WASHINGTON -- The National Institutes of Health needs to improve management of its AIDS research program to deal with budget problems even as the epidemic continues to spread, says a two-year study made public yesterday by Institute of Medicine.
The report by the institute, which is part of the National Academy of Sciences, praised the health institutes for "unprecedented speed" in responding to the epidemic. "Never has so much been learned so quickly about any disease," said Dr. William H. Danforth, chairman of the committee that wrote the report.
But the report made more than 40 recommendations for changes in the institutes' AIDS program, from including more blacks and women in experimental drug trials to ending what the report called a neglect of behavioral research.
The report said the institutes should adopt a five-year plan to set priorities on which drugs to study. It also said the director of the health institutes should have more power to funnel money where he chooses. And the report said the institutes should start now to carry out the huge amount of work that will be needed when vaccines against AIDS begin to be tested for their effectiveness in humans.
The report also said the institutes should leave to industry many experiments on AIDS drugs, while carrying out those unlikely to be done by pharmaceutical companies.
Dr. Anthony Fauci, who runs the AIDS program at the health institutes, and members of the Institute of Medicine group that wrote the report agreed that a fundamental change was needed to carry out research as the epidemic continued.
In conventional research projects, scientists furnish ideas for experiments, design them and then pass them up through a maze of panels for review to get them approved.
At a hearing yesterday before the House Government Operations Committee's Subcommittee on Human Resources and Intergovernmental Relations, Dr. Fauci said the institutes' AIDS program would face serious budget problems in the coming year.
He said he requested $1.2 billion from the Department of Health and Human Services, but the department asked for only $800 million from the White House. The president's final budget request to Congress was about $850 million.