Refreshing the NIH Intramural Research Program

Comprising nearly 10% of the NIH budget ($2.9 billion, supporting ~6,000 scientists), the Intramural Research Program (IRP) “has a highly regarded history of discovery but today lacks a clearly defined mission within the overall NIH effort” according to Faster Cures, a part of the Miliken Institute. To help the NIH address this oversight,

Faster Cures convened a task force headed by Nobel Laureate Dr. David Baltimore to recommend to the new Administration a framework within which to refresh the Intramural Research Program, giving it a distinct mission and identity in the service of improving public health. This mission is three-fold:

  • to focus on translational research, especially work that utilizes the unique capabilities of the NIH Clinical Center;
  • to be prepared to respond expeditiously to new scientific opportunities and challenges; and
  • to focus on high-risk, long-term basic research goals that would be difficult to pursue in the extramural research environment.

It’s been 20 years since the Institute of Medicine released A Healthy NIH Intramural Program: Structural Change or Administrative Remedies [fair warning, the online version seems to have been infiltrated by a symposium on Education for the Manufacturing World of the Future], and there was the [Richard] Klausner Report in 1992 (summarized & discussed in Science), commissioned by former NIH director Bernadine Healy following complaints by basic scientists and completed in time for the arrival of Harold Varmus, who coincidentally is re-arriving on the scene as an Obama adviser. But more recently, how does the NIH itself view the intramural research program?

In 2006 Congressional testimony, Deputy Director for Intramural Research Michael Gottesman noted that “The intramural research program provides unique opportunities and resources to encourage important high-risk, high impact scientific inquiries that may be difficult to pursue in the private sector or academia. … The NIH Clinical Center is the focal point of the intramural enterprise, where laboratory scientists and clinicians work in close physical and intellectual proximity, providing a unique cauldron for translational and clinical research, with the cost of patient participation covered by the NIH budget.”

Okay then. How about Faster Cures? As summarized here, the Task Force had 5 major recommendations:

1) NIH should articulate an overarching mission for the IRP and strategies for meeting goals over the next five years, focused specifically on advancing translational and clinical research in the interest of public health.

2) The Clinical Center must be fully utilized and the IRP’s clinical research program should be expanded.

3) The IRP should be encouraged to systematically and proactively mobilize resources to rapidly and effectively respond to emerging scientific challenges and opportunities.

4) The IRP should be the premier national program for translational and clinical research training.

5) The IRP should play a central role in developing and sustaining large-scale, long-term projects.

Hmm. Sounds familiar. And I thought the CTSA Consortium was supposed to cover a lot of these goals, particularly #4 (compare with the 4th bullet of the CTSA vision) but also #3 & #5.

No, perhaps the biggest refreshment seems to be focused on basic research, as noted in the full white paper:

Importantly, the IRP should become more outcomes-focused, meaning it should strategically seek solutions to clinical problems through benchwork, animal models, and human studies. Its focus on basic questions should be seen as supportive of solving pressing health problems, and the IRP should be measured by its success in contributing to improved health. …

Because of its distinctive budgetary status within the NIH—which provides its scientists with long-term stable funding—and because of the availability of the Clinical Center, the IRP should adopt a clear mission, focused specifically on advancing translational and clinical research in the interest of public health This mission would not eliminate basic research from the IRP toolset, but it should require that basic research programs be either 1) related to translational and clinical goals, or 2) high-risk and well suited to the review and funding mechanisms of the IRP versus the ERP. …

… improve the quality of their programmatic and individual reviews in ways that support and reinforce the mission. Review criteria must be altered to more aggressively encourage risk-taking and innovation in translational and clinical research. Programs not pursuing translational or clinical research (including use of the Clinical Center) should be asked to justify their strategy (e.g., scientific opportunities lie elsewhere).

Aha. Perhaps this explains the exodus of intramural bench scientists to BICO of late …

5 Comments »

  1. What the fuck is BICO?

    Sorry. It was late: Baby It’s Cold Outside

  2. whimple said

    This sounds fabulous. How do I sign up?

  3. bikemonkey said

    For all the stuff that I’ve followed from intramural research it could have been done extramurally. I’d like to see some justification for a unique role. Long term support is stupid as a claim- they could do that with extramural labs if so inclined.

  4. whimple said

    Long term support is stupid as a claim- they could do that with extramural labs if so inclined.

    Not really. Many of these pre-clinical studies are going to require timescales that exceed standard extramural granting intervals. Apparently, the NIH doesn’t trust the judgement of their own study sections to keep this required continuity going extramurally, or to award fundable scores to “risky” and “descriptive” work. I think this fear on the part of the NIH is well-founded, and backed up by their own CSR statistics on the success rates of grant employing human subjects. See also: https://writedit.wordpress.com/2008/07/06/why-clinical-r01s-fare-worse-than-non-clincial-r01s/

  5. bikemonkey said

    so exceed “standard granting intervals”, duh. jebus, why is it so hard for people to think outside of the box when it comes to the NIH. the way it was is not necessarily the way it has to be.

    and by the bye, many extramural clinical research Centers manage to pull this off 5 yrs at a time anyway. in fact these sorts of arguments make them practically immune to being closed.

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