A group of outside advisers to National Institutes of Health Director Francis Collins has recommended merging the two NIH institutes that study alcoholism and drug abuse. Although Collins has expressed interest in the idea, Congress is also likely to play an important role in any decision.
It may seem obvious to combine institutes that study addiction. And during the 1970s and '80s the research and mental health programs were together as part of another federal health agency. But in general, Congress has been creating institutes at NIH, not consolidating them. There are now 27 focusing on everything from cancer to biomedical imaging.
Leaders such as former NIH Director Harold Varmus (now National Cancer Institute chief) have complained that the sprawl hobbles NIH's ability to respond to new science. In response, Congress asked NIH in 2006 to create a Scientific Management Review Board that would look at ways to reorganize. The board began by examining a proposal to combine the National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Researchers supported by the $1.06 billion-a-year NIDA generally favored a merger, while those funded by the smaller ($462 million) NIAAA fretted that their areas would get less emphasis and that the legal use of alcohol would be stigmatized. In its report, the review board's working group offered two options—a merger or better coordination of addiction research across NIH.
But on Wednesday, the full board voted 12 to 3 for a merger. The board also recommended an outside search for a director, quashing a rumor that NIDA Director Nora Volkow might be named the new institute's chief. (NIAAA currently has an acting director.)
Even if Collins agrees to the merger, it may not be a done deal. According to the law creating the review board, the secretary of Health and Human Services, Kathleen Sebelius, has to notify Congress of the proposed merger and wait 180 days before moving forward. Chances are that Congress will want to weigh in.