONG THOSE LINES IT
MAY BE HELPFUL TO CONSIDER
ORGANIZING IN TERMS OF A VIS
VISUALIZATION.
I MAY BE EASIER TO UNDERSTAND
HOW THEY CROSS CUT.
AND IN TERMS OF FUNCTIONAL
INTEGRATION YOU CALLED OUT
CLINICAL TRIALS AND THERE COULD
BE SUBSTRATES FOR WORKING GROUP.
IN TERMS OF A BALANCED PORTFOLIO
IT'S EASY TO CRITICIZE NOT
HAVING A BALANCED PORTFOLIO BUT
STOCK MARKET CAN SAY YOU NEED
THIS MUCH RISK AND I DON'T THINK
WE KNOW THAT FOR SCIENCE AND
THAT ISSUE MAY WARRANT
EXPLORATION IT'S NOT FAIR TO
CRITICIZE WHEN NOBODY KNOWS THE
RIGHT ANSWER BUT MAYBE WE CAN
EXPLORE THE RESEARCH THROUGH
METASCIENCE TYPE OF RESEARCH.
MY LAST COMMENT SORRY FOR BEING
SO LONG WINDED IS THAT I THINK
SOME OF THESE CAN'T BE DONE IN
ISOLATION.
CLINICIAN SCIENTISTS AND THE
ISSUE OF SOFT MONEY, THE REALITY
IS ACADEMIC CENTERS ARE
STRUGGLING AND RESEARCH AND
TEACHING SUFFERS BECAUSE OF THAT
AND THEY RELY ON SOFT MONEY AND
MISCONDUCT IS DONE BY EMPLOYEES
WORKING IN ACADEMIC CENTERS.
I THINK THERE MAY BE HOW OLD WE
TIE IN WHAT WE DO IN THE
ACADEMIC CENTERS AND MAYBE THAT
COULD BE PART OF THE PLAN.
THANK YOU.
>>
>> WHAT IS THE RIGHT NUMBER OF
INSTITUTES OR CENTERS.
WHAT IS THE RIGHT BALANCE THOSE
ARE COMPLICATED QUESTIONS AND
MORE THAN ONE RIGHT ANSWER
DEPENDING ON THE DATE AND TIME.E
THERE WILL BE A LOT OF
CONSIDERATIONS ON THE PORTFOLIO
BALANCE AND INSTITUTIONS AS WELL
WILL HAVE THOUGHTS AND THERE'S
OTHER PLACE AND SUGGESTIONS.
PREVENTING RESEARCH MISCONDUCT
AND SEXUAL HARASSMENT WE'RE
PROBABLY ALL IN AGREEMENT WE
WANT TO PRIORITIZE AND PREVENT.
HOW WE GET THERE M
DIFFERENT AND WHEN WE CAN
ENGAGE CONGRESS IN IDEAS WE HAVE
OR THEY HAVE, THAT'S A PLACE
WHERE WE'D WANT TO PROVIDE
TECHNICAL ASSISTANCE AND AREAS
WHERE WE HAVE ADDITIONAL NEED
FOR LEGISLATIVE AUTHORITIES.
THEY'LL NEED DIFFERENT LEVELS OF
INPUT AND PROBLEM SOLVING SKILL.
>> WE HAVE HEARD THINGS ARE
DIFFERENT NOW WELL OF ONE OF THE
FIRST THINGS I GET ASKED IS THE
REORGANIZATION OF THE NIH.
NOW THAT THERE IS A MORE FORMAL
WAY OF LOOKING AT IT, I THINK IT
WOULD BE VERY HELPFUL TO HAVE
BULLET POINTS OF HOW TO
COMMUNICATE THIS SO WE ALL
DIRECTORS BECOME THE SAME VOICE.
YOU CAN GUARANTEE THIS IS GOING
TO BE ONE OF THE QUESTIONS THAT
EMERGES BECAUSE RESEARCHERS ARE
VERY CONCERNED ABOUT WHAT THIS
MEANS TO THEM AND THEIR RELATED
RESEARCH.
>> I WANT US TO MAKE A MENTAL
NOTE OF WHAT NORA SAID SPEAKING
IN ONE VOICE OF WHAT IS
HAPPENING.
>> WOW, FIRST THAT'S DEPRESSING.
I KNOW YOU'RE THE MESSENGER BUT
THAT'S A LOT ALARMING.
WILL ANY OF THESE SORTS OF
THINGS IN THE REPORTS CHANGE
WITH THE NEW ADMINISTRATION AND
POSITIONS IN PLACE AND MY SECOND
QUESTION IS WHEN I RESPOND TO AA
GRANT ARE REVIEW I CHOOSE A FEW
THINGS THAT ARE VERY IMPORTANT
AND RESPOND TO THOSE AND OTHER
THINGS LIKE ON THE DIRECT COST
LIKE IN KENTUCKY WOULD DEF
STRAIGHT OUR ABILITY TO DO
RESEARCH.
SOME ARE BROAD REACHING AND
WOULD TAKE A WHOLE UNDERSTANDING
IN THEMSELVES THERE WAS IN THERE
AND THOSE ARE SOME CAN YOU PICK
SOME THAT ARE MAJOR AND WILL ANY
OF IT CHANGE?
>> I THINK THINGS WILL CHANGE
NEXT YEAR.
ON THE SENATE SIDE THE
REPUBLICANS WILL TAKE CON
NEXT YEAR SO IF SENATOR KASSIDY
REMAINS IN A LEADERSHIP ROLE
HE'LL MOVE FROM CHAIR TO RANKING
MEMBER.
IT WILL BE A DIFFERENT VOICE
HE'LL BE SPEAKING FROM.
AND GIVE HIM A DIFFERENT
PLATFORM AND VOICE TO AN
SPEAK ABOUT THE ISSUE AND MOVE
FORWARD A BILL IF HE SO CHOOSES.
SO HE'LL BE IN A DIFFERENT ROLET
AND KATHY McRODGERS WILL NO
LONGER BE IN THE HOUSE SO
THERE'LLE' BE DIFFERENT
LEADERSHIP.
AND THEY ARE PLAY HAVE OTHER
ISSUES TO PURSUE BUT IF THEY
WANTED TO PURSUE
RE-AUTHORIZATION THERE MAY BE
THEY WANT TO
RE-PRIORITIZE.
IN TERMS OFIZING
CERTAINLY I THINK YOU'LL ALL
HAVE PRIORITIZE BECAUSE
THERE'S A LOT OF WITHIN HERE BUT
YOU THINK THERE'S ALSO IN TERMS
OF THE MEATIER QUESTIONS NA HAVE
DIFFERENT PERSPECTI AND
BALANCED PORTFOLIO AND HOW TO --
THERE'S OTHER PIECES THAT WE MAY
ALL AGREE WE WANT TO FIGURE OUT
A BETTER SOLUTION OR MAY ALL
AGREE THIS IS A SPACE THAT NEEDS
TO BE IMPROVED OR OPTIMIZED HOW
WE GET THERE.
TAKING ON SOME OF THE BIGGER
QUESTIONS AND FIGURING OUT SOME
OF THE LOWER HANGING FREWED
WHERE THERE'S AGREEMENT WE DO
AND DO AND AYOGS THEY'RE
CONGRESSIONAL PROPOSALS BUT WE
ABELOW THERE'S MORE AUTHORITIES
WE NEED TO DO A BETTER JOB IN
THE SPACE.
NEGOTIATION AND DISCUSSION.D
IF THERE WERE TO BE A
RE-AUTHORIZATION PROCESS N-A
YEAR, TYPICALLY THE HOUSE WILL
HAVE A BILL AND SENATE WILL HAVE
A BILL.
WE USUALLY HAVE AN OPPORTUNITY
TO PROVIDE FEEDBACK.
MANY OF OUR PARTNERS AROUND
STAKEHOLDERS WILL BE CONSULTED.
INSTITUTIONS IN YOUR STATE
OFFERED THE OPPORTUNITY TO WEIGH
IN.
ONE PERSON IN A
ROOM WRITING A BILL.
THERE'S LOTS OF OPPORTUNITIES
FOR INPUT TO STRENGTHEN IT.
>> I ALSO FIND THE REPORT
ESPECIALLY THE RESTRUCTURING OF
THE INSTITUTES REALLY
CONCERNING.
WHAT I FIND MOST DIFFICULT IS I
DON'T UNDERSTAND WHERE IT'S
COMING FROM.
ARE THEY LOOKING FOR MORE
COLLABORATION AND SO EVIDENCE OF
COLLABORATION WOULD BE USEFUL?
ARE THEY LOOKING FOR MORE
OPERATIONAL EFFICIENCIES?
SO AND I THINK REORGANIZING THE
INSTITUTES IS TRAUMATIC ON MANY
LEVELS.
IT MAY BEAY THAT WE CAN MAKE
THINGS MORE EFFICIENT AND
PRODUCE BETTER SCIENCE BY
REORGANIZING BUT I THINK OF
PATIENTS.
LIKE THE PARENT OF A DEAF CHILD
OR CHILD WHOSE BLIND.
THE PATIENTS HAVE AN EMOTIONAL
CONNECTION
WITH OUR INSTITUTES
BECAUSE THEY SEE THAT AS THEIR
HOPE TO MAKE THINGS BETTER.
AS WE START TO THINK ABOUT THE
PUBLIC MESSAGING ASPECT OF THIS,
THAT'S VERY CONCERNING ON THE
OTHER HAND HAVING A CONVERSATION
CAN BE SEEN AS DISINGENUOUS.
JUST SOME THOUGHTS.
>> ALISON.
>> IT WOULDE HELPFULUL TO FIND
WHAT MADE THEM DECIDE 27 TO 15
WAS THE DECISION.
DID THEY JUST DO A WORD
ASSOCIATION WITH THE TITLES OR
DID THEY HAVE DEEP INFORMATION
ON THE INSTITUTES THAT MADE THEM
DECIDE THESE COULD BE ONE.
DO YOU KNOW WHAT INFORMATION
THEY HAD?
>> I'D BE HESITANT TO SPEAK FOR
THEM HOW THEY CHOSE --
>> WHAT DATA WERE THEY LOOKING
AT?
>> WE DON'T KNOW.
>> HARD TO SAY.
THERE WERE CONTEXTTE CLUES.
27 I.C.s AND HUGE ESTABLISHED
CLINICAL TRIAL NETWORKS -- DO WE
NEED THAT OR WOULD THERE BE
EFFICIENCY -- I THINK THEY WANT
TO ASK SOME OF THOSE QUESTIONS.
NOW, ONE OPTION IS TO
CONSOLIDATE I.C.s SO YOU DON'T
HAVE 27L TRIAL NETWORKS,
YOU HAVE 15 PUT MAYBE THERE'S
OPPORTUNITY FOR US TO COME AND
SAY ARE DIVE IN AND SAY HERE'S
THE VALUE AND HERE'S HOW WE MAKE
IT NOT DUPE -- DUPLICATIVE.
THAT'S A WAY TO OFFER BUT YOU
CAN SEE SOME THEIR THINKING IN
THE PROPOSALS THERE.
>> TO ME IT'S ABOUT GIVING THEM
INFORMATION AND NOT NECESSARILY
[OFF-MIC]-M
>> ALISON.
>> I HAVE A COMMENT.
YOU MADE A POINT ABOUT SOME
THINGS IN THE TWO DOCUMENTS WE
ALL AGREE ON.
AND FRAMING THAT MAY BE HELPFUL
SO WE CAN SORT OUT THESE THINGS
ARE RELATIVELY EASY AND THESE
ARE HARD.
THE SECOND COMMENT IS ABOUT THE
REAUTHORIZATION.
SO COULD YOU EXPLAIN THE TIMING
IN THE MIDDLE OF SIX MONTHS OR
THE END AND HOW DOES THAT IMPACT
OUR WORK?
IS OUR REPORT PREEMPTIVE OR
FOLLOWING THAT?
>> I'LL GET TO THAT ON ONE
SECOND BUT ON THE HARD/EASY
PIECE.
I'D ALSO THROW IN YOU ALL MAY
IDENTIFY AUTHORITIES OR CHANGES
OR THINGS THAT WE WANT AND WOULD
THINK THERE'S OPPORTUNITY FOR
NIH SHARE THOUGHTS ON THINGS WE
HAVE IDENTIFIED THAT MAY NOT
HAVE COME UP YET IN A
CONVERSATION ON THE HILL AND
FIND PLACES WHERE W ALIGNED
ON THE GOAL OR G OBJECTI O EVENI
HOW WE GET THERE ISN'T CLEAR
YET.
IN TERMS OF PROCESS PROCESS
THERE'S NO HARD AND TIME LINE
FOR CONGRESS TO DO ITS WORK ON
THE RE-AUTHORIZATION PROC
THERE'S A NEW SESSION AND NEW
ADMINISTRATION.
THERE'LL BE A LOT OF PRIORITIES
NEW ADMINISTRATION IS LIKELY
GOING TO COME IN WITH IT'S GOING
TO WANT CONGRESS TO FOCUS ON IN
THE BEGINNING.
THE FIRST 100 DAYS THERE'S A LOT
OF THE DIRECTION COMING FROM THE
ADMINISTRATION.
WHERE NIH REAUTHORIZATION MAY
FIT ON THE PRIORITY LIST AND
WHERE THERE'S TIME ON THE
CALENDAR WILL DEPEND ON FACTORS
OUTSIDE OF YOUR CONTROL AND
WHERE THAT COMES IN WITH YOUR
WORK IS JUST HARD TO SAY.
>> THIS IS A LOT TO TAKE IN.
I HAVE A QUICK QUESTION.
EARLIER IN YOUR PRESENTATION YOU
MENTIONED RESTRUCTURING NIH
WOULD BE A CONGRESSIONAL ACT.
IS THAT YEKT?
>> YES.
>> DOES IT REQUIRE INPUT FROM
THIS COMMITTEE OR CAN THEY JUST
DO IT?
>> CONGRESS?
>> YES.
>> YES, IF THEY CHOSE TO D IT
THEY'RE BACK IN SESSION THIS
WEEK IF THEY HAVE THE
LEGISLATION THEY COULD MOVE
FORWARD WITH IT AND IT WOULD
HAVE TO PASS THE HOUSE, SENATE
AND THE PRESIDENT WOULD HAVE TO
SIGN IT INTO LAW.
>> THANK YOU.
>> ANY FINAL COMMENTS OR
QUESTIONS?
>> CAN I PICK UP ON THE LAST
THREAD.
I GUESS ONE TLICH QUESTIONS I
WOULD HAVE IS THEY CAN DO
WHATEVER THEY ARE WANT, WE KNOW
THAT BUT WE EXIST FOR A REASON.
IS THERE AN OPPORTUNITY FOR
DIALOGUE SO THAT IF WE SAID THIS
COMMITTEE'S NOW BACK IN ACTION
AND WE'RE TACKLINGA, B AND C AN
THERE A WAY TO HAVE OPEN
DIALOGUE SO WE HAVE A CHANCE TO
HAVE THIS BODY INFORM THEIR
DISCUSSIONS IN A SYNERGISTIC AND
COLLABORATIVE WAY.
RIGHT NOW IT SEEMS LIKE WE'RE
GOING GETTING AND THEY'RE GOING
TO DO THEIR THING BUT THERE MUST
BE SOME OPPORTUNITY THROUGH YOU
OR OTHERS TO TRY TO BRING IT ALL
TOGETHER SO IT'S SOMEHOW
CHOREOGRAPHED TO BE MUTUALLY
HELPFUL.
>> WE HAVE ALL THE PROPOSALS AND
S AND WANTED THE INPUT THAT WILL
COME FROM
I THINK WE HAVE TO TAKE THEM AT
THEIR WORD THEY'RE LOOKING
FORWARD TO GETTING THAT FROM YOU
AND WILL BE A PERSPECTIVE THEY
WON'T NECESSARILY BE ABLE TO GET
FROM OTHER SOURCES.
>> BUT BASED ON HISTORY IT TAKES
ABOUT A YEAR TO PRODUCE A REPORT
AND YOU MADE POINT WE'RE
BACK IN SECTIONN NEXT WEEK.
MY POINT IS IS THERE A WAY TO
HAVE A DIALOGUE SAYING WE'RE TO
ESTABLISH THREE WORKING
COMMITTEES THAT SPEAK TO THREE
ELEMENTS BUT IT WILL TAKE US A
YEAR.
DO YOU THINK THERE'S HOPE THAT
WOULD INFLUENCE -- I KNOW YOU
DON'T KNOW WHAT THEIR PRIMARIES
ARE --
>> THEY'VE ASKED FOR THIS TO BE
ESTABLISHED.HEBL
I THINK THEY DO WANT YOUR INPUT
AND WOULD WANT IT BEFORE
DRAFTING.
MY OFFICE WILL PLAY A ROLE BUT
ALL THESE MEETINGS ARE PUBLIC AS
WELL SO I'M SURE THEY'LL BE
FOLLOWING THEM AND THE WORK
THAT'S ONGOING AND TO THE EXTENT
IT'S APPROPRIATE TO KEEP THEM
UPDATED WE CAN DO THAT.
>> WILL THERE BE AN OPPORTUNITY
FOR THE CHAIR OR MAYBE THE CLAIR
AND A COUPLE MEMBERS DO GO SPEAK
WITH KEY STAFFERS -- I KNOW ALL
THIS IS INFLUX BECAUSE THE
COMMITTEES AND PEOPLE ARE
CHANGING BUT IT SEEMS TO ME QUE
READ WHAT THEY WROTE AND W THEYM
THE DISCUSSION AND DEVELOP NOT
THROUGH THE WHOLE BODY BUT JUST
MAYBE THROUGH REPRESENTATIVES
THE LEADERSHIP OF THE GROUP AND
SOME DON'T WANT TO LOSE JOBS BUT
WE CAN INFORM THE DISCUSSION BUT
ESPECIALLY THE EXTERNAL MEMBERS
OF THE GROUP.
>> I THINK THAT'S SOMETHING WE
CAN DISCUSS AND HAPPY TO HELP.
>> I THINK THAT'S A GREAT
SUGGESTION.
IT WILL PROBABLY ADD ANOTHER LAX
DAY TO OUR MEETING BUT IT'S
CRITICAL TO HELP US UNDERSTAND
BECAUSE THE QUESTIONS WE'RE ALL
ASKING AND PUTTING IT ON YOU IT
WILL BE NICE AND GREAT
SUGGESTION.
>> I WAS NOT ONLY THI O OF IT
ASTF A MEETING.
>> I THINK WE'RE GETTING A
LITTLE LEAD OF OURSELVES.
>> EVERYBODY IS ON THE SAME
PAGE.
HOW IT'S ACTUALIZED IS ANOTHER
ISSUE.
YOU HAVE A COMMENT?
>> I WAS A LITTLE BIT WANTING
MORE INFORMATION ABOUT THE SCOPE
OF THE COMMITTEE.
FOR EXAMPLE, IS IT OUR MANDATE
TO SAY YOU SHOULD BE X NUMBER
INSTEAD OF THIS OR TO SAY IT
LOOKS LIKE THERE'S PERHAPS TOO
MANY?
YOU NEED TO DO THE SELF-STUDY TO
REORGANIZE.
WHERE DO WE WEIGH IN MAKING OUR
RECOMMENDATIONS?
>> I THINK TURNING IT BACK TO
NIH KICKS THE CAN DOWN THE ROAD
IS NOT GOING TO BE FUL.
US IS ON THE COMMITTEE TO
MAKE WHATEVER INFORMED
RECOMMENDATIONS THEY HAVE.
YOU ARE CERTAINLY ENCOURAGED TO
BRING IN IN WORKING GROUPS
ADDITIONAL EXPERTISE WHENEVER
THAT IS NEEDED, THE CHAIR AND
COMMITTEE WILL DECIDE.
BUT I DON'T THINK IT CAN BE
BEING YEAH, YOU NEED TO BE
SOMETHING GO FIGURE IT OUT.
I DON'T THINK THAT'S ON THE O
TABLE.
>> THAT'S THE BIG JOB WE HAVE TO
DO.
>> ALL RIGHT.
THREW VERY MUCH, KATE.
NOW THE CHAIR WILL SUMMARIZE ALL
THIS AND MAKE SENSE OF IT.
>>
IT'S EASY BECAUSE SHE'S BEEN
FEEDING CHAT GPT ALL DAY AND
ASKED FOR A 300 WORD SYNOPSIS OF
THE DAY.
>> FIRST OF ALL I JUST WANT TO
THANK EVERYBODY AGAIN FOR BEING
HERE AND FOR PARTICIPATING IN
THE CRITICALLY IMPORTANT
COMMITTEE.
I THINK AT THE BEGINNING OF THE
DAY WE WERE WONDERING WHAT OUR
TASK WAS AND NOW WE KNOW IT'S
HUGE.
THANK YOU FOR NOT WALKING OUT OF
THE ROOM IN THE MIDDLE OF THE
ROOM AND SAYING NO THANK YOU.
THANK YOU FOR THE STAFF FOR
HELPING ME PUT TOGETHER THE
COMMENTS TO REVIEW THE DATA WE
HAD AND END WITH NEXT STEPS AND
WHERE WE'LL GO FROM HIRE.
HERE.
ALSO I WANT TO ACKNOWLEDGE THAT
PUBLIC FOLKS IN THE ROOM AND
ONLINE AND ACKNOWLEDGE THERE'S
BEEN NO PUBLIC COMMENTS FROM OUR
PUBLIC MEETING TODAY.
WE HEARD HEARD FROM CLAIRE WHO
REVIEWED OUR COMMENTS NECESSARY
FOR US TO HAVE A COMPLETE AND
THOROUGH UNDERSTANDING AND THEN
WE HEARD FROM DR. BERTAGNOLLI
WHO GAVE A WONDERFUL OVERVIEW OF
THE NIH AND FOCUSSED ON
CHALLENGES WE HAVE.
ONE OR TWO OF THOSE BEING
INTERNATIONAL SYSTEM HEALTH CARE
RANKING AROUND HEALTH CARE
DISPARITY AND COLLABORATION AS
WE CAN HIGHLIGHT AS WE GO
THROUGH THE REPORT SEEING
THERE'S BEEN COMMENTS ABOUT
SILOS AND ONE OF THE THINGS SHE
EMPHASIZED WAS THERE AREN'T AS
MANY AS IT LOOKS LIKE FROM THE
OUTSIDE SO WE MIGHT WANT TO
EMPHASIZE THAT IN OUR COMMENTS
AND REPORT.
AND ADVANCING RESEARCH EQUITY
FOR HEALTH AND THE CARE PROGRAM.
AND BEING ABLE TO HARNESS
RESEARCH USING HEALTH DATA.
SHE EMPHASIZED DATA AND WE WANT
TO KEEP THAT IN MIND GOING
THROUGH THE REPORT THAT FIRST OF
ALL TO BRIDGE THE SILOS OF DATA
THOUGH I'M NOT SURE THERE'S AS
MANY AS NIH AS THE SENATE AND
CONGRESSMAN WANT TO BELIEVE BUT
CERTAINLY FOR DATA IT'S A HUGE
CHALLENGE BEING PART OF THE
INITIATIVE GETTING DNA
INFORMATION FOR EVERY DISEASE,
ETCETERA IS CHALLENGING.
THAT HEALTH DATA IS A
SIGNIFICANT PRIORITY.
THE RESTART OF THE CHARGE OF OUR
COMMITTEE WE SPENT TIME TRAUKING
ABOUT THE DAY AND KNOW THE NIH
REQUEST THE SMRB EVALUATE THE
CURRENT STRUCTURE.
THAT WE REEXAMINE THE 2010
REPORT THE FIRST DOCUMENT THE
DELIBERATING AND ORGANIZATIONAL
CHANGE AND EFFECTIVENESS.
WE'LL CONSIDER THE CONGRESSIONAL
PROPOSALS THAT WE JUST HEARD
ABOUT.
WE'RE GOING TO RE-EVALUATE THE
EXISTING AND GUIDING PRINCIPLES
OF THE ORGANIZATIONAL CHANGES
AND THEN COME UP WITH
RECOMMENDATIONS.
EASY, NO PROBLEM.
ONE OF THE DISCUSSION I WANT TO
REMIND US ABOUT IS I TRIED TO
CAPTURE A LOT OF OUR THOUGHTS
AND COMMENTS IS WE WANT TO
RE-ESTABLISH TRUST AND BETTER
COMMUNICATE AND THAT'S EVIDENT
IN THE COMMENTS MADE BECAUSE
WE'RE ALL SCRATCHING OUR HEADS
LIKE HOW COULD THEY ARE THINK
THAT BUT THERE HASN'T BEEN GOOD
COMMUNICATION FOR WHATEVER
REASON AND NEED TO CHANGE THAT
AND INCREASE THE IMPACT OF THE
AGENCY'S WORK AND HOW DO WE MAKE
IT CLEAR THAT WE'RE PRIORITIZING
COMMUNITY PARTNERSHIP BECAUSE WE
KNOW THAT THE COMMUNITY AND THE
PATIENT REALLY IS AT THE CENTER
OF OUR PRIORITIES AND SHOULD BE
AT THE CENTER OF WHAT WE'RE
TRYING TO DO IN THIS
RE-ORGANIZATION OR DEEP DIVE
INTO THE NIH.
AND PRIORITIZING HEALTH CARE
DISPARITIES AND HEALTH CARE
RESEARCH SHOULD ALSO RUN THROUGH
WHAT WE'RE DISCUSSING.
AND LARRY GAVE US INFORMATION ON
CONGRESSIONAL INTEREST AND THE
DETAILED OVERVIEW OF THE
CHARTER.
WE TALKED ABOUT ALL THE THINGS
LISTED THERE IN THE BULLETS AND
MAJOR DISCUSSION POINTS FOCUSSED
ON HOW WE MAKE SURE THE BOARD'S
RECOMMENDATIONS ARE IMPACTFUL.
THIS IS ALSO SOMETHING WE WANT
TO KEEP IN MIND.
MR. SHAPIRO WAS TALKING ABOUT
THE BUDGETING AND PRIORITIES OF
THE NIH AND MECHANISMS.
IT'S CRITICALLY IMPORTANT TO
KEEP THAT IN MIND BECAUSE WE
REALLY AS WE GO THROUGH EACH
INSTITUTE, EACH CENTER TO
UNDERSTAND HOW MUCH OF THE
RESOURCES ARE BEING POURED INTO
THE CENTER AND WHETHER WE'RE
GETTING A RETURN FOR OUR DOLLARS
SO TO SPEAK ON THE RESOURCES
THAT ARE POURED INTO THAT
INSTITUTION OR WHETHER WE COULD
BE GETTING MORE OF A RETURN
WHETHER THAT RETURN IS IN
MANUSCRIPTS OR IN NEW DRUGS OR
WHETHER THAT RETURN IS IN
ESTABLISHING OUR HEALTH CARE
BETTER AND OUR COMMUNITIES AND
ACTUALLY IMPROVING THE HEALTH
CARE.
AND THE EXTRAMURAL BUDGET AND
FUNDING OPPORTUNITY
ANNOUNCEMENTS AND THE NIH GRANTS
DATABASE ARE PART OF THAT.
GRIF HELPED US FOCUS ON OUR
HISTORY.
THEY SAID IF YOU DON'T KNOW YOUR
HISTORY YOU'RE DOOMED TO REPEAT
IT.
SO WE WANT TO LOOK BACK AT ALL
THE EIGHT PUBLISHED REPORTS.
WE WANT TO LOOK BACK AT THE
DETAILS OF WHAT THEY
RECOMMENDED.
WE'LL HAVE IT SUMMARIZED AND
HELP US SUMMARIZE WHICH OF THE
RECOMMENDATIONS HAVE BEEN
COMPLETED OR INCOMPLETE.
AND PERHAPS ALSO SOME BARRIERS
AS TO WHY THE RECOMMENDATIONS
FROM THE 2010, 2011 REPORT HAVE
NOT BEEN COMPLETED.
AND MAJOR DISCUSSIONS FOCUSSED
ON LESSONS LEARNED AND
STAKEHOLDER INPUT AND DON'T WANT
TO FORGET TO INCLUDE ALL
STAKEHOLDERS SO WE DON'T FIND
OURSELF IN A SIMILAR SITUATION
TO 2015, 2016.
AND THE GUIDING PRINCIPLES.
THESE ARE THE PRINCIPLES LARRY
WENT OVER IN THE DOCUMENT THAT
YOU CAN LOOK AT LATER BUT THIS
IS JUST A SUMMARY AND DR. AND
NUMBERED AND TO THE PROCESS IS
IMPORTANT BETWEEN NOW AND THE
NEXT MEETING.
WE NEED TO DISCUSS ABOUT WHAT
WE'LL DO AND HOW WE'LL EVALUATE
AND HOW MANY COMMITTEES WE'LL
HAVE AND WHAT THE COMMITTEES
WILL FOCUS ON AND MAKING SHUSH
THE UNDERPINNING ATTRIBUTES OF
COMMUNICATION AND ACCOUNTABILITY
ARE A THREAD IN ALL WE DO.
THE LEGISLATIVE OPTIMIZATION WAS
OF A GUT PUNCH.
I THINK IT WAS A WAY FOR US TO
REALLY UNDERSTAND THAT WHAT WE
HAVE TO FOCUS ON AND THOSE FOUR
KEY AREAS OF STRUCTURAL PORTION
OF THE NIH AND THE LEADERSHIP,
POLICIES AND GRANTS AND THE
FUNDING.
AS WE TALK ABOUT NEXT STEPS,
SOME THINGS WE DISCUSSED TODAY
IS MAKING SURE THAT WHEN WE'RE
DOING OUR STRATEGY WE FOCUS ON
WHAT'S WORKED AND NOT WORKED.
WE DON'T WANT TO MAKE THE SAME
MISTAKES OVER AND HAVE A
COMPLETE SET OF DATA TO MAKE
DECISIONS.
THOSE ARE IMPORTANT IN
DEVELOPING THE STRATEGY AND DATA
OVER TIME TO SEE AT EACH
INSTITUTE HOW THINGS HAVE
CHANGED OR MAYBE NOT CHANGED
OVER TIME.
AND THEN WAITING TO OUTLINE KEY
QUESTIONS AND SET PRIORITIES AND
MAKE SURE THAT WE HAVE TANGIBLE
METRICS WE CAN FOCUS ON IN OUR
RECOMMENDATIONS.
WE DECIDE WHETHER WE WANT TO BE
MORE TACTICAL OR MORE BLUE SKY
AND MAKE SURE PHYSICAL STABILITY
IS AT THE CENTER.
WE WANT TO MAKE SURE WE INCLUDE
IMPLEMENTATION SCIENCE AND WANT
TO ASSURE THAT FOR ALL OUR
SCIENCES WE'RE MAKING AN
INCUBATOR ENVIRONMENT TO
MULTIPLY THE SUCCESS OF THE
INVESTIGATORS WE FUND.
SO THE NEXT STEPS ARE MEETING
CADENCE.
LARRY AND I TALKED ABOUT
POSSIBLE CADENCE.
WE HAVE TO HAVE AT LEAST FIVE
MEETINGS AND WERE THINKING TO
ALTERNATE VIRTUAL AND IN PERSON
AND JANUARY, MARCH, MAY, JULY,
SEPTEMBER, NOVEMBER.
THAT'S SIX.
DOES THAT SOUND OKAY?
DOES THAT SOUND TOO MUCH?
TOO LITTLE?
THAT MAKES IT ALMOST EVERY TWO
MONTHS AND GIVES US SUMMER WHEN
MANY ARE OFF AND IF WE STARTED
UP JANUARY WITH VIRTUAL AND
EVERY OTHER VIRTUAL AND IN
PERSON OR MORE VIRTUAL OR JUST A
COUPLE IN PERSON.
I'LL GET YOUR THOUGHTS AND
ESTABLISH THE WORKING GROUP AS A
PRIORITY ONCE WE DISCUSS OUR
STRATEGY AND HOW TO APPROACH IT
AND MAKE WORKING GROUP
SUGGESTIONS TO RECRUIT PEOPLE IN
THE WORKING GROUPS.
THAT'S ALL I HAVE.
I'LL STOP THERE AND GET OPINIONS
ON THE MEETINGS.
>> WE HAVE TO HAVE SIX MEETINGS
BEFORE WE ISSUE A REPORT?
>> WE HAVE TO HAVE FIVE.
>> WE CAN THROW OUT THREE
REPORTS AS LONG AS WE HAVE FIVE
MEETINGS WE JUST HAVE TO BE
ACTIVELY DISCUSSING ALONG THE
WAY.
>> RIGHT.
THEY ALL HAVE TO BE PUBLIC.
THE MEETINGS WE CHOOSE HAVE TO
BE PUBLIC WHETHER IN PERSONAL OR
VIRTUAL HAVE TO BE IN PUBLIC.
HOW'S THAT SOUND?
COMMENTS, QUESTIONS?
OKAY.
SO WE'LL DOANRY -- DOANRY --
DO JANUARY VIRTUAL AND MARCH IN
PERSON AND EVERY OTHER.
OKAY.
I THINK THAT'S A GOOD END.
OTHER COMMENTS?
THIS IS THE END OF OUR WONDERFUL
DAY AND WE STARTED THINKING
ABOUT SHEEP AND NOW WE'RE
PROBABLY THINKING ABOUT MANY
OTHER THINGS.
USE THE MICROPHONE.
>> HOW MANY -- YOU SAID YOU WERE
STILL GOING TO BE BRINGING NEW
MEMBERS ON AND WONDERING THE
TIME FRAME FOR THAT.
IT SEEMS IT WOULD BE DIFFICULT
FOR THEM TO COME IN AFTER
MISSING THIS MEETING.
>> AS YOU NOW COUNCILS TURN OVER
ALL THE TIME.
WE'LL COME IN MID STREAM.
THERE ARE TWO INDIVIDUALS BEING
VETTED AND I THINK IF I'M NOT
MISTAKEN WE HAVE TWO MORE SLOTS
WE CAN USE PAUSE WE'RE ALLOWING
UP TO 21 RAND I THINK WE HAVE 21
NOW IF I'M NOT MISTAKEN.
AGAIN IT'S AN ITERATIVE PROCESS.
THESE ARE SEPARATE.
>> AND THIS RECORDED SO
PRESUMABLY THOSE INDIVIDUALS
HAVE THE OPPORTUNITY TO SEE THIS
RECORDING.
OTHER QUESTIONS, COMMENTS BEFORE
WE END?
ALL RIGHT.
THANK YOU, THANK YOU.
>> I HAVE A QUESTION.
DR. HILDRETH.
>> ARE THE WORKING GROUP
MEETINGS ALSO PUBLIC?
>> THEY CAN BE CONDUCTED YO OUT
SIDE THE PUBLIC BUT HAVE TO
REPORT BACK IN A PUBLISHED
MEETING RECOMMENDATIONS THEY'RE
MAKING TO THE GROUP.
THEY CAN'T THEMSELVES DECIDE
ANYTHING.
ALL THEY ARE CAN DO IS MAKE
A-LIKED TO THE GROUP FOR THIS
GROUP'S CONSIDERATION.
>> IN THE PREVIOUS WORKING
GROUPS, GIVE ME A FLAVOR.
WAS IT USUALLY A PAIR OF
CO-CHAIRS, WERE THEY MEMBER OF
THIS PARENT GROUP OR --
>> GRIF WILL HELP ME REMEMBER
BUT AS I RECALL THERE IS AT
LEAST ONE MEMBER OF THIS GROUP
AS A CO-CHAIR.
>> I UNDERSTAND AND ANOTHER
PERSON AND PEOPLE FROM OUTSIDE.
>> AND EXPERTS.
>> OKAY.
>> I HAVE A QUESTION BECAUSE IN
JANUARY WE HAVE THE NEXT TIME
BUT IN THE MEANTIME IT WOULD BE
VALUABLE TO HAVE A SET OF POINTS
WE CAN DISCUSS.
WE'LL BE EXPOSED TO A LOT OF
MEETINGS IN THE NEXT SIX WEEKS.
>> THANK YOU FOR REMINDING ME TO
SAY THAT.
ONCE THE TEAM GIVES ME THE
SUMMARY INFORMATION WE'VE
ALREADY ASKED FOR AS FAR AS
LOOKING AT THE PRIOR REPORT AND
RECOMMENDATIONS AND WHAT WAS
COMPLETED AND INCOMPLETE, I'LL
SEND A BULLETED LIST OF
HOPEFULLY NO MORE THAN 10
QUESTIONS I NEED TO YOU THINK
ABOUT AND ADDRESS TO PREPARE US
FOR THE NEXT MEETING IN THE
CONTEXT OF THE AGENDA FOR THE
NEXT MEETING.
I'LL MAKE THE AGENDA FOR THE
JANUARY -- I'M SORRY.
>> TALKING POINTS AND IF WE GET
ASKED THE QUESTION, HOW DO WE
RESPOND?
>> OH, THOSE TALKING POINTS.
WHAT I THOUGHT YOU MEANT WAS
MORE DOWN THE LINE.
YOU MEAN NOW AND THE TIME WE
HAVE THE REPORT?
>> YES.
>> LET ME ASK LARRY.
>> WE'LL DEVELOP SOME DRAFT FOR
THE CHAIR TO CONSIDER AND IF
SHE'S COMFORTABLE WITH THEM THEN
WE'LL DISSEMINATE.
>> I THOUGHT YOU MEANT FOR THE
NEXT MEETING.
SO ANYWAY, I NEEDED TO SAY THAT
ANYWAY.
SO FOR THE JANUARY MEETING I'M
GOING TO BE SENDING OUT A
PROPOSED AGENDA FOR YOU ALL TO
LOOK AT AND WITH EACH ITEM ON
THE AGENDA THERE WILL BE HOME
WORK QUESTIONS, IF YOU WILL, TO
HAVE A ROBUST DISCUSSION.
OKAY.
>> FOR THE IN PERSON MEETINGS
CAN YOU TRY TO GET TENTATIVE
DATES OUT AS SOON AS POSSIBLE.
>> I THINK THE TEAM HEARD YOU,
YES.
>> WE ONLY INVITE PEOPLE WHO
AREN'T BUSY AND HAVE NOTHING
ELSE TO DO.
>> THANK YOU, GUYS.
THANK YOU.